[Clinical concern for antibiotic resistance]

Antibiotic resistance represents such a serious problem in the field of infectious diseases as to constitute as a threat for a post-antibiotic era. Currently, it contributes to increase treatment failures, morbidity and mortality rates, and health costs. Since 1993, the international scientific community has identified five different priorities in the struggle against antibiotic-resistance which are represented by the following bacterial species: Mycobacterium tuberculosis, Streptococcus pneumoniae, Staphylococcus spp, Enterococcus spp and Neisseria gonorrhoeae. At present three different approaches have been identified to overcome this phenomenon: identification of mechanisms of bacterial resistance; epidemiological surveys; synthesis of new molecules active against multiresistant microrganisms.Besides the above mentioned strategies, preventive interventions should also be carried out mainly through the optimisation of antibiotic prophylaxis, optimisation of choice and duration of therapy, improvement of antibiotic prescriptions by means of educational and administrative programs, monitoring and feedback of bacterial resistance and finally by the definition and diffusion of guidelines for therapy.