Principles of antimicrobial therapy: what should we be using?

Although the use of antimicrobials has had an insurmountable impact on preventing patient morbidity and mortality, problems with antimicrobial resistance and antimicrobial-induced diarrhea are becoming more apparent in human and veterinary medicine. The mortality associated with nosocomial infection with antimicrobial-resistant bacteria in human patients is alarming. Similarly, in veterinary medicine, the morbidity and high cost of treatment of patients with postoperative infection, for example, are concerns. Specifically in equine medicine, the high morbidity and mortality associated with antimicrobial-induced diarrhea have been devastating in many equine practices. Misuse of antimicrobials is extremely common in human and veterinary medicine. All clinicians have the responsibility to consider the appropriateness of their antimicrobial use carefully and, whenever possible, to minimize antimicrobial administration to patients.