The responsibility of the infectious disease community for the optimal use of antimicrobial agents

Antimicrobial agents are a critical element of the therapeutic armamentarium of modern medicine. How well they are used reflects our ability to treat and prevent infectious diseases. The major consideration for proper usage is to select the optimal agent at the proper dosage. Secondary, but important concerns are to minimize the emergence of resistance and to provide health services at a reasonable cost. The infectious disease community must work in concert with the pharmaceutical industry to achieve these goals. The relations of infectious disease physicians with the industry have been remarkably effective in evaluating and introducing new drugs, however, it is natural that conflicts should arise. Although the overall accomplishments have been outstanding, there is considerable evidence that antimicrobial agents are often abused and used excessively. This paper outlines some of the issues of marketing and the problems inherent in industry-sponsored trials. As specialties other than infectious diseases have encountered major difficulties, it is timely that this society adopts a code of ethical conduct for its work with industrial sponsors and takes the initiative in developing programs for education of other physicians in the field of infectious diseases and antimicrobial therapy both in this country and in developing nations.