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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Antimicrobial resistance: implications for managing respiratory failure

C Chenoweth1, J P Lynch

  • 1Division of Infectious Diseases, University of Michigan Medical Center, Taubman Center, Ann Arbor 48109-0360, USA.

Current Opinion in Pulmonary Medicine
|March 1, 1997
PubMed

Insights

Antibiotic resistance in respiratory pathogens is rising, with significant increases in resistance to beta-lactam and penicillin antibiotics among common bacteria. This trend necessitates improved infection control and antibiotic stewardship to combat resistant microorganisms.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Antibiotic resistance in respiratory pathogens is a growing global health concern.
  • Increasing resistance to beta-lactam antibiotics is observed in community-acquired pathogens like *Moraxella catarrhalis*, *Haemophilus influenzae*, and *Streptococcus pneumoniae*.
  • Penicillin resistance in *S. pneumoniae* has risen significantly, with high-level resistance noted in recent US studies.

Purpose of the Study:

  • To review the escalating prevalence of antibiotic resistance in key respiratory pathogens.
  • To highlight the mechanisms and patterns of antimicrobial resistance in both community and hospital-acquired infections.
  • To emphasize the role of antibiotic use in the emergence and spread of resistant microorganisms.

Main Methods:

  • Literature review of recent studies on antibiotic resistance patterns.
  • Analysis of resistance trends in common respiratory pathogens (*M. catarrhalis*, *H. influenzae*, *S. pneumoniae*).
  • Examination of antimicrobial resistance mechanisms and prevalence in hospital-acquired pathogens (*Pseudomonas aeruginosa*, *Enterobacteriaceae*, *Staphylococcus aureus*, *Escherichia coli*).

Main Results:

  • Rapidly increasing antibiotic resistance in respiratory pathogens, particularly to beta-lactam antibiotics.
  • Alarming rates of penicillin resistance in *S. pneumoniae* (up to 23.6% in the US), with 9.5% high-level resistance.
  • Growing resistance to beta-lactams (including imipenem) in *P. aeruginosa* and extended-spectrum beta-lactamases in *Enterobacteriaceae*.
  • Increased fluoroquinolone resistance in *P. aeruginosa*, *S. aureus*, and *E. coli*.

Conclusions:

  • Excessive antibiotic use is a primary driver for the emergence and spread of resistant microorganisms.
  • Rigorous infection control measures are crucial for limiting resistant organisms.
  • Modification of antibiotic prescribing patterns is essential to mitigate antimicrobial resistance.

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