Editorial-Bugs, drugs, and us: The dance goes on
http://www.100md.com
《美国医学杂志》
Michigan State University, USA
In the past seven decades, clinicians have seen a spectrum of antimicrobial agents ranging from sulfonamides to receptor-directed anti-viral agents. A number of previously fatal diseases have been tamed while new infectious agents continue to emerge. Still some old microbes (e.g. Mycobacterium tuberculosis and Neisseria More Details gonorrhoeae ) keep evolving to acquire resistance to the drugs that once were highly effective. About forty years ago, emergence of penicillin resistant Staphylococcus aureus was a concern.[1] Today, methicillin resistant Staphylococcus aureus is prevalent in all continents and vancomycin resistant Staphylococcus aureus is looming on the horizon.[2]
The articles published in this symposium describe the most recently developed antimicrobials to: (1) treat a variety of resistant gram-positive coccal infections; (2) manage patients with HIV infection; and (3) treat selected viral pathogens. Immunomodulators are also an emerging group of compounds that have potential for the treatment of a variety of viral infections and are discussed herein.
Despite all this progress, there are dark clouds on the horizon as well.[3] I will paraphrase what the great physician William Osler said, "The desire to take medicine is the greatest feature which distinguishes man from animals." As human beings, we love to take medications and as physicians we believe that it is our sacred duty to prescribe medications. Misuse of all medications, specifically antibiotics, is of great concern particularly in developing countries with limited resources. Dispensing medications without prescriptions and injudicious use of antibiotics not only leads to a poor therapeutic benefit but also to the emergence of resistance.[4] ,[5] If we would just remember that the microbes have been around in this universe longer than us, and so, the bugs will always find a way to beat the drugs. Only with the judicious use of these wonderful antimicrobials could these infectious diseases be controlled. It is the responsibility of the pharmaceutical industry to develop effective drugs and bring those to the market. However, as physicians, ultimately it is up to us to use them wisely. We must watch our steps - but let the music play and the dance continue.
References
1. Craven DE, Shapiro DS. Staphylococcus aureus: Times, They Are A-Changin'. Clinical Infectious Diseases 2006; 42: 179-180.
2. Lassence A, Hidri N, Timsit J et al . Control and Outcome of a Large Outbreak of Colonization and Infection with Glycopeptide-Intermediate Staphylococcus aureus in an Intensive Care Unit. Clinical Infectious Diseases 2006; 42: 170-178.
3. Spacek LA, Shihab HM, Kamya MR et al . Response to Antiretroviral Therapy in HIV-Infected Patients Attending a Public, Urban Clinic in Kampala, Uganda. Clinical Infectious Diseases 2006; 42: 252-259.
4. Peterson LR. Penicillins for Treatment of Pneumococcal Pneumonia: Does In Vitro Resistance Really Matter Clinical Infectious Diseases 2006; 42: 224-233.
5. Chiou CC. Does Penicillin Remain the Drug of Choice for Pneumococcal Pneumonia in View of Emerging in Virtro Resistance Clinical Infectious Diseases 2006; 42: 234-237.(Kumar Ashir)
In the past seven decades, clinicians have seen a spectrum of antimicrobial agents ranging from sulfonamides to receptor-directed anti-viral agents. A number of previously fatal diseases have been tamed while new infectious agents continue to emerge. Still some old microbes (e.g. Mycobacterium tuberculosis and Neisseria More Details gonorrhoeae ) keep evolving to acquire resistance to the drugs that once were highly effective. About forty years ago, emergence of penicillin resistant Staphylococcus aureus was a concern.[1] Today, methicillin resistant Staphylococcus aureus is prevalent in all continents and vancomycin resistant Staphylococcus aureus is looming on the horizon.[2]
The articles published in this symposium describe the most recently developed antimicrobials to: (1) treat a variety of resistant gram-positive coccal infections; (2) manage patients with HIV infection; and (3) treat selected viral pathogens. Immunomodulators are also an emerging group of compounds that have potential for the treatment of a variety of viral infections and are discussed herein.
Despite all this progress, there are dark clouds on the horizon as well.[3] I will paraphrase what the great physician William Osler said, "The desire to take medicine is the greatest feature which distinguishes man from animals." As human beings, we love to take medications and as physicians we believe that it is our sacred duty to prescribe medications. Misuse of all medications, specifically antibiotics, is of great concern particularly in developing countries with limited resources. Dispensing medications without prescriptions and injudicious use of antibiotics not only leads to a poor therapeutic benefit but also to the emergence of resistance.[4] ,[5] If we would just remember that the microbes have been around in this universe longer than us, and so, the bugs will always find a way to beat the drugs. Only with the judicious use of these wonderful antimicrobials could these infectious diseases be controlled. It is the responsibility of the pharmaceutical industry to develop effective drugs and bring those to the market. However, as physicians, ultimately it is up to us to use them wisely. We must watch our steps - but let the music play and the dance continue.
References
1. Craven DE, Shapiro DS. Staphylococcus aureus: Times, They Are A-Changin'. Clinical Infectious Diseases 2006; 42: 179-180.
2. Lassence A, Hidri N, Timsit J et al . Control and Outcome of a Large Outbreak of Colonization and Infection with Glycopeptide-Intermediate Staphylococcus aureus in an Intensive Care Unit. Clinical Infectious Diseases 2006; 42: 170-178.
3. Spacek LA, Shihab HM, Kamya MR et al . Response to Antiretroviral Therapy in HIV-Infected Patients Attending a Public, Urban Clinic in Kampala, Uganda. Clinical Infectious Diseases 2006; 42: 252-259.
4. Peterson LR. Penicillins for Treatment of Pneumococcal Pneumonia: Does In Vitro Resistance Really Matter Clinical Infectious Diseases 2006; 42: 224-233.
5. Chiou CC. Does Penicillin Remain the Drug of Choice for Pneumococcal Pneumonia in View of Emerging in Virtro Resistance Clinical Infectious Diseases 2006; 42: 234-237.(Kumar Ashir)