Antibacterial Chemotherapy: Theory, Problems, and Practice

93 Pages·2010·0.84 MB·English

by  Sebastian Amyes

OOOO IIII DDDD LLLL

O XFORD INFECTIOUS DISEASES LIBRARY

Antibacterial
Chemotherapy
Theory, Problems and Practice

i
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that the drug dosages in this book are correct. Readers must there-
fore always check the product information and clinical procedures
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are for the non-pregnant adult who is not breast-feeding.

ii
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OXFORD PAIN MANAGEMENT LIBRARY

Antibacterial
Chemotherapy
Theory, Problems and Practice

iii
By
Sebastian G. B. Amyes
PhD, DSc, Drhc, FRCPath
Professor of Microbial Chemotherapy,
Centre for Infectious Diseases,
University of Edinburgh, UK
Great Clarendon Street, Oxford OX2 6DP
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First published 2010
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Typeset by Newgen Imaging Systems (P) Ltd, Chennai, India
Printed in Italy
on acid-free paper by
Lego S.p.A
ISBN 978–0–19–959127–5
10 9 8 7 6 5 4 3 2 1
Contents

Dedication vii
Preface ix
Abbreviations xi

1 Antibiotic action—general principles v1
2 Antibiotics—mechanisms of action 7
3 Pharmacokinetics applied to antimicrobials 23
4 Sensitivity and identification tests 29
5 Genetics of antibiotic resistance 41
6 Mechanisms of antibiotic resistance 49
7 Multi-drug resistant (MDR) bacteria and
healthcare-acquired infections 59
8 Anti-mycobacterium therapy 67
9 Clinical use of antibiotics to prevent
or control resistance 71

Index 77
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Dedication

For Jackson and Thomas

vii
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Preface

Antibiotics are one of the most important discoveries of the 20th
century. Almost immediately the majority of infectious diseases
caused by bacteria could be cured and it is estimated that this has
increased global life expectancy by 10 years. The fear of these infec-
tions was instantly removed. Soon after the introduction of antibiot-
ics, resistant bacteria began to emerge. These resistant bacteria were
largely checked by the discovery of new antibiotics and infections
caused by them continued to be controlled; however, the era of
new drugs is now long past and the proportion of bacteria resistant
to the current antibiotics continues to increase. This is most keenly
felt in hospitals where there are now incidences of bacteria causing
severe infections that are resistant to virtually every antibiotic avail-
able to treat them. The judicious use of antibiotics and the control
of the spread of resistance are now the responsibility of all health-
ix
care workers who deal with infectious diseases and no longer the
duty of just the microbiologist.
Failure by all stakeholders in healthcare to recognise the problems
of antibiotic resistance is likely to lead to a bleak outlook for future
treatment of bacterial infections. This book not only describes the
antibiotics themselves but also draws attention to the problems of
resistance and how it needs to be considered when prescribing
these drugs.