How antibiotics can make us sick: the less obvious adverse effects of antimicrobial chemotherapy

被引:144
作者
Dancer, SJ [1 ]
机构
[1] Scottish Ctr Infect & Environm Hlth, Glasgow G3 7 LN, Lanark, Scotland
关键词
D O I
10.1016/S1473-3099(04)01145-4
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Antimicrobial agents are associated with side-effects, which are usually tolerated because the benefits of treatment outweigh the toxic effects. Clinicians know about these side-effects but are less likely to understand additional adverse events, such as the overgrowth of resistant microorganisms. Overgrowth can itself precipitate a secondary infection, which can be more difficult to treat. Resistant organisms then spread to other patients and the environment, and contribute to increasing antimicrobial resistance worldwide. Organisms exposed to antibiotics undergo molecular changes that might enhance virulence. Enhanced pathogenicity would affect patients, particularly if the organism is also multiply resistant. Clinicians have a responsibility to select the correct antibiotic as soon as they have diagnosed infection, but an absence of microbiological understanding and ignorance of the potential environmental effects have contributed to inappropriate prescribing. The less obvious results of antimicrobial consumption probably go unrecognised in routine clinical care.
引用
收藏
页码:611 / 619
页数:9
相关论文
共 104 条
[1]   Biodegradability of cefotiam, ciprofloxacin, meropenem, penicillin G, and sulfamethoxazole and inhibition of waste water bacteria [J].
Al-Ahmad, A ;
Daschner, FD ;
Kümmerer, K .
ARCHIVES OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY, 1999, 37 (02) :158-163
[2]   Persistence of antibiotic resistant bacteria [J].
Andersson, DI .
CURRENT OPINION IN MICROBIOLOGY, 2003, 6 (05) :452-456
[3]   Recurrent nonmenstrual toxic shock syndrome: Clinical manifestations, diagnosis, and treatment [J].
Andrews, MM ;
Parent, EM ;
Barry, M ;
Parsonnet, J .
CLINICAL INFECTIOUS DISEASES, 2001, 32 (10) :1470-1479
[4]  
[Anonymous], BR J INFECT CONTROL
[5]   Vancomycin in surgical infections due to meticillin-resistant Staphylococcus aureus with heterogeneous resistance to vancomycin [J].
Ariza, J ;
Pujol, M ;
Cabo, J ;
Peña, C ;
Fernández, N ;
Liñares, J ;
Ayats, J ;
Gudiol, F .
LANCET, 1999, 353 (9164) :1587-1588
[6]   SELECTION OF ANTIBIOTIC-RESISTANT STANDARD PLATE-COUNT BACTERIA DURING WATER-TREATMENT [J].
ARMSTRONG, JL ;
CALOMIRIS, JJ ;
SEIDLER, RJ .
APPLIED AND ENVIRONMENTAL MICROBIOLOGY, 1982, 44 (02) :308-316
[7]   Glycopeptide resistance in Enterococcus faecium from broilers and pigs following discontinued use of avoparcin [J].
Bager, F ;
Aarestrup, FM ;
Madsen, M ;
Wegener, HC .
MICROBIAL DRUG RESISTANCE, 1999, 5 (01) :53-56
[8]  
BERGSTROM CT, 2004, P NATL ACAD SCI US
[9]   INCREASED TRANSMISSIBILITY OF STAPHYLOCOCCI TO PATIENTS RECEIVING AN ANTIMICROBIAL DRUG [J].
BERNTSEN, CA ;
MCDERMOTT, W .
NEW ENGLAND JOURNAL OF MEDICINE, 1960, 262 (13) :637-642
[10]   ALPHA-TOXIN OF STAPHYLOCOCCUS-AUREUS [J].
BHAKDI, S ;
TRANUMJENSEN, J .
MICROBIOLOGICAL REVIEWS, 1991, 55 (04) :733-751