51 - Basic principles of antimicrobial chemotherapy

Abstract

The term chemotherapy was originally used to describe the use of drugs that were 'selectively toxic’ to microbial pathogens (e.g. bacteria, viruses, protozoa, fungi and helminths) while having minimal effects on the host. It also refers to the use of drugs to treat tumours and, in the public mind at least, is usually associated with those cytotoxic anticancer drugs that cause distressing and unwanted effects such as loss of hair, nausea and vomiting. In this chapter, we focus on antimicrobial chemotherapy; anticancer drugs are covered in Chapter 57. The feasibility of the selective toxicity strategy depends on the ability to exploit such biochemical differences as may exist between the infecting organism and the host. While the bulk of this section of the book describes the drugs used to combat such infections, in this introductory chapter we consider the nature of these biochemical differences, outline the molecular targets of drug action and discuss the grave problem of antibiotic resistance and its possible solutions.