Antimicrobial Chemotherapy 6th edition, Roger Finch, Peter Davey, Mark Wilcox, William Irving OUP 2012

Abstract

As junior registrars learning the ropes of medical microbiology back in the early 80 s (when the first edition of Antimicrobial Chemotherapy was published), we decided that advising on antibiotics was probably the easiest part of the job – at least, compared with learning infectious diseases, trying to think of some decent research and dealing with consultant surgeons. In those days the problem of multi-resistant Klebsiella was more or less behind us, and we had not yet encountered other multi-drug resistant Gram negatives and TB, epidemic MRSA and Clostridium difficile. Now, of course, antimicrobial management is up there with Infection Control in terms of complexity and workload for infection specialists. Unlike some of the antimicrobial books from those days (such as Kucers' Use of Antibiotics, which is now at least five times the size), this volume has remained concise and succinct and is all the better for it. It is not a reference book, but a very readable overview of each antimicrobial and every infection. Not only does it deal with the drugs themselves in a systematic way, but later chapters review each of the major infection syndromes. In these, antibiotic treatments are preceded by a very useful summary of key clinical and diagnostic criteria. Although some of the detail of antimicrobials in the early chapters is more than I would expect a final year medical student to know, I would thoroughly recommend each one of them to study each of these clinical disease sections. If I may suggest a few areas that deserve a little more emphasis, addition or amendment, they would be as follows. Firstly, extend the section on the management of allergy and mention the early-onset IgE-mediated severe skin rash as a contraindication to all beta-lactams (poor allergy histories are such a problem in daily clinical practice). Secondly, provide more detail on antifungals, especially prophylaxis in neutropenics, e.g. posaconazole and other new azoles and thirdly, update the antimicrobial resistance data for urinary pathogens (2003 was a long time ago and we have all seen far more multi-drug resistant pathogens from the community). Thirdly, there was a mis-placed heading (Haematological toxicity) on page 182, and a graph with too few lines for the annotation (figure 21.2). I suspect the authors have already spotted these when examining their published copies, always a depressing experience! The expansion in this edition of antiretrovirals will be particularly welcomed by non-virologists like me who need to know the basic details of this complex field, and the whole volume seems to be very up-to-date. The layout is very clear and the writing style, tables and attention to detail are all excellent. The appendix seems to be very comprehensive. I can thoroughly recommend Antimicrobial Chemotherapy for a wide range of practitioners including pharmacists, postgraduate doctors (whatever their specialty) and those training in infection as a career. It will provide a solid understanding of the extraordinary nature of these drugs, and their control, management and clinical applications across the full spectrum of infections.