Abstract
Resistance to antimicrobials is a continuing and growing problem. Nearly all the bacteria that our patients and we have contact with in the healthcare system are now more resistant than 20 years ago. Many of these resistant bacteria are difficult to treat. In Australia common examples are MRSA, vancomycin resistant enterococci (VRE) and bacteria carrying extended spectrum beta-lactamase genes (ESBLs) – most often E. coli and Klebsiella spp. But we also have other infections for which we may have no effective antibiotics, for example Acinetobacter spp, Pseudomonas spp and other multi-resistant Gram-negative rods. If, however, you want truly frightening figures, look at developing countries such as China. While we worry here about heading towards a ‘postantibiotic’ era, for huge numbers of people in the developing world that is already the reality. Even with common but serious infections (e.g. E. coli bacteraemia), no effective antibiotic therapy may be available.
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