Journal of Antimicrobial Chemotherapy (2001) 47, 129-140
© 2001 The British Society for Antimicrobial Chemotherapy
Review |
Evidence to support the rationale that bacterial eradication in respiratory tract infection is an important aim of antimicrobial therapy
a The Pediatric Infectious Disease Unit, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel; b Pneumococcal Diseases Research Unit of the South African Institute for Medical Research, University of the Witwatersrand and the Medical Research Council, Johannesburg, South Africa; c University of Wisconsin, Madison, WI, USA; d Hospital Ramón y Cajal, Madrid, Spain
Clinical outcome is dependent upon antibiotic-mediated bacterial eradication in a number of infections. However, in respiratory tract infections, the need for bacterial eradication has been controversial. Clinical data are now available that support the need for active bacterial eradication in otitis media. This may also be the case for other respiratory tract infections. An increase in antimicrobial resistance reduces the probability of achieving eradication. Conversely, failure to eradicate bacteria may promote the emergence and dissemination of antimicrobial-resistant clones. Pharmacokinetic/pharmacodynamic parameters can be used to predict the bacteriological efficacy of antimicrobial therapy. In conclusion, the aim of antimicrobial therapy in respiratory tract infections should be the eradication of the infecting organism.
* Correspondence address. POB 151, Beer-Sheva 84101, Israel, Tel: +972-8-6400547; Fax: +972-8-6232334; E-mail: rdagan{at}bgumail.bgu.ac.il
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