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Prevention of Antibiotic Resistance in Hospitals
- Marin Kollef, MD
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IN RESPONSE:
Dr. Fraser and I agree with Dr. Johnson that patients' underlying host defenses play a very important role in determining susceptibility to infection with antibiotic-resistant microorganisms. In addition, studies attempting to define the impact of antibiotic resistance on clinical outcomes need to take severity of illness and other underlying patient characteristics into account. Only in this way can accurate estimates be made concerning the impact of antibiotic resistance on hospital mortality and other clinical outcomes. We also thank Drs. Singh and Yu for clarifying how they used the clinical pulmonary infection score in their clinical trial. More studies that define optimal management practices for the use of antibiotics among hospitalized patients are needed. These studies must define the costs and benefits of antibiotic exposure, as well as the potential harm caused by increasing the burden of antibiotic-resistant microorganisms in the hospital setting.
Marin Kollef, MD
Washington University School of Medicine; Barnes-Jewish Hospital; St. Louis, MO 63110
- Copyright ©2004 by the American College of Physicians
