Crisis in infectious diseases: Time for a new paradigm?

被引:56
作者
Casadevall, A [1 ]
机构
[1] ALBERT EINSTEIN COLL MED, DEPT MICROBIOL & IMMUNOL, BRONX, NY 10461 USA
关键词
D O I
10.1093/clinids/23.4.790
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Current practices in the treatment of infectious diseases are the result of two fundamental changes in antimicrobial therapy that occurred in the mid-20th century: the transition from pathogen-specific therapy to non-pathogen-specific therapy and the shift toward emphasis on antiinfective strategies that target microbial pathogens over those that enhance host immunity. The alarming rise in antimicrobial-resistant strains, the increasing frequency of serious infections in immunocompromised patients, and the paucity of new types of antibiotics suggest the need for reevaluation of the manner in which infections are treated. In the short term, the situation may be addressed-at least in part-by increased emphasis on improved diagnosis and, when possible, the use of specific or narrow-spectrum treatments. In the long term, a return to pathogen-specific therapy, possibly in combination with adjunctive immunotherapy, may be an attractive and desirable option provided that significant advances are made in diagnostic microbiology and drug discovery.
引用
收藏
页码:790 / 794
页数:5
相关论文
共 55 条
  • [21] FINLAND M, 1979, REV INFECT DIS, V1, P4
  • [23] RECOMBINANT HUMAN INTERLEUKIN-1 RECEPTOR ANTAGONIST IN THE TREATMENT OF PATIENTS WITH SEPSIS SYNDROME - RESULTS FROM A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL
    FISHER, CJ
    DHAINAUT, JFA
    OPAL, SM
    PRIBBLE, JP
    BALK, RA
    SLOTMAN, GJ
    IBERTI, TJ
    RACKOW, EC
    SHAPIRO, MJ
    GREENMAN, RL
    REINES, HD
    SHELLY, MP
    THOMPSON, BW
    LABRECQUE, JF
    CATALANO, MA
    KNAUS, WA
    SADOFF, JC
    ASTIZ, M
    CARPATI, C
    BONE, RC
    FREIDMAN, B
    MURE, AJ
    BRATHWAITE, C
    SHAPIRO, E
    MELHORN, L
    TAYLOR, R
    KEEGAN, M
    OBRIEN, J
    SCHEIN, R
    PENA, M
    WASSERLOUF, M
    OROPELLO, J
    BENJAMIN, E
    DELGUIDICE, R
    EMMANUEL, G
    LIE, T
    ANDERSON, L
    MARSHALL, J
    DEMAJO, W
    ROTSTEIN, O
    FOSTER, D
    ABRAHAM, E
    MIDDLETON, H
    PERRY, C
    LEVY, H
    FRY, DE
    SIMPSON, SQ
    CROWELL, RE
    NEIDHART, M
    STEVENS, D
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1994, 271 (23): : 1836 - 1843
  • [24] CANDIDEMIA IN A TERTIARY CARE HOSPITAL - EPIDEMIOLOGY, RISK-FACTORS, AND PREDICTORS OF MORTALITY
    FRASER, VJ
    JONES, M
    DUNKEL, J
    STORFER, S
    MEDOFF, G
    DUNAGAN, WC
    [J]. CLINICAL INFECTIOUS DISEASES, 1992, 15 (03) : 414 - 421
  • [25] A CONTROLLED CLINICAL-TRIAL OF E5 MURINE MONOCLONAL IGM ANTIBODY TO ENDOTOXIN IN THE TREATMENT OF GRAM-NEGATIVE SEPSIS
    GREENMAN, RL
    SCHEIN, RMH
    MARTIN, MA
    WENZEL, RP
    MACINTYRE, NR
    EMMANUEL, G
    CHMEL, H
    KOHLER, RB
    MCCARTHY, M
    PLOUFFE, J
    RUSSELL, JA
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1991, 266 (08): : 1097 - 1102
  • [26] ANTIMICROBIAL CHEMOTHERAPY
    JAWETZ, E
    [J]. ANNUAL REVIEW OF MICROBIOLOGY, 1956, 10 : 85 - 114
  • [27] KLATERSKY J, 1983, REV INFECT DIS S, V5, pS21
  • [28] KLEIN JO, 1983, REV INFECT DIS, V5, pS55
  • [29] KOLLEF MH, 1994, HEART LUNG, V23, P363
  • [30] USE OF ANTIBIOTICS - BRIEF EXPOSITION OF PROBLEM AND SOME TENTATIVE SOLUTIONS
    KUNIN, CM
    TUPASI, T
    CRAIG, WA
    [J]. ANNALS OF INTERNAL MEDICINE, 1973, 79 (04) : 555 - 560