Antibiotics in Laboratory Medicine, 6 Ed.

Appendix. Antiinfective Resistance Resource Guide

Daniel Amsterdam

Antimicrobial resistance is recognized as a significant worldwide public health concern. Several key health care quality indicators focus on infection prevention and treatment, including selective use of antimicrobial agents, length of hospital stay, ventilator-associated pneumonia, catheter-associated infections, surgical site infections, and readmission rates. These indicators are clearly influenced by resistance to antimicrobial agents (1).

The recognition that resistance to therapeutic agents has increased in recent decades has been reported by laboratories identifying clinical isolates exhibiting resistance to many antimicrobial agents (2,3). Resistance is relevant to all microbiologic species, encompassing viruses, bacteria, mycobacteria, fungi, protozoa, and parasites. Commonly identified bacteria exhibiting resistance to antibiotics have broad implications in our hospitals and clinics (1). Such organisms include Staphylococcus aureusStreptococcus pneumoniaeEnterococcus species, Acinetobacter species, Pseudomonas species, and Klebsiella (24). Antibiotic stewardship programs and antibiograms are approaches used by experts in clinical microbiology and pharmacology to inform clinicians about the state and extent of antimicrobial resistance in their institutions to ensure appropriate use of antimicrobial agents (1). These practitioners also evaluate and compare changes in resistance patterns at their institutions with those reported elsewhere. The data repositories documenting these changes are demonstrated by the Web sites provided in the attached tables.

Given the rapid changes in resistance of microbes in recent decades, clinical microbiologists, pharmacologists, and clinicians, including infectious disease experts, must be able to quickly retrieve this information. Such data resources will also assist those caring for individuals harboring resistant organisms from other areas of the world, and may prevent the spread of antibiotic-resistant microorganisms. These resources can also provide materials to educate the community about issues of resistance.

Web sites that contained information on antimicrobial resistance have been previously published (24). Provided in this Appendix are updated representative Web sites, links, and international networks relevant to the problem of antimicrobial resistance to facilitate the work of clinicians, laboratorians, and pharmacologists involved with prevention, research, education, and care of individuals infected by potentially resistant microorganisms.


 1.  Davey P, Brown E, Charani E, et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev 2013;(4):CD003543.

 2.  Harbarth S, Emonet S. Navigating the World Wide Web in search of resources on antimicrobial resistance. Clin Infect Dis 2006;43:72–78.

 3.  Falagas ME, Karveli EA. World Wide Web resources on antimicrobial resistance. Clin Infect Dis 2006;43:630–633.

 4.  Zhanel GG, Low DE. Launching of the CAN-R Web site—the official Web site of the Canadian Antimicrobial Resistance Alliance. Can J Infect Dis Med Microbiol 2007;18:151–152.

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