Therapeutic principles of antimicrobial therapy and new antimicrobial agents.

It is important that newly developed antibiotics be used so as to increase our ability to eradicate infection, rather than to complicate the treatment of infection by spawning the creation of organisms resistant to multiple antibiotics. One must peruse the literature with a very critical eye, as most new agents are touted as tremendous advances on past antibiotics. With rising medical costs becoming of ever-greater significance, proper choice of antimicrobial agent assumes more importance as well. The proper bacterial coverage in a given clinical setting, duration of treatment, and drug pharmacokinetics and the concept of the "total cost" of administering an antibiotic (taking into account fixed and variable hospital costs) all must be considered. Although it is virtually impossible to become experienced in using all of the currently available antibiotics, it is not necessary, either. Based on the literature and discussion with infectious disease colleagues, one can choose to use one or two antimicrobials in each broad class and gain the benefits of that class for his or her patients.