TY - JOUR
T1 - Crisis in infectious diseases
T2 - Time for a new paradigm?
AU - Casadevall, Arturo
N1 - Funding Information:
Received 12 March 1996; revised 26 Juue 1996. Grant support: National Institutes of Health (grants AI22774 and AI13342). Reprints or correspondence: Dr. Arturo Casadevall, Department of Medicine, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York 10461.
PY - 1996
Y1 - 1996
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=0029745684&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0029745684&partnerID=8YFLogxK
U2 - 10.1093/clinids/23.4.790
DO - 10.1093/clinids/23.4.790
M3 - Review article
C2 - 8909846
AN - SCOPUS:0029745684
SN - 1058-4838
VL - 23
SP - 790
EP - 794
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 4
ER -