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Management of Antimicrobials in Infectious Diseases: Impact of Antibiotic Resistance
  1. M J Gill
  1. Division of Infection and Immunity, Medical School, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK

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    Edited by Arch G Mainous III, Glaire Pomeroy. Pp 350; $99.50. New Jersey: Humana Press, 2000. ISBN 0-896-03821-1.

    Over the years, many books on the use of antimicrobials in the treatment of infectious disease have been written. Although few of these books have a subtitle implying that resistance will be specifically dealt with (as with this book), most of them by necessity write about this topic. I approached this book with a degree of cynicism, expecting to find the same tales retold in the same formulaic way. The first part of the book was not what I expected and I was pleasantly surprised. The first seven chapters dealt with the science of resistance generally, and then with specific examples, in a way that was informative and relevant to many clinicians. These early chapters also information on epidemiology, public health measures, and vaccination that are relevant to managing the problems of resistant organisms. Although this is a multiauthor book, there seemed to be more consistency in approach and writing in these early chapters than those found later. The latter part of the book was little more than the systems based summary of antimicrobial use found in so many books.

    As is to be expected with a book written by American authors, there are differences in practice from that in the United Kingdom: recommendations for treatment of community acquired pneumonia differ from those of the British Thoracic Society; recommendations for the treatment of infective endocarditis differ from those of the BSAC Working Party. Although generic drugs, some of these are different (although comparable) from those we would use in the United Kingdom. The authors frequently recommend the use of trimethoprim-sulfamethoxazole; because of the risk of sulphonamide toxicity, the CSM only recommends the use of this combination for specific indications in the United Kingdom. In the chapter on meningitis the authors do not recommend the immediate use of penicillin upon clinical suspicion (UK guidance). The controversy of use of antibiotics in the treatment of infective diarrhoea is not discussed. Most importantly, the adverse effects of using antibiotics in shigellosis in children and EHEC infection are not mentioned.

    The chapters on the treatment of sexually transmitted infections and HIV are short for a specialist reader, and there really should have been a separate chapter on hepatitis. I doubt there is much in this book that the established GUM clinician or scientist will find helpful. The trainee GUM physician may be confused or misled.

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