The medical literature contains numerous articles concerned with antibiotic resistance. Many describe the mechanisms of resistance, but to noninfectious disease clinicians terminology is variable and often confusing. The resistance described is relative rather than absolute, and usually refers to acquired rather than natural resistance. Relative resistance refers to the gradual increase in the minimal inhibitory concentration (MIC₉₀) that occurs in susceptible organisms over time. In relative resistance an antibiotic is still effective against the sensitive organism. Increase in relative resistance is manifested by a gradual increase in MICs, and accounts for most of the resistance problems referred to in the literature and encountered in clinical practice. Absolute resistance occurs when a previously sensitive organism suddenly is no longer sensitive to an antibiotic, independent of the dose. Acquired absolute resistance to antibiotic therapy represents the most common and serious resistance problem encountered in critical care practice.<sup>13 Cunha BA: Emerging resistant organisms in the outpatient setting. Semin Respir Ther (in press), 1997.

Cliquez ici pour aller à la section Références, 14 Danziger L.H., Pendland S.L. Bacterial resistance to β-lactam antibiotics Am J Hosp Pharm 1995 ;  52 : S3

Cliquez ici pour aller à la section Références, 15 Dudley M. Bacterial resistance mechanisms to β-lactam antibiotics: assessment of management strategies Pharmacotherapy 1995 ;  15 : 9S

Cliquez ici pour aller à la section Références, 23 Marr J.J., Moffitt H.L., Kunin C.M. Guidelines for improving the use of antimicrobial agents in hospitals: a statement by the Infectious Disease Society of America J Infect Dis 1988 ;  157 : 869  [cross-ref]

Cliquez ici pour aller à la section Références, 27 Murray B.E. Problems and dilemmas of antimicrobial resistance Pharmacotherapy 1992 ;  12 : 86S

Cliquez ici pour aller à la section Références, 28 O'Brien T.F. The global epidemic nature of antimicrobial resistance and the need to monitor and manage it locally Clin Infect Dis 1997 ;  24 : S2

Cliquez ici pour aller à la section Références, 29 Qadri S.M.H., Kroschinsky R., Cunha B.A. Antimicrobial resistance of clinical isolates in Saudi Arabia and the USA Curr Ther Res 1990 ;  47 : 130

Cliquez ici pour aller à la section Références, 30 Qadri S.M.H., Cunha B.A., Domenico P. Activity of cefepime against nosocomial bacteremia blood culture isolates J Antimicrob Chemother 1995 ;  36 : 531

Cliquez ici pour aller à la section Références, 31 Qadri S.M.H., Ueno Y., Cunha B.A. Susceptibility of clinical isolates to expanded spectrum β-lactams alone and in the presence of β-lactamase inhibitors Chemotherapy 1996 ;  42 : 334

Cliquez ici pour aller à la section Références, 36 Shea K.W., Ueno Y., Abumustafa F. , et al. Doxycycline activity against Streptococcus pneumoniae. Chest 1995 ;  107 : 1775  [cross-ref]

Cliquez ici pour aller à la section Références, 40 Tenover F.C., McGowan J.E. Reasons for the emergence of antibiotic resistance Am J Med Sci 1996 ;  311 : 9  [cross-ref]

Cliquez ici pour aller à la section Références</sup>