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This volume continues the tradition of the editors' first volume, Antibiotic Policies: Theory and Practice, by assembling contributions from experts around the world concerned with responsible antibiotic resistance and fighting resistance. This volume looks at many of the crucial issues of resistance in a clinical context, with an emphasis on MRSA; surely the greatest challenge to our antibiotic and infection control policies that modern health care systems have ever seen. Other fascinating chapters explore the psychology of prescribing, modern management techniques as an adjunct to antibiotic policies, and the less obvious downsides of antibiotic use. Lastly, several chapters from authors living in Mediterranean countries give a perspective from an area of the world with some of the greatest problems in antibiotic use and resistance.
In 1971, I started a fellowship in infectious diseases and medical microbiology at the Channing Laboratory of the Harvard Medical Service at Boston City Hospital. My mentor, Dr. Maxwell Finland, had encouraged me to return there from the Center for Disease Control (as CDC was known then), where I had studied inf- tious diseases epidemiology and hospital-associated infection epidemiology, with the idea that we would review the demographic patterns of bacteremia and several other infections during Dr. Finland's long tenure at the hospital. We did so, but I was surprised to find that he also invited me to help with the assessment of the success or failure of the programs to control antimicrobial use that he and c- leagues had put into place at the hospital over several years. The paper describing that review finally was published in 1974, after a long and tortuous process of review at several journals. Several reviewers felt that such attempts to improve use amounted to interferencewith the patient's physician to do what was best. Others felt that such programs focused incorrectly on a subject other than treating the current patient. Fortunately, today, it is clear that antimicrobial resistance results in major part, but not entirely, from the ways that we use antimicrobial agents, and that the ov- all interests of patients in general, as well as those of society, are well served by efforts to use these drugs as well as possible.
In 1971, I started a fellowship in infectious diseases and medical microbiology at the Channing Laboratory of the Harvard Medical Service at Boston City Hospital. My mentor, Dr. Maxwell Finland, had encouraged me to return there from the Center for Disease Control (as CDC was known then), where I had studied inf- tious diseases epidemiology and hospital-associated infection epidemiology, with the idea that we would review the demographic patterns of bacteremia and several other infections during Dr. Finland's long tenure at the hospital. We did so, but I was surprised to find that he also invited me to help with the assessment of the success or failure of the programs to control antimicrobial use that he and c- leagues had put into place at the hospital over several years. The paper describing that review finally was published in 1974, after a long and tortuous process of review at several journals. Several reviewers felt that such attempts to improve use amounted to interferencewith the patient's physician to do what was best. Others felt that such programs focused incorrectly on a subject other than treating the current patient. Fortunately, today, it is clear that antimicrobial resistance results in major part, but not entirely, from the ways that we use antimicrobial agents, and that the ov- all interests of patients in general, as well as those of society, are well served by efforts to use these drugs as well as possible.