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2017 ; 64
(7
): 823-828
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Crisis in Infectious Diseases: 2 Decades Later
#MMPMID28362950
Casadevall A
Clin Infect Dis
2017[Apr]; 64
(7
): 823-828
PMID28362950
show ga
The development of nontoxic broad-spectrum antimicrobial drugs in the mid-20th
century led to a culture of empiricism, underdevelopment of diagnostics, neglect
of immunotherapy, and selection for drug resistance, which together created the
conditions that underlie the current crisis. In 1996 an article in this journal
predicted a crisis in infectious diseases, which subsequently unfolded with a
paucity of new drugs, increases in antimicrobial resistance, and underdevelopment
in both immunotherapy and diagnostics. This article argues that the root cause of
the current-day problems lies in the enormous success of the mid-20th century
antibiotic revolution. The availability of low-toxicity broad-spectrum drugs
fostered a culture of empiricism and widespread use, which in turn stunted the
development of both the specialty and rapid diagnostics while promoting increases
in resistance. Two decades later, there are promising signs that widespread
recognition of these problems is leading to fundamental changes in the approach
to the therapy of infectious diseases. Ultimately, a concerted effort to
simultaneously develop pathogen-specific drugs, immunotherapy, and improved
diagnostics could provide a qualitatively new platform for confronting the
challenge of infectious diseases, which now also includes host dysbiosis.
|*Drug Resistance, Microbial
[MESH]
|*Global Health
[MESH]
|Anti-Infective Agents/isolation & purification/*pharmacology/*therapeutic use
[MESH]