Antimicrobial therapy: principles of use

Antimicrobial use differs from other medications by its potential for collateral damage, specifically the generation of antimicrobial resistance, in both the patient and the wider population. This must be considered in addition to the challenges involved in finding an agent with the appropriate spectrum of antimicrobial activity that also achieves a sufficient concentration at the site of infection. Minimizing the risk of Clostridium difficile infection is also a central focus of antibiotic prescription. New antibiotic development has not kept up with the development of bacterial resistance, particularly for Gram-negative pathogens, and the risk of untreatable infections is growing. The role of antibiotic stewardship, limiting unnecessary antimicrobial use, is therefore more important than ever.