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.
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Article info
Footnotes
Address reprint requests to Burke A. Cunha, MD, Chief, Infectious Disease Division, Winthrop-University Hospital, Mineola, NY 11501
Identification
Copyright
© 1998 W. B. Saunders Company. Published by Elsevier Inc. All rights reserved.
