Improving Antibiotic Use Has Become Essential-Can Surgery Lead the Way?

The past few years have seen a remarkable increase in antimicrobial resistance of organisms that were susceptible to many drugs a few years ago.1 Worse, some organisms have developed resistance to drugs that have worked for years.2,3 For the first time in many decades, we face the specter of organisms for which no adequate chemotherapy exists. For example, enterococci have developed resistance to 1-lactams, aminoglycosides and now vancomycin.4 How to treat serious infection caused by enterococci that acquire all three of these resistance mechanisms is totally unclear. These developments mean that we now are facing a precarious time in attempting to keep patients with serious infections alive.