Antimicrobial Therapy and Vaccines

Victor L. Yu, Thomas C. Merrigan Jr, Steven L. Barriere Lippincott Williams & Wilkins, Philadelphia, 1998.ISBN 0-683-30061-X. $165.00. Two hundred and twenty-two authors, the majority from North America, have contributed to this first edition. There are three sections dealing with bacteria, fungi and viruses, and each section is subdivided into parts dealing with individual pathogens and classes of antimicrobial agents. The omission of protozoa and helminths is to be corrected in the second edition, which is already in preparation. The chapters on pathogens concentrate on antimicrobial susceptibility and choice of therapy. There is relatively little on microbiology and clinical disease. The book title raises expectations on its coverage of vaccines; however, this is disappointing. Only one paragraph is devoted to BCG, and the chapter on Streptococcus pneumoniae does not mention pneumococcal vaccines at all. Indeed, the overall discussion of vaccines is rudimentary compared with the comprehensive discussion of antimicrobial agents and therapy. But even within the accounts of the latter there are omissions. For instance ribavirin, which has an important place in antiviral therapy, is not given a chapter, unlike amantadine and rimantidine. Overall the book is to be commended for its detailed and up to date coverage of antimicrobials and therapeutics. However, the focus of the book is on specific pathogens and antimicrobials and it does not really address clinical, infectious syndromes and empirical choices of therapy. Therefore, it will prove useful as a reference when microbiologists, who have isolated pathogens, wish to advise on therapy, but will be less useful to clinicians managing patients in the absence of microbiological information. Future editions should rectify the omissions in this book: an electronic version is being prepared, and frequent updates and improvements are promised.