Antibiotics and Gram-Negative Bacteremia

AN ARTICLE appeared in the March 4 issue ofThe Journalpurporting to link the alleged overprescribing of antibiotics with "new and major hazards" to public health.1The misuse and overuse of antibiotics, the article claimed, has resulted in recent dramatic increases in the incidence and mortality of Gram-negative bacteremia. The authors cite an estimate of "as many as 300,000 episodes and more than 100,000 fatalities from Gram-negative bacteremia"2annually. The authors also quote from an editorial inThe Journal of Infectious Diseasesattributing "a minimum of 50,000 deaths" to Gram-negative bacteremia,3and suggest that the United States is presently in the throes of a "full-blown national epidemic." The implication that antibiotics are the sole factor in the rising incidence of Gram-negative bacteremia and death is hardly credible in the light of the many complex variables involved in the etiology and treatment of Gram-negative infections. This article