BACTERIAL-RESISTANCE TO ANTIBIOTICS IN ACUTE RESPIRATORY-INFECTIONS (ARIS)

In this review article, we make suggestions on how to approach the inc reasing problem worldwide of bacterial acute respiratory infections re sistant to antibiotics. After a brief description of the main mechanis ms of bacterial resistance, i.e., enzymatic inactivation by beta-lacta mases, reduction in the permeability of the outer membrane and the dev elopment of PBPs that have decreased affinity for the antibiotic, we a nalyze documented experiences on the response to different groups of a ntibiotics (beta- lactam antibiotics, cephalosporins, carbapenems and quinolones), of the most commonly isolated bacteria from invasive resp iratory infections (Haemophilus influenzae, Streptococcus pneumoniae a nd Moraxela (Branhamella) catarrhalis. Antimicrobial agent susceptibil ity in vivo and in vitro testing and the correlation of their results provide the basic information for the adoption of adequate policies an d strategies for better use of antibiotics in bacterial respiratory in fections; proper surveillance would allow to make intelligent changes in such a policy. Standardized recommendations for clinical practice o n the-use of antibiotics could be misleading, iatrogenic, and could co mplicate the resistance problem. To prevent and control the rise and s pread of bacterial resistance, an interdisciplinary approach is needed .