항균제 내성기전

Abstract

Besides the benefits of antimicrobial agents in the control of infectious diseases, widespread and prolonged use of antimicrobial agents has brought out both the increase of drug-resistant strains in a communily and the profound changes in the pattern of infectious diseases. The bacterial resistance to antimicrobial drugs has become an increasingly important public health problem in Korea as well. Studies over the past two decades have greatly increased our understanding of the mechanisms for dissemination of resistance genes and of the problem how efficient is the spread of resistance genes relative to the amount of selection pressure exerted by the extensive use of antimicrobial drugs. With these facts in mind, this review article attempted to clarify some of the aspects of what we know of microbial genetics relevant to understanding bacterial resistance. We pointed out the needs to recognize where we stand in regard to multiple resistance problems in Korea, thus to inquire to what conclusions the accumulated facts in Korea seem to indicate. and to ascertain in what direction we may look for successful management of emergence of resistant pathogenic bacteria in the future. Finally, it was suggested that there had been a number of clinial situations in which current methods to use antimicrobial drugs should be re-evaluated in light of information concerning the emergence of multiply resistant gram-negative bacterial infections in hospital in Korea. Even though many new powerful antimicrobial drugs are being and will continue to be developed for the solution of the serious problem of multiple bacterial resistance over the coming years, the empirical treatment of bacterial infections, largely relying for the most part on the successful past experience, but not on the adequate laboratory data, should be abandoned until the discovery of clinically applicable methods of curing microorganism of resi· stance.