Abstract：
:Recent decades have witnessed the emergence and spread of parasites resistant to standard drug therapies, particularly malaria. Chloroquine-resistant Plasmodium falciparum has now spread to most malarial areas, and resistance to other antimalarial drugs, including mefloquine and sulfadoxine-pyrimethamine, have become significant problems in some parts of Southeast Asia and South America. Chloroquine-resistant P. vivax is well established in Papua New Guinea and Indonesia and has been reported in other areas. Trichomonas and Giardia infections resistant to metronidazole have also been documented. This article reviews the current status of drug resistance among parasites, particularly malaria, and offers strategies for managing patients with these infections. :Reviewed in this article is the research literature on issues related to the development, spread, and impact of drug resistant malaria and current recommendations on chemoprophylaxis for the prevention of malaria. Also examined is metronidazole resistance in both Giardia and Trichomonas and the possibility of ivermectin resistance in human filariasis. Consistent themes in the literature on drug resistance include widespread and uncontrolled use of drugs, heavy reliance on a small number of drugs, use of single drug therapy, poor compliance with recommended treatment regimens, and slow development of new therapeutic alternatives. The way existing drugs are administered must be improved so their usefulness can be sustained. New drugs should not be introduced before they are needed to delay selection of resistant parasite strains. Mass drug administration should be used cautiously. Where possible, treatment should be based on a specific diagnosis. Efforts are needed to improve patient compliance with multiple-dose treatments. Although multidrug therapy has been proposed as an effective way to limit resistance, it poses problems in terms of increased cost and complexity. Finally, vaccines, appropriate and sustainable vector avoidance or elimination strategies, environmental control, and human behavior modification are important to reduce the need for drug therapy.
journal_name
Infect Dis Clin North Amjournal_title
Infectious disease clinics of North Americaauthors
Barat LM,Bloland PBdoi
10.1016/s0891-5520(05)70400-1subject
Has Abstractpub_date
1997-12-01 00:00:00pages
969-87issue
4eissn
0891-5520issn
1557-9824pii
S0891-5520(05)70400-1journal_volume
11pub_type
杂志文章,评审abstract：:Although antibiotic therapy is the mainstay of therapy for gram-negative bacillary bacteremia, the amelioration of the underlying conditions, the correction of predisposing factors, the drainage of abscesses, the removal of infected foreign bodies, and adequate supportive care are also of paramount importance for curi...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1991-12-01 00:00:00
abstract：:The desideratum of "appropriate" antibiotic therapy include efficacy, safety, and low cost. Strategies for achieving these goals include education, control of the hospital formulary, written justification forms and automatic stop orders, ongoing utilization review, restriction, required consultation, control of labora...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-12-01 00:00:00
abstract：:No practitioner can hide from HIV. Patients infected with HIV are treated in every type of practice setting as the number of cases increases at an alarming rate. This article provides 10 basic guidelines for the care of HIV-infected patients. ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章
doi：
更新日期：1994-06-01 00:00:00
abstract：:Influenza is a zoonotic respiratory virus that affects birds, mammals, and humans. Influenza viruses are unique in their genetic instability, which frequently results in antigenic drift or shift. Antigenic shifts are responsible for influenza epidemics. Influenza A pandemics have been responsible for millions of death...
journal_title：Infectious disease clinics of North America
pub_type： 历史文章,杂志文章
doi：10.1016/S0891-5520(03)00095-3
更新日期：2004-03-01 00:00:00
abstract：:The unknowns persisting in the understanding of the mode of action of anti-core lipopolysaccharide antibodies are discussed, and a study of two anti-lipid A monoclonal antibodies is reviewed. This article also critically analyzes the results of the recent clinical trials with monoclonal antibodies. ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1991-12-01 00:00:00
abstract：:Fulminant meningitis requires aggressive management in an intensive care unit setting. The pathophysiology of the various factors that damage the central nervous system in this disease have been reviewed, as well as the management of the many complications of this serious, often devastating, infection. The etiologic a...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-03-01 00:00:00
abstract：:This article reviews the changing epidemiology of infections associated with injection drug use, perceived barriers to care, features of successful programs for outpatient antimicrobial treatment, models of shared decision making at the time of discharge, and linkage to preventative care after antimicrobial completion...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2020.06.009
更新日期：2020-09-01 00:00:00
abstract：:The viral hemorrhagic fever (VHF) syndrome is a potentially life-threatening infection typified by a combination of a capillary leak syndrome and bleeding diathesis. Most but not all agents causing VHF are arboviruses, with transmission to humans resulting from an arthropod bite. Agents of VHF affect humans on all con...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2012.02.003
更新日期：2012-06-01 00:00:00
abstract：:Animal models have proven to be invaluable in bridging the gap between in vitro susceptibility testing of an antibiotic and anticipating results obtained in clinical studies. Variables such as antibiotic concentration, inoculum of organism, and pharmacokinetic parameters of the drug can be carefully controlled to prov...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1989-09-01 00:00:00
abstract：:Occupational transmission of hepatitis B virus (HBV), hepatitis C virus, and HIV has been documented. The risk for occupationally transmitted infection varies for these three viruses. Despite effective pre- and postexposure prophylaxis for HBV and recent recommendations for postexposure chemoprophylaxis after an HIV e...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(05)70359-7
更新日期：1997-06-01 00:00:00
abstract：:Septic arthritis still continues to be a common and serious problem at major urban medical centers and is one of the most rapidly destructive forms of acute arthritis. The yearly incidence of bacterial arthritis varies from 2 to 10 per 100,000 in the general population to 30 to 70 per 100,000 in patients with rheumato...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章
doi：10.1016/j.idc.2006.09.005
更新日期：2006-12-01 00:00:00
abstract：:The problem of prophylaxis in orthopedic implant surgery will become increasingly important and complex as the population ages and requires more arthroplasty procedures, and the prevalence of antimicrobial-resistant bacteria meanwhile also continues to rise. Energy spent preventing prosthetic joint infection is more e...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2005.07.002
更新日期：2005-12-01 00:00:00
abstract：:The treatment of severe sepsis and septic shock remains a challenge as we approach the next millennium. Although more attention is being given to guidelines and care pathways for sepsis, these are unfortunately based primarily on consensus opinion. Additional research into supportive interventions in this potentially ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(05)70088-x
更新日期：1999-06-01 00:00:00
abstract：:CSF evaluation is the single most important aspect of the laboratory diagnosis of meningitis. Analysis of the CSF abnormalities produced by bacterial, mycobacterial, and fungal infections may greatly facilitate diagnosis and direct initial therapy. Basic studies of CSF that should be performed in all patients with men...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1990-12-01 00:00:00
abstract：:This article establishes the pharmacokinetic-pharmacodynamic parameters that are important when considering the intracellular activity of antibiotics. Generally speaking, the main classes of antibiotics seem to share globally the same properties against extracellular and intracellular organisms. The specific cellular ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(03)00066-7
更新日期：2003-09-01 00:00:00
abstract：:In the preantibiotic era, deep fascial space infections were common, and physicians were well acquainted with their complex and sometimes subtle manifestations. Widespread use of antibiotics, however, not only has significantly decreased the incidence of deep neck infections but also has altered their clinical manifes...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1988-03-01 00:00:00
abstract：:The urinary tract undergoes profound physiologic and anatomic changes during pregnancy that facilitate the development of symptomatic urinary tract infections in women with bacteriuria. While the adverse effects of asymptomatic bacteriuria on maternal and fetal health continue to be debated, it is clear that asymptoma...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1987-12-01 00:00:00
abstract：:Fever of unknown origin is a topic that has enduring interest to physicians. Prolonged fevers of infectious etiology were of particular concern to the ancient physician. This overview of prolonged fevers in antiquity focuses on malaria and typhoid fever as the primary infectious causes. By studying texts from Mesopota...
journal_title：Infectious disease clinics of North America
pub_type： 历史文章,杂志文章
doi：10.1016/j.idc.2007.08.010
更新日期：2007-12-01 00:00:00
abstract：:Zygomycosis is an increasingly common infection in immunocompromised patients. Advances in the understanding of Zygomycetes pathobiology and the introduction of new drugs with improved activity and tolerability for treatment of zygomycosis have improved the prospects of effectively controlling this devastating infecti...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2006.06.003
更新日期：2006-09-01 00:00:00
abstract：:Herpes zoster (HZ) is the result of reactivation of latent varicella zoster virus (VZV) and occurs most frequently in older adults. Classically, HZ presents as a unilateral, selflimited, dermatomal rash. Postherpetic neuralgia (PHN) is a common sequela, presenting as severe pain that persists after the rash has resolv...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2017.07.016
更新日期：2017-12-01 00:00:00
abstract：:Compromised travelers represent a diverse and challenging group of individuals. They include HIV-infected patients who are at risk for potentially adverse reactions to immunizations, and new exposures to enteric water-borne opportunistic pathogens associated with chronic infections. Such travelers may encounter unfami...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(05)70010-6
更新日期：1998-06-01 00:00:00
abstract：:HTLV-1 infection is endemic in several Latin American countries. HTLV-1-associated myelophathy/tropical spastic paraparesis (HAM/TSP) and adult T-cell leukemia lymphoma (ATLL) are emerging diseases in the region. Documented risk factors for acquiring the virus include breast-feeding, contaminated blood transfusion, an...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(05)70225-7
更新日期：2000-03-01 00:00:00
abstract：:Legionella is a common cause of community- and hospital-acquired pneumonia. New information on the pathogenesis of infection and the host immune response is reviewed. Specialized laboratory tests, especially culture, are necessary for diagnosis since the clinical presentation is nonspecific. New antimicrobial agents a...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1991-09-01 00:00:00
abstract：:Oral mucositis is a serious complication of cancer therapy and in severely immunosuppressed patients. In immunosuppressed patients, the signs and symptoms of infection often are muted because of limited host response, and accurate diagnosis and appropriate treatment may be difficult. Prevention of mucosal breakdown, s...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2007.03.003
更新日期：2007-06-01 00:00:00
abstract：:A wide range of soft-tissue infections can occur in diabetic patients, the consequences of which can be devastating. Early recognition and intervention, which may involve both surgical and medical approaches, can improve clinical outcomes. ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1995-03-01 00:00:00
abstract：:Considering experience acquired in the past years, it seems as though physicians have reached a plateau in the frequency of peritonitis. A peritonitis rate of 1 every 2 patient years may be acceptable. Further reduction of this peritonitis rate will require inordinately large efforts on all fronts. One will have to co...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(05)70171-9
更新日期：2001-09-01 00:00:00
abstract：:Bioterrorism preparedness is clearly a goal for the health care community, working in concert with city, county, state, and federal public health and emergency authorities and in collaboration with law enforcement at the local and federal levels. Opening the channels of communication between all groups involved, obtai...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/s0891-5520(05)70189-6
更新日期：2001-12-01 00:00:00
abstract：:Diarrhea is one of the most common causes of morbidity and mortality in children worldwide. The causes of acute diarrhea in children vary with the location, time of year, and population studied. There is increasing recognition of a widening array of enteric pathogens associated with diarrheal diseases. Adequate fluid ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2005.05.003
更新日期：2005-09-01 00:00:00
abstract：:Infections accompanying severe pancreatitis are secondary and of three types: infected pancreatic necrosis, infected pseudocyst (including peripancreatic fluid collection), and pancreatic abscess. The first is an earlier, more morbid process, with antibiotics supportive and surgical debridement necessary. The latter t...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：
更新日期：1992-09-01 00:00:00
abstract：:This article discusses two tick-borne illnesses: Powassan encephalitis, a rare cause of central nervous system infection caused by the Powassan virus, and Colorado tick fever, an acute febrile illness caused by the Colorado tick fever virus common to the Rocky Mountain region of North America. ...
journal_title：Infectious disease clinics of North America
pub_type： 杂志文章,评审
doi：10.1016/j.idc.2008.03.001
更新日期：2008-09-01 00:00:00
