Antibiotic therapy: impact and resistance

Many achievements in modern medicine, such as in transplantation medicine, cancer therapy, surgery, and intensive care medicine would have been impossible without effective treatment of bacterial infections. Antibiotic resistance is on the rise; the reasons for this are complex and vary greatly. Knowledge about the impact of antibiotics and mechanisms of antibiotic resistance, which are the cornerstones of calculated and targeted antibiotic therapy, is imperative. This review describes the pharmacodynamics of relevant antibiotics in emergency and intensive care medicine. Commonly resistant bacteria with clinical relevance and the respective mechanisms of resistance are highlighted. Furthermore, the use of antiinfectives for reserve treatment of severe infections is discussed. Understanding the mechanisms of resistance and effects of antibiotics are fundamental for efficient and successful treatment of bacterial infections and for the reduction of resistant species.