Consequences of bacterial resistance to antibiotics in medical practice.

The rate of bacterial resistance to antibiotics is significant epidemiologically and ecologically. The consequences of resistance must be considered medically and economically in terms of the patients who are infected with antibiotic-resistant microorganisms. However, before the so-called "disease consequences of resistance" can be considered, it should be noted that positive changes in prescribing behavior occur when information on resistant organisms is released to practitioners and to the public. The impact of such information has not been investigated and measured. However, it is likely that knowledge about bacterial resistance increases the use of new antibiotics and additional diagnostic tests. The disease consequences of resistance should be assessed according to the morbidity and mortality rate due to antibioticresistant organisms. It can be assumed that resistant microorganisms lead to an increase in morbidity and mortality since resistance increases the risk of inappropriate therapy. There is an increased risk that patients who do not receive appropriate treatment will have a longer course of disease or a fatal outcome; moreover, as these patients remain infectious for a longer period, morbidity and transmission of the microorganism are increased. Such increased morbidity was documented in outbreaks of diseases such as shigellosis, typhoid fever, and pneumococcal infections.