In search for the lost antibiotic: a multidisciplinary approach to address the problem of the emergence of antibiotic resistance

The resistance to antibiotics, appeared in the 50s, at the same time of the introduction of these drugs, has become today a public health emergency of international importance. This problem is extremely complex because it is based on many factors, including inappropriate use of antibiotics and their massive presence in the feed of farm animals. Today this problem has become a real public health priority not only for the clinical implications (increased morbidity, mortality and duration of disease, the possibility of developing complications and infections), but also for the economic impact of infections by bacteria resistant, due to the additional cost for more expensive drugs and procedures and for stretching the hospitalization. The European Centre for Disease Prevention and Control (ECDPC) in Stockholm has recently estimated that the bacteria with multiple resistances are responsible for about half of thirty-seven thousand deaths per year in the twenty member countries of the European Union. The importance of this phenomenon has prompted several surveillance systems based on the collection of laboratory data to local or national level. To standardize and interpret the data collected and to facilitate comparison between different realities, in 1998 the EU has decided to finance a European surveillance network (EARSS: European Antimicrobial Resistance Surveillance System), which involves several national surveillance networks. Despite the increase of antimicrobial resistance in clinical isolates of both gram positive and gram negative, there are very few new antimicrobial agents in development. Only a multidisciplinary approach, combining various skills in medicine, can help us cope with this emergency and to use the resources available.