Antibiotic resistance in bacteria. A current and future problem.

Bacterial pathogens have become increasingly resistant to commonly used antibiotics. In some cases, there are no remaining first-line options for therapy. Problem pathogens which may cause dermatologic and rheumatologic infections will be discussed, including vancomycin-resistant staphylococci and enterococci as well as the multiply-resistant Gram-negative bacilli. Risk factors for acquisition of these organisms and diagnostic studies available for their detection will be reviewed. The underlying mechanisms of resistance, geographic prevalence, potential for continued spread, and proposed strategies for prevention and control are examined. Finally, information on the newer topical and systemic antimicrobial agents, including investigational therapies, will be presented.