Resistance issues and community-acquired respiratory infections.

Antimicrobial resistance, associated with both excessive and inappropriate use of antimicrobial agents, is a global problem. It is a particular problem in the management of community-acquired respiratory infections, which most often result in the use of antimicrobial therapy. Infections caused by resistant and multiresistant pathogens may also result in high hospitalization rates, long lengths of stay, severe illness, and high mortality, all of which have a great impact on health care costs. The Tracking Resistance in the United States Today (TRUST) Program, the largest longitudinal continuous-surveillance program of its kind, has been conducted every year since 1996 and tracks consecutive respiratory seasons on a year-to-year basis to monitor resistance patterns of respiratory pathogens. This article discusses some of the findings of the TRUST Program, particularly trends in Streptococcus pneumoniae resistance.