Why appropriate antimicrobial selection is important: Focus on outcomes

There is a general consensus that antimicrobial resistance in the hospital setting has emerged as an important variable that influences patient outcomes and overall resource utilization (1-3). Hospitals worldwide are faced with increasingly rapid emergence and spread of antibiotic-resistant bacteria. Both antibiotic-resistant gram-negative bacilli and gram-positive bacteria are reported as important causes of hospital-acquired infections (4, 5). In many cases, few antimicrobial agents remain for effective treatment, particularly with methicillin-resistant and vancomycin-resistant Staphylococcus aureus (MRSA, VRSA) and gram-negative bacteria producing extended-spectrum beta-lactamases with resistance to many other antibiotics (6-8).