11/8/11 Antimicrobial Stewardship Protecting a Valuable Resource November 8, 2011 Edward Lifshitz, MD Medical Director Communicable Disease Service NJDHSS
[email protected] (609) 826-5964 Edward Lifshitz, MD
[email protected] “One can think of the middle of the twentieth century as the end of one of the most important social revolutions in history, the virtual elimination of infectious diseases as a significant factor in social life” 1962 Sir Frank MacFarlane Burnet Director of the Walter and Eliza Hall Institute of Medical Research 1960 Nobel Prize co-winner in Physiology or Medicine Edward Lifshitz, MD
[email protected] “Unless we act to protect these medical miracles, we could be heading for a post-antibiotic age” 2001 Gro Harlem Brundtland WHO Director-General Edward Lifshitz, MD
[email protected] 1 11/8/11 Antimicrobial Stewardship “Antimicrobial stewardship programs in hospitals seek to optimize antimicrobial prescribing in order to improve individual patient care as well as reduce hospital costs and slow the spread of antimicrobial resistance.” Clinical Microbiology Reviews, October 2005, p. 638-656, Vol. 18, No. 4 Edward Lifshitz, MD
[email protected] Microbes vs Humans Microbes Microbes Humans by factor # on Earth 5 x 1031 7 x 109 ~ 1022 # cells in a Human 5 x 1013 5 x 1012 ~ 5 - 10 Mass - kg 5 x 1019 3 x 1011 ~ 108 Generation time 30 min 30 years ~ 5 x 105 Time on earth, years 3.5 x 109 4 x 106 ~ 103 Data: Schaechter M, et al, Microbiology in the 21st century: