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Doody's Review ServiceReviewer: Lisa A Clough, MD (University of Kansas Medical Center)
Description: This introductory textbook outlines fundamental principles of antimicrobial therapy. This edition emphasizes the importance of understanding basic antimicrobial properties as well as the complex issues of microbial resistance in order to achieve good prescribing habits.
Purpose: The authors' intent is to introduce medical students and other health professionals to the principle of rational antimicrobial design. Their aim is to provide the necessary knowledge base required for recognizing and implementing good practice. This goal is exceedingly important today with the increasing pressure of antimicrobial resistance, decreasing number of new agents, and the increase in the types and complexity of illness. Antibiotic stewardship is an essential foundation which must be taught early in training.
Audience: The intended audience is medical students, residents, and other healthcare professionals involved in antimicrobial prescribing. The book is written at a level appropriate for this audience. The authors are educators and writers with extensive publications in this field.
Features: The book is appropriately divided into four sections that represent a systematic approach to good prescribing practices. Responsible prescribers must have an understanding of basic properties of antimicrobial classes and individual agents, mechanisms of antimicrobial resistance, and general principles of use as well as specific therapeutic indications. The section on properties of antimicrobial agents is a concise guide with careful inclusion of clinically practical information. The figures and tables for the most part highlight important concepts. The authors include periodic highlighted bulleted reviews (which they term prescriber's survival kit) that do not seem particularly useful. Unique to most introductory antimicrobial texts is a chapter on guidelines, formularies and policies. The authors are correct in acknowledging that guidelines and policies now have significant impact on antibiotic prescribing and these documents need to be thoughtfully reviewed and used accurately. Instructing learners early on regarding appropriate use of these resources is important. The final section on specific therapeutic indications provides not only specific treatment options but also the appropriate background and rational for making such choices. Throughout the book, the authors are careful to include a historical context for drug development and use. This appropriately provides readers additional rationale for proper antibiotic choices.
Assessment: This is a useful overview of antimicrobial therapy. The authors provide essential information to answer several basic questions each prescriber should ask when writing antimicrobial prescriptions: what agent am I choosing, why am I choosing it, and how can I make a better choice. The information is updated in the hopes of giving healthcare providers a sound knowledge base to continue good prescribing practices.