Abstract
Young: I thank Dr. Phillips for quoting me correctly. I would like to stress the fact that in the Table, I have pooled the results of Schimpf and collaborators and our own. I think that this is permissible, because we were using a rather similar protocol to study antimicrobial therapy in neutropenic patients. The point is that if one is looking at individuals with a socalled rapidly fatal disease, one can see that the majority of them will do poorly. On the other hand, if you look at the original McCabe and Jackson report it appears that 70% of the patients treated for Gram-negative rod bacteremia with a nontatal underlying disease, recovered despite inappropriate antimicrobial therapy. The significance of resistance is most evident in individuals with compromised host defenses. If you look at a report from the pre-antimicrobial era, say the one published by Felty and Kiefer in 1924, it appears that the published by Felty and Kiefer in 1924, it appears that the survival of patients with E. coli bacteremia, was about 70% in the absence of antimicrobial theraphy. This percentage is virtually identical to what McCabe and Jackson reported for non-fatal underlying disease treated inappropriately. So my conclusion is that the host is of paramount importance if one looks at the relationship between drug resistance and outcome.
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© 1982 Martinus Nijhoff Publishers, The Hague
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Michel, M.F. (1982). Discussion. In: Van Furth, R. (eds) Evaluation and Management of Hospital Infections. New Perspectives in Clinical Microbiology, vol 5. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-7657-3_7
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DOI: https://doi.org/10.1007/978-94-009-7657-3_7
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