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Canadian Journal of Infectious Diseases
Volume 9 (1998), Suppl E, Pages 10E-15E

The Evolution of Antimicrobial Resistance in Respiratory Pathogens in Canada: What are the Clinical Consequences?

Donald E Low

Mount Sinai and Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada

Copyright © 1998 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The use of antimicrobial agents has led to reductions in illnesses and deaths from a variety of infectious diseases. Antimicrobial resistance has followed the introduction of almost every new antimicrobial agent and is now emerging as an important public health problem, especially in respiratory tract pathogens in the community. During the past decade in Canada, a rapid and relentless increase in antimicrobial resistance in Streptococcus pneumoniae and Haemophilus inflluenzae has been witnessed. Adverse implications as a result of the treatment of an infection with an antibiotic to which the offending pathogen is resistant have been recognized in only a few infectious disease syndromes (eg. bacterial meningitis). More often, resistance in vitro does not result in resistance in vivo (eg, respiratory tract infections). Therefore, before recommendations regarding empirical or directed therapy are changed, it is essential that evidence to support those decisions is obtained. More important, the prevention and control of such resistance must be addressed by reducing the burden of antibiotic selective pressure by curtailing inappropriate antibiotic use.