THE LIBERAL, though not indiscriminate, use of antibiotics in pediatrics has resulted in far more assets than liabilities, although the statement has been made that 90% of antibiotics used in this country today are wasted. Often the pediatrician is able to select the correct and most effective antibiotic on the basis of clinical examination alone. At other times, laboratory examinations are necessary to establish an etiologic diagnosis. This information frequently allows the selection of the most favorable antibiotic when the bacterial species is of predictable sensitivity. Cases in which the bacterial species isolated are of unpredictable sensitivity require determination of the in-vitro efficacy of antibiotics. It must be stressed that many bacterial pathogens are as sensitive to penicillin and other antibiotics today as they were years ago, and that the emergence of antibiotic-resistant bacteria is not a general phenomenon. For example, the vast majority of strains of group A hemolytic streptococcus, gonococcus, pneumococcus, influenza bacillus, and the spirochete of syphilis have not become antibiotic resistant. In contrast, the staphylococcus has become a serious problem, particularly in hospitals and hospital-acquired infections. With the widespread use of penicillin and other antibiotics the percentage of antibiotic-resistant bacteria isolated from lesions in man has increased substantially. In addition, workers in hospitals rather frequently have become carriers of these strains and thus may in turn spread the infection to patients.
Status of Current Antibiotics
During the last few years several antibiotics have been added to the armamentarium of the physician. The present status of these antibiotics or special preparations may be summed up as follows.
Allele identification using immobilized mismatch binding protein: detection and identification of antibiotic-resistant bacteria and determination of sheep susceptibility to scrapie