The first book was on "Theory and Practice" of antibiotic stewardship in its broadest sense -the how to do it and the do's and don ts. The second, on "Controlling resistance" was very much on the relationships between use and resistance and beginning to home in on the hospital as the main generator of resistance, but mainly looking at it from a disease/clinical perspective. The last 3 chapters on MRSA, ended where the 3rd book will take off. "Controlling HAI " will concentrate on specific MDR organisms highlighting their roles in the current pandemic of HAI and emphasizing that the big issue is not so much infection control but antibiotic control, in the same way that antibiotic over-reliance/ over-use has caused the problem in the first place. Up 'till now the emphasis for controlling MRSA, C diff and all the other MDROs has very much been on IC, which clearly isn't working. This book will gather all the evidence for the increasingly popular view that much more must be done in the area of antibiotic policies/ stewardship, especially when we are in danger of a "post antibiotic" era, due to a real shortage of new agents in the pipeline. Hospitals worldwide are currently suffering an epidemic of infections, generated in and spreading in those instituitions whose very raison d etre is to protect and improve the health of their patients. This paradox comes at a time of possibly unprecedented investment in preventative measures (infection control). To better control these infections, however, we need to understand their causes, many of which are related, paradoxically, to the success of antibiotic therapy. It is possible that the golden era of antibiotics led subconsciously to a loss of emphasis on the importance of hygiene in the control of HAI. Moreover, the majority of HAIs are due to multiply antibiotic resistant bacteria whose emergence has been hastened by over-enthusiastic antibiotic prescribing. Accumulating evidence also suggests that antibiotics not only select for resistance but can actually increase the numbers of HAIs and even their virulence.§This comprehensive compilation, written by eminent international researchers, explores these hypothesis in the context of recent epidemiology and evidence for the success of various antibiotic stewardship measures in controlling and even reversing resistance. It contains chapters by acclaimed authors on all the major causes of HAI, including MRSA, VRE, Clostridium difficile and multi resistant gram negative infections which are increasingly pan-resistant and untreatable; the nearest thing we have yet experienced to a Doomsday bug .§This book is an excellent source of information for students, researchers and practitioners in infection control, hospital epidemiology, antimicrobial prescribing and microbiology.
