Fighting infection: an ongoing challenge, part 1.

Since the beginning of time, infections have been a major cause of disability and death of humans in every part of the world. For centuries, little was known about what caused infection, how to prevent infection, or how to cure infection. With the discovery of sulfa and penicillin in the 1930s, the ability to fight infection became reality. During the next six decades, antimicrobials were developed to fight bacterial, fungal, and viral infections. It truly seemed as if the battle against infection was won, until the rapid and global spread of drug resistance began to threaten the effectiveness of all currently available antimicrobials. A new phase of the war against infection began, and the search for methods of reducing the spread of drug resistance began. Today, it is apparent that identifying the agents of infection, understanding how antimicrobials are targeted against specific infectious organisms, and practicing the judicious application of antimicrobials will help reduce the threat of continued escalation of antimicrobial resistance. Part 1 of this three-part series will provide an overview of how antimicrobials are designed to target specific agents of infection and how drug resistance develops. Parts 2 and 3 will examine individual antibacterial, antifungal, and antiviral agents and the recommendations for their appropriate use.