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Antimicrobial agents are essential for the treatment of life-threatening infections and for managing the burden of minor infections in the community. In addition, they play a key role in organ and bone marrow transplantation, cancer chemotherapy, artificial joint and heart valve surgery. Unlike other classes of medicines, they are vulnerable to resistance from mutations in target microorganisms, and their adverse effects may extend to other patients (increased risk of cross-infection). As a consequence, there is a constant requirement for new agents, as well as practices that ensure the continued effective prescribing of licensed agents. Public awareness and concerns about drug resistant organisms has led to widespread publicity and political action in the UK, Europe and worldwide. The control of drug resistance and the implementation of good prescribing practice are now legal requirements in the UK as a result of the UK Health Act (2008). These fundamental changes underscore the need for a thorough understanding of the advantages and risks associated with specific antibiotic choices. This sixth edition of Antimicrobial Chemotherapy continues to be a valuable resource for undergraduates and graduates requiring a thorough grounding in the scientific basis and clinical application of these drugs. This new edition is updated to include the most recently licensed agents, notably in the treatment of viral infections including HIV/AIDS, and contains new guidance on prescribing practice and infection control practices that limit the development and spread of resistant organisms. * An essential guide to the principles of antimicrobial chemotherapy, providing an aid to informed, rational prescribing * Covers the basic properties of antibacterial, antifungal, antiparasitic and antiviral (including antiretroviral) drugs * Provides a historical introduction, to place the subject in context * Therapeutic use is covered, both the general principles and site-specific, practical advice * Includes commentary on the way drugs are developed and marketed * Covers issues specific to both the developed and developing world New to this edition * A complete revision and update of a highly acclaimed textbook of antimicrobial chemotherapy * Includes new agents and therapeutic insights * Updated guidelines, formularies and antimicrobial drug policies, including legal requirements in the UK as a result of the UK Health Act (2008) * Includes Key Points at the end of each chapter to aid with understanding * Includes two completely new chapters on antiviral drugs and the treatment of viral hepatitis Roger Finch , Professor of Infectious Diseases, University of Nottingham and Nottingham University Hospitals NHS Trust, Peter Davey , Lead Clinician for Clinical Quality Improvement Quality Safety and Informatics Research Group, Dundee, Mark H. Wilcox , Consultant, Clinical Director of Microbiology and Pathology, Leeds Teaching Hospitals NHS Trust; and Professor of Medical Microbiology, University of Leeds, and William Irving , Professor and Honorary Consultant in Clinical Virology, University of Nottingham and Nottingham University Hospitals NHS Trust CONTENTS Historical Introduction Preface Part One - Antimicrobial chemotherapy - the agents and their general properties 1: Inhibitors of bacterial cell wall synthesis 2: Inhibitors of bacterial protein synthesis 3: Synthetic antibacterial agents and miscellaneous antibiotics 4: Antivirals - an introduction 5: Antiviral drugs 6: Anti-HIV Agents 7: Antifungal agents 8: Antiprotozoal and anthelminthic agents Part Two - Antimicrobial chemotherapy - drug resistance, impact and control 9: The problem of resistance 10: The genetics and mechanisms of acquired resistance 11: Control of the spread of resistance Part Three - Antimicrobial chemotherapy - the science and practice of use 12: Laboratory investigations and the treatment of infection 13: General principles of the treatment of infection 14: Pharmacokinetic and pharmacodynamic principles 15: Prescribing in children and the elderly 16: Outpatient Parenteral Antibiotic Prescribing 17: Adverse drug reactions 18: Preventing infection - chemoprophylaxis and immunoprophylaxis (immunisation schedule) 19: Guidelines, formularies and antimicrobial policies 20: Antimicrobial stewardship and the multi-professional antimicrobial management team Part Four - Antimicrobial chemotherapy - their therapeutic use 21: Respiratory tract infections 22: Topical use of antimicrobial agents 23: Urinary tract infections 24: Sexually transmitted infections 25: Gastrointestinal infections 26: Serious blood stream infections 27: Infections of the bones and joints 28: Infections of the central nervous system 29: Infections of the skin and soft tissues 30: Tuberculosis and other mycobacterial diseases 31: Infections in the immunocompromised patient including HIV/AIDS 32: Viral infections 33: HIV infections 34: Viral hepatitis 35: Parasitic diseases 36: ostscript: the development and marketing of antimicrobial drugs