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Illustration by George Folz, © 2019 Board of Regents of the University of Wisconsin System


The term infectious diseases is used to describe illnesses caused by microorganisms, such as viruses, bacteria, parasites, or fungi, that can be transmitted by animals, insects, food, or other people.1 Although tremendous strides have been made toward controlling and treating infectious diseases, this broad category of disease still ranks as the second leading cause of death worldwide.2 In the United States, it ranks third collectively.3 While death rates have declined since the 1980s, substantial differences exist according to geographic region.4,5 Patients of any age, background, gender, or ethnicity can be at risk of acquiring an infectious disease. That said, those who are at highest risk of infections and their complications include young children and the elderly, people with compromised immune systems caused by medications or secondary to another health condition (e.g., cancer, human immunodeficiency virus [HIV]), and individuals who engage in high-risk behaviors such as those depicted in Illustration 8-1.

Due to the frequency of infectious diseases, all health professionals should be capable of recognizing common infections, such as respiratory and skin infections, and have the requisite knowledge to refer patients for specialty care when warranted. Infectious diseases (ID) specialists play an important role in the study, treatment, control, and prevention of complicated cases.6 Pharmacists in ID can serve as clinical specialists within the interprofessional ID team, as depicted in the illustrated cases “Wounded” and “Superinfection” in this chapter, and/or antimicrobial stewardship pharmacists. Pharmacists who run antimicrobial stewardship programs (ASPs) coordinate the safe, effective, and judicious use of antimicrobial medications used throughout entire healthcare organizations.7 Broadly speaking, the term antimicrobial is used to capture all medications intended to treat infectious diseases; this includes antibiotics (antibacterials), antifungals, antivirals, and antiparasitic agents.

From the early 1900s until now, there has been a nearly 30-year increase in life expectancy in the United States.8 Improvements in public health, coupled with the discovery, development, and commercialization of antimicrobial medications are the key reasons for this positive change. Antimicrobials have ushered in the modern era of medicine and are now essential to perform both general and sophisticated patient care; for example, childbirth, surgery, treatment of cancer, and solid organ or bone marrow transplantation. However, the rising and rapid spread of antimicrobial resistance worldwide and limited development of new antimicrobial medications have combined to become a significant threat to global health.9

Antimicrobial resistance describes the unfortunate situation whereby a once-effective antimicrobial medication ceases to work.10 This has long been recognized as a consequence of unnecessary and inappropriate antimicrobial use. The World Health Organization estimates that 10 million deaths will be attributable to antimicrobial resistance every year by 2050.11 In 2019, the US Centers for Diseases Control and ...

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