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Resistant Infections, edited by Debra A. Miller. 200 pgs. Farmington Hills, MI: Greenhaven Press, 2009. ISBN: 978-0-7377-4464-4

Alexander Fleming’s 1928 discovery of penicillin, the first antibiotic, marked a new era in medicine. That "wonder drug" and its counterparts proved remarkably effective against infections, yet over-use of antibiotics today is threatening their efficacy against disease. This Current Controversies volume offers an examination of factors believed to threaten antibiotic effectiveness, exploring the mechanisms proposed to preserve these powerful pharmaceuticals for the most desperate cases.

Hospital-born infection is more deadly than automobile collisions. Almost five percent of hospital patients will develop some type of infection, with as many as 90,000 people each year dying from them. The most common and well-known of these resistant infections is Staphylococcus aureaus, known commonly as staph. Health care settings are particularly concerned about the methiclinn-resistant variety of staph (MRSA). Though the effects of infection vary radically in each individual, they may prove deadly in otherwise health people.

More individuals are contracting resistant infections in non-clinical settings, through what is known as "community acquisition." These sorts of infections, which can manifest as relatively benign-looking pimples or boils, can pose a public health crisis for schools. MRSA and other infections are so rampant in the U.S. that all Americans can be assumed to be carriers of drug-resistant microbes. Journalist Arthur Allen provides a vivid description of how Americans hospitalized abroad can be treated as infection-carrying bio-hazards until proven otherwise through comprehensive testing. Resistant infections are not limited to humans and are developing and passing among pet populations in the same household or veterinary clinic.

The drug-resistance is linked to a number of factors derived from the current medical system. Articles describe how doctors often treat viral upper-respiratory infections with antibiotics, because patients vociferously demand quick-acting pharmaceuticals which are really only appropriate for severe bacterial infections. Other pieces share post-prescription warnings about patients not finishing courses of antibiotics after symptoms abate and flushing leftover pharmaceuticals into the water supply. Because of the protracted timeline for developing new pharmaceuticals and relatively small patient population for a pharmaceutical treating, say, resistant tuberculosis, the antibiotic field is not a priority for pharmaceutical development. The medical community calls for outside investment in research with incentivization for minimizing the use of the antibiotics which are often the company’s own product.

The preface in this volume of the Current Controversies series suggests its suitability in "controlled research" settings, describing a variety of projects requiring solid information resources and supporting materials. One topic sure to engage students emerges from the third of the book’s four sections, which tackles the sub-therapeutic use of antibiotics in meat production. One side argues that the levels of antibiotics are "not effective when disease is absent," while others suggest that current additive use of antibiotics to promote feed efficiency is not really economically viable given the demand for premium products without antibiotics. Given the process and timeline for drug approvals to feed additives described, antibiotic additives in place for decades would take almost as long to eliminate from the food supply. European producers have banned similar supplements to eliminate the interplay of antibiotic resistance and the food chain. This title offers an eye-opening look into the politics and industrial influences underpinning American agriculture, as well as background information in this important topic. As public health decisions are sure to come under scrutiny given the H1N1 outbreaks and public option proposals, Resistant Infections is a solid supplemental resource for schools and public libraries.