By Paul P. Cook, MD, FACP, FIDSA

Antimicrobial resistance is part of natural selection and has existed for millennia. The development of antimicrobial agents over the past 80 years has only intensified the problem. Antibiotic resistance occurs in the community and the hospital setting. In the community, the clinician usually is faced with quinolone-resistant Escherichia coli urinary tract infections, methicillin-resistant Staphylococcus aureus (MRSA) skin infections, and macrolide-resistant