ABSTRACT
Significant progress in critical care medicine has been the result of tireless observation, dedicated research, and well-timed serendipity. This article provides a historical perspective for four meaningful therapies in critical care medicine: blood transfusion, fluid resuscitation, vasopressor/inotropic support, and antibiotics. For each therapy, key discoveries and events that have shaped medical history and helped define current practice are discussed. Prominent medical and social pressures that have catalyzed research and innovation in each domain are also addressed, as well as current and future challenges.
Subject(s)
Anti-Bacterial Agents/history , Blood Transfusion/history , Cardiotonic Agents/history , Critical Care/history , Fluid Therapy/history , Vasoconstrictor Agents/history , ABO Blood-Group System/history , Animals , Anti-Bacterial Agents/therapeutic use , Carbapenems/history , Carbapenems/therapeutic use , Cardiotonic Agents/therapeutic use , Cephalosporins/history , Cephalosporins/therapeutic use , Critical Care/methods , Europe , Fluid Therapy/instrumentation , Fluid Therapy/methods , Fluoroquinolones/history , Fluoroquinolones/therapeutic use , Glycopeptides/history , Glycopeptides/therapeutic use , History, 16th Century , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , History, Ancient , Humans , Infusions, Intravenous/history , Isotonic Solutions/administration & dosage , Isotonic Solutions/history , Japan , Lipopeptides/history , Lipopeptides/therapeutic use , Military Medicine/history , Oxazolidinones/history , Oxazolidinones/therapeutic use , Ringer's Solution , United States , Vasoconstrictor Agents/therapeutic useABSTRACT
The quinolone class of antimicrobial agents has generated considerable interest since its discovery >40 years ago. Substantial progress has been made in our understanding of the molecular mechanisms of the action of quinolones against pathogenic bacteria, the induction of resistance to quinolones in these organisms, and the potential of each quinolone compound to induce toxicity in treated patients. Here, these key discoveries are reviewed; the present indications approved by regulatory agencies are described in detail, with comments on adverse events caused by quinolones in treated patients; and speculation about the future of the quinolones is proffered, even though their future is difficult to predict, because many factors may affect their clinical usefulness. However, the emergence of bacterial resistance to the quinolones is a major factor that will determine the future clinical effectiveness of these agents, so that intense investigation of mechanisms to either prevent or curtail resistance to quinolones is of prime importance to their future.
