By Iosifina Giannakikou, MD

Dr. Giannakikou is an anesthesiologist and critical care physician who divides her time between Johns Hopkins Hospital, Baltimore, and Hygeia Hospital and Mitera Hospital, both in Athens, Greece.

Greece is a small country with some big problems—and one of them is the incidence of multidrug-resistant pathogens. Although there is a worldwide increase in the infections caused by multi-resistant gram negative pathogens, the pathogens’ high incidence and upstream rise from previous studies in Greece are particularly concerning.

The Greek System for the Surveillance of Antimicrobial Resistance (GSSAR) provides alarming data about these pathogens. Extended-spectrum β-lactamase Enterobacteriaceae are becoming an epidemic in the country.

By Milena Griffith, PharmD, BCPS

As we reported in Pulmonary Reviews Milena Griffith, PharmD, BCPS, from Midwestern University and Northwestern Memorial Hospital, Chicago, and colleagues wrote a review article published in the March Clinical Infectious Diseases about how anti-infective medication shortages can affect patient care and the measures the US government is taking to prevent deficits. Griffith elaborates on these issues in her commentary below. (You can also listen to her audiocast.) Please weigh in with your opinion on the topic in the comments.

The introduction of the HR 3839 Drug Shortage Prevention Act of 2012 marks the third legislative bill to be put before Congress regarding the issue of overall drug shortages. The large amount of attention that has been directed towards this topic is due to the increase in the number of shortages and the potential impact on patient care.

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How often are patients given inappropriate care? According researchers in the January 23 Archives of Internal Medicine, the overuse of medical services—that is, the provision of healthcare services for which the harm outweighs the benefit to the patient or provides no added advantage—may be a bigger problem than is realized. However, there are few studies that describe the overuse of care, they said.

Deborah Korenstein, MD, from Mount Sinai School of Medicine, New York City, and colleagues conducted a literature review and found 172 articles encompassing 241 studies of on the overuse of medical services. The types of services examined in the studies included the following:

• Therapeutic procedures (eg, coronary artery bypass grafting, coronary angiography, carotid endarterectomy)
• Diagnostic tests (eg, upper endoscopy, colonoscopy, plain film radiography, prostate-specific antigen testing)
• Administration of medications and other therapeutics (eg, antibiotics, bronchodilators, acid blockers)