I spent today at Mulago Hospital helping some of the Pharmacy Interns put the final touches on their learning case presentation to the other Interns on Hospital-Acquired Pneumonia.  After the presentation, I gave a talk on Antimicrobial Stewardship, which is how to use antibiotic drugs appropriately and effectively to treat patients without causing adverse consequences to the patient in terms of side effects and other infections. This practice also helps to avoid the development of resistant organisms.  You have probably heard the term MRSA (pronounced Mer-sah) as a serious and difficult to treat organism that can cause life-threatening infections, especially skin infections. There are also other organisms that can become resistant for which we have few drugs that kill them and those are very expensive. So, it is always important to use antibiotics judiciously, but it is even more important in a resource-poor environment like Uganda, so that the supply of drugs available will still work when needed.  Unfortunately, I suspect that there already is a serious problem with resistance with the antimicrobial drugs that are currently used.  One reason for this is that almost every infection is treated with the same 2 antibiotics.  It doesn’t matter if these are the most potent drugs, which they are not, any health system that doesn’t vary the antibiotics used will see the microorganisms become resistant.  There is definitely hope, though, if this can be studied, recognized, and the information used to make decisions about different drugs to keep in the hospital. Then, once new drugs are available, their use must be carefully considered.  When cultures of the offending microorganisms show that other, more basic antibiotics can be used successfully, the more potent drugs must be changed to protect their use for more difficult to treat organisms.