[Antibiotic resistance and community-acquired infections].

The selective pressure of extended broad-spectrum antibiotic administration is leading to a progressively growing selection of common gram-positive and gram-negative organisms which show unpredictable in vitro antimicrobial susceptibility levels to current first-line therapeutic choices. This phenomenon is examined from an epidemiological, microbiological, therapeutical, and pharmacoeconomic point of view, focusing our attention on the most common community-acquired infectious diseases interesting upper and lower airways, genito-urinary and gastrointestinal tract, skin and soft tissues. A broad spectrum of variables is responsible for this ever changing scenario, whose solution cannot be entrusted to the development of new compounds, but it first relies on a rational and judicious administration of existing molecules, and an expanded medical and patient interaction aimed at avoiding overprescription of antimicrobial agents.