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Antimicrobial Drug Resistance: Burden, Outcomes, Economics, and Antibiotic Stewardship Po-Ren Hsueh Divisions of Clinical Microbiology and Infectious Diseases, Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan Antimicrobial resistance has become a major health problem worldwide, but marked variations in resistance profiles of bacterial pathogens are found among countries and in different patient settings, especially in Asia-Pacific. The emerging problem of methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase (ESBL)-producing and/or quinolone-resistant Escherichia coli and Klebsiella pneumoniae isolates is substantial. Extensively drug-resistant (XDR, resistant to all antibiotics available but one or two) Gram-negative bacilli of clinical importance include K. pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia. Combination therapy with at least one in vitro active agent for invasive XDRGNB infections is usually recommended. Antibiotic resistance is not always, but usually, associated with significant morbidity, longer hospitalization, excess costs and mortality. Excess costs associated with resistant microorganisms may be due to obligation to use more expensive antibiotics, longer hospital stay, higher mortality, delayed appropriate antibiotic therapy, and a necessity to perform surgery. The discovery of new drugs active against hospital-acquired XDRGNB infections to prevent a future medical, social, and economic catastrophe is ongoing. In the interim, appropriate use of currently available antibiotics (antibiotic stewardship) and strict adherence of adequate infection control policy are crucial.