Infection of the lower respiratory tract is a major determinant of the course of cystic fibrosis. Although numerous efforts have been made to elucidate the specific mechanisms predisposing the respiratory mucosa of cystic fibrosis patients to infection, so far no clinically relevant procedures for completely effective prevention or control of infection have resulted. Hence, in dealing with infections in cystic fibrosis, we continue to rely mainly on antimicrobials. Antiinfective measures are inseparably correlated with microbiology, and the quality of antiinfec tive therapy directly reflects the quality of microbial monitoring. Vali dated guidelines for microbiologic testing and antiinfective use need to be developed and made available to all health providers and their cystic fibrosis patients. Several years ago, the editors cochaired a symposium at the Interna tional Congress of Chemotherapy on the Global Perspectives of Micro biological and Clinical Infectious Diseases in Patients with Cystic Fibrosis. During this half-day symposium, the editors heard reports from several countries around the world with an alarming range of survival for patients with cystic fibrosis. This sent a dramatic message to us that the understanding of this disease, its diagnosis, management and prevention was different in various countries and that patients may be inconsistently served. That is how our journey began."

Comprehensive Manuals in Pediatrics are designed to broaden the prac titioner's clinical scope by providing a wide range of diagnostic and management skills ordinarily considered to be the exclusive domain of the specialists. Although the series as a whole constitutes a comprehensive text in pediatrics, each volume stands on its own as a self-contained reference for the busy practitioner. In order to maintain a uniform style and coverage of each subject, each manual is usually written by no more than one or two authors. Each author is an acknowledged expert in his or her field and provides a comprehensive, up-to-date account of the topic under discussion. Prac tically oriented, each volume offers concise guidelines and courses of treatment. Michael Katz E. Richard Stiehm Preface The preface-my opportunity to rationalize this labor, titillate the reader, philosophize or otherwise self-indulge. I'll take full advantage. Why write a book? After fifteen years' experience as an infectious disease consultant, teacher and researcher, I feel it is time to speak out I have spent the majority of my waking hours thinking, reading and writing about childrens' infectious disease problems, have amassed a veritable Fort Knox of publications on the subject and have been reasonably out spoken. Yet the field continues to progress with reckless speed and the gaps between our knowledge and effective communication of new infor mation remain wide. I am eager to accept more responsibility for teaching yet my audience has been limited."