From a variety of contacts with hospital infection control personnel, it has become clear to us that the historical perspective about and internal workings of the Food and Drug Administration (FDA) are confusing and deserve clarification. The accompanying article in this issue (“Regulation of TopicalAntimicrobials: History, Current Status and Future Perspective,” pp. 505-508) details the regulation of topical antimicrobial drugs administered by the FDA. We believe it is necessary to provide a special context for this article.

I have two major concerns about the immunocompromised host field in 1989. The first relates to the tremendous impact that acquired immunodeficiency syndrome (AIDS) has had on nosocomial infections and the management of hospitalized patients. It is a major consideration in screening patients for organ transplants. Concern about AIDS influences all aspects of blood transfusion therapy.

The second concern relates to the increasing demand for expensive technologically-oriented procedures involved in the management of immunocompromised hosts. I believe the demand for these approaches is irresistible and adds to the mounting problems that hospitals face in containing basic costs. Since there is a finite dollar available for medical expenses, 1 see these demands exacerbating the rationing of medical resources.

It is not difficult to predict the future of hospital epidemiology. It will become increasingly important. The need to prevent and control hospital-acquired infections and to protect the staff from communicable diseases will grow. Hospitals will continue to be filled with patients, life-prolonging technical advances will continue to be introduced, resistance will emerge to the new antimicrobial agents, the number of patients with acquired immunodeficiency syndrome (AIDS) will increase and the population will continue to age. Concomitant increases in costs and demands for accountability and for quality assurance will occur (Table 1).

The future for practitioners of hospital epidemiology is less assured. We will have to continue to convince hospital administrators that we are more than “bean counters” engaged mainly in surveillance. We must assure them that the benefits of our work justify the costs of maintaining effective infection control units and that we are dedicated to prevention and control.

Over several years, I have used microcomputers for most of my statistical analyses. This article is a summary of some of my preferences and thoughts from this experience. Some of the ideas expressed here, of course, are distillations and re-expressions of the thoughts of others.

When you use a microcomputer for your analyses, you assume all the roles traditionally associated with a computer center. You are responsible for the purchase of your machines, supplies and program selection. One problem that may arise is that you may not have a program you need or it may not exist in a version for your computer. If this is the case, you must either find a program that does the job you want or move the data set to a different computer. This problem is less severe now than it was a few years ago because many major statistical packages are available.