Resistance: Effectiveness of Current Interventions

There is a demonstrated link between antibiotic resistance and the overuse of antibiotics. In addition, antibiotic misuse, such as the use of an inappropriate antibiotic or patients failing to complete their therapy, may also promote antibiotic resistance. Strategies are needed to tackle current and expected levels of resistance and to slow the development of antibiotic resistance. The 2 main strategies to address resistance are the development of new antibiotics that target resistant bacteria and better clinical practice. To encourage pharmaceutical companies to develop new antibiotics, it will be necessary to use economic incentives, such as the Bioshield 2 “wild card” scheme, and improve the regulatory environment. Better clinical practice includes improved diagnosis of bacterial and viral infections; use of the appropriate antibiotics in situations in which there is proven benefit, through the use of guidelines or protocols; and promotion of patient compliance. Vaccine may be an effective strategy for some resistant organisms. The 7valent pneumococcal conjugate vaccine has had a major effect in reducing resistant pneumococcal infections in children, and herd immunity has helped protect unvaccinated children and adults. However, there are still concerns about increases in disease caused by nonvaccine serotypes, particularly 19A, which mean that appropriate antibiotic use programs are still vital. (Adv Stud Med. 2006;6(7C):S659-S666)