Antibiotic resistance. An impending crisis.

The global emergence of antimicrobial resistance has become a pre-eminent concern in medicine and public health. Antimicrobial resistance is of particular concern because the problem is widespread, the causative factors are uncontrolled, and national strategies to address the problem are lacking. The persisting burden of infectious diseases makes elimination of antibiotic use unethical, but dramatic overuse and misuse of antimicrobial agents around the world must be reduced to extend the useful lifetimes of these drugs. Population genetic models suggest that resistance emerges rapidly under the selective pressure of antibiotics, but decays slowly once that pressure is removed. Hence, measures to prevent the emergence of resistance must be implemented urgently. A multiplicity of factors drive antibiotic resistance, and solutions require the collaboration of governmental agencies, the pharmaceutical companies, healthcare providers, and consumers. Leadership in the form of a national steering committee on antimicrobial resistance is needed in the Kingdom of Saudi Arabia to guide collective action to control the threat of antibiotic resistance.