Global Burden of Antimicrobial Resistance

Analysis of the global burden of antimicrobial resistance may give answers to several questions important for treatment decisions: Does overall antibiotic consumption drive antibiotic resistance? Why are there differences in consumption between countries? Are there differences between penicillins, cephalosporins, and macrolides in terms of resistance induction? Antibiotic consumption appears to correlate with increases in antibiotic resistance, particularly for Streptococcus pneumoniae, and this is most clearly observable in data from the European Surveillance of Antimicrobial Consumption study in Europe. Of the various factors that influence antibiotic consumption, the physician/patient relationship is key. A patient-education campaign in Belgium to promote patient understanding of the appropriate use of antibiotics had dramatic effects on the level of prescribing. Mathematical models of antibiotic resistance demonstrate that antibiotic treatment can increase the transmission of resistant bacteria within a population, even when treated individuals have no increased risk of resistance. Antimicrobial agents that can eradicate resistant and susceptible strains have a theoretical advantage in these models, in terms of reducing the risk of transmission of resistance in the community. However, further studies are required to provide definitive data comparing different antibiotic classes. (Adv Stud Med. 2006;6(7C):S644-S651)