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Minimising antibiotic resistance

David M Livermore1

  • 1Antibiotic Resistance Monitoring and Reference Laboratory, Centre for Infections, Health Protection Agency, London NW9 5HT, UK. david.livermore@hpa.org.uk

The Lancet. Infectious Diseases
|June 28, 2005
PubMed

Insights

Reducing antibiotic prescriptions has not effectively curbed antibiotic resistance, with some bacteria becoming more resistant. Strategies must focus on using antibiotics less prone to resistance and encouraging new drug development.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Public Health Policy

Background:

  • Antibiotic resistance is a significant global health concern, prompting numerous reports and guidelines since 1998.
  • Efforts to reduce antimicrobial prescribing have been implemented in several countries, including the UK.
  • Despite reduced prescribing, evidence linking this to a decrease in resistance is limited, with some pathogens showing increased resistance.

Purpose of the Study:

  • To evaluate the effectiveness of reduced antimicrobial prescribing on antibiotic resistance.
  • To propose alternative strategies for managing antibiotic resistance.
  • To highlight the need for renewed antimicrobial drug development.

Main Methods:

  • Review of existing literature and governmental reports on antibiotic resistance and prescribing trends.
  • Analysis of the relationship between prescribing patterns and resistance development in key pathogens.
  • Examination of historical case studies, such as *Neisseria gonorrhoeae*, to understand guideline impacts.

Main Results:

  • A weak correlation between decreased antimicrobial prescriptions and reduced resistance has been observed.
  • Notable increases in resistance have been documented in pathogens like *Escherichia coli*.
  • Narrowly focused guidelines may inadvertently promote resistance by concentrating selection pressure.

Conclusions:

  • Over-reliance on simply reducing prescriptions may be insufficient to combat antibiotic resistance.
  • Prioritizing antibiotics with lower resistance selection potential and considering diverse prescribing practices are crucial.
  • Revitalizing antimicrobial research and development within the pharmaceutical industry is essential.

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