Epidemiology of antibiotic resistance

Antimicrobial resistance has been found since 1910. Mechanisms responsible for the resistance antedate introduction of antibiotics. However, proliferation of resistant strains can be closely linked to patterns of antibiotic use. This is seen most often in the hospital setting. Infection control personnel should monitor: (1) antibiotic resistance at least four times per year; (2) key bacteria for multi-drug resistance; and (3) certain index drugs where emergence of resistance may be critical. If a problem with resistant strains develops, the following steps should be taken: (1) identify and decrease inappropriate antibiotic use; (2) segregate patients harboring resistant strains; and (3) consider elimination of certain or all antibiotics.