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Review
. 2013 Sep 12;10(9):4274-305.
doi: 10.3390/ijerph10094274.

Strategies to minimize antibiotic resistance

Chang-Ro Lee  1 , Ill Hwan Cho, Byeong Chul Jeong, Sang Hee Lee
Affiliations
Review

Strategies to minimize antibiotic resistance

Chang-Ro Lee et al. Int J Environ Res Public Health. .

Abstract

Antibiotic resistance can be reduced by using antibiotics prudently based on guidelines of antimicrobial stewardship programs (ASPs) and various data such as pharmacokinetic (PK) and pharmacodynamic (PD) properties of antibiotics, diagnostic testing, antimicrobial susceptibility testing (AST), clinical response, and effects on the microbiota, as well as by new antibiotic developments. The controlled use of antibiotics in food animals is another cornerstone among efforts to reduce antibiotic resistance. All major resistance-control strategies recommend education for patients, children (e.g., through schools and day care), the public, and relevant healthcare professionals (e.g., primary-care physicians, pharmacists, and medical students) regarding unique features of bacterial infections and antibiotics, prudent antibiotic prescribing as a positive construct, and personal hygiene (e.g., handwashing). The problem of antibiotic resistance can be minimized only by concerted efforts of all members of society for ensuring the continued efficiency of antibiotics.

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Figures

Figure 1
Figure 1
Regional proportions (%) of ESBL-producing bacteria (Escherichia coli, Klebsiella pneumonia, Klebsiella oxytoca, and Proteus mirabilis) isolated from patients with appendicitis: 2008–2010 results from the study for SMART with 95% confidence intervals.
Figure 2
Figure 2
(a) ESBL-producing rates (%) in Escherichia coli isolated from intra-abdominal infections in the Asia-Pacific region from 2002–2010 results from the study for SMART. (b) Resistance rates (%) for various antibiotics (CAZ: ceftazidime; CRO: ceftriaxone; EPM: ertapenem; IMP: imipenem) in Enterobacteriaceae isolated from intra-abdominal infections (IAIs) in the Asia-Pacific region from 2002–2010 (2002, blue; 2003, gray; 2004, green; 2005, purple; 2006, sky-blue; 2007, orange; 2008, black; 2009, pink; 2010, red) results from the study for SMART.
Figure 3
Figure 3
Resistance rates (%) for various antibiotics (CAZ, ceftazidime; CRO, ceftriaxone; EPM, ertapenem; IMP, imipenem) in Enterobacteriaceae isolated from urinary tract infections (UTIs) in the Asia-Pacific region from 2009–2010 results from the study for SMART.
Figure 4
Figure 4
The emergence of novel antibiotics.
Figure 5
Figure 5
Strategies to minimize antibiotic resistance. Education is the very important strategy. The multidisciplinary core group, including physicians, pharmacists, microbiologists, epidemiologists and infectious disease specialists, can be the teachers educating various members of society. ASPs, PK/PD, and MIC/MPC mean antimicrobial stewardship programs, pharmacokinetic/pharmacodynamics properties of drug, and the minimum inhibitory concentration/the mutant prevention concentration, respectively.
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