Antimicrobial misuse—effects and suggestions for control

Winnipeg’s Tertiary Care Centres’ Program for the Prevention of Antimicrobial Resistance

“…Thus, an antimicrobial stewardship program should serve as a vehicle for the rational management of antimicrobial use. Discrimination of antimicrobial use has been advocated for prevention of the emergence of antimicrobial-resistant microorganisms (2)(3)(4). Various groups have recommended antimicrobial control methods as ways to slow down the emergence of antimicrobial-resistant bacteria (5)(6)(7).…”

Low-Cost Medical Practices

“…They also entail risk of side effects, occasionally fatal. Widespread use of antimicrobials has altered the ecology of bacterial infections, and produced a reservoir of antimicrobial-resistant bacteria in modern hospitals (59)(60)(61). Thus, use of antimicrobial agents entails short-run and long-run risks, costs, and benefi ts to both present and future patients.…”

“…Responses to the problem of antimicrobial misuse in hospitals include establishing infectious disease committees, monitoring use of various agents, setting dosage limits in the pharmacy to prompt discussion with the ordering physician, and instituting educational programs (59,60,67).…”

Should Topical Antibiotics Be Used for the Treatment of Acne Vulgaris?

“…The effect of introducing a topical preparation of an antibiotic already in oral use on the level of antibiotic resistance among pathogenic bacteria has been vividly demonstrated with gentamicin. Strains of gentamicin-rcsistant 5. aureus began to emerge after several years of indiscriminate topical use (Warren & Roberts, 1976;Wyatt et al, 1977;Buckwold & Ronald, 1979;Lancet, 1981). These strains often showed multiple resistance and have been responsible for several outbreaks of S. aureus infection (Speller et al, 19761 Bint et al, 1977;Wyatt et al, 1977;Lewis & Altmeier, 1978;Graham et al, 1980).…”