Solutions to the problem of bacterial resistance.

Abstract

The recent increase in bacterial resistance has been, and continues to be, unmatched by drug discovery and development. The judicious use of antibacterials must be observed so as to contain bacterial resistance and maintain the utility of agents currently on the market. Appropriate antibacterial use involves antibacterial avoidance when not indicated. When indicated, appropriate antibacterial use dictates that the optimal drug, dose and duration be utilized. Professional society guidelines facilitate drug selection as well as outline diagnostic criteria and important considerations for patient stratification. Pharmacodynamics is also key for drug selection and often guides determination of not only the optimal drug but also the optimal dose and duration. Importantly, bacterial eradication is essential, as it will reduce clinical failure, recurrence, or relapse and prevent the selection of resistance. Additional strategies to influence antibacterial prescribing and use such as formal continuing medical education, printed educational materials, better diagnostic tests, and vaccination contribute to the efforts to minimize bacterial resistance and are also addressed.