JAC Advance Access published online on July 1, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh340
© 2004 by The British Society for Antimicrobial Chemotherapy
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1 City Hospital, Birmingham, UK
* To whom correspondence should be addressed. E-mail: r.wise{at}bham.ac.uk.
Antibiotics have undoubtedly made a major contribution to improvements in both human and animal health and welfare. Recent years have brought alarming rises in the prevalence of resistance to some agents among certain groups of bacteria. Concern is growing that therapeutic options will become increasingly limited if resistance rates continue to rise. There is widespread agreement that action is required to reverse or at least slow this process. Necessary steps to manage the situation include better surveillance to assess accurately the extent of problems, more prudent use of the available antibiotics to conserve valuable therapeutic resources and improved infection control to limit the spread of resistant organisms. Achieving these goals will not be possible without government, the medical profession and the public being better informed and educated. Regulatory bodies and the pharmaceutical industry need to work together to ensure a steady supply of new antimicrobials. Our understanding of the processes driving resistance at both the molecular and population levels is advancing. However, the relative contributions of the various uses of antimicrobials to the resistance problem and which will be the most effective containment measures are still hotly debated. Progress is being made, but continued concerted action is necessary if the usefulness of this most important group of therapeutic agents is to be preserved.
The 2003 Garrod Lecture
The relentless rise of resistance?
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