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JAC Advance Access published online on December 1, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh506
© 2004 by The British Society for Antimicrobial Chemotherapy
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Leading article

Antibiotic cycling: more than it might seem?

Robert G. Masterton 1*

1 Ayrshire and Arran Acute Hospitals Trust, Crosshouse Hospital, Kilmarnock, Ayrshire KA2 0BE, UK

* To whom correspondence should be addressed.
Robert G. Masterton, E-mail: robert.masterton{at}aaaht.scot.nhs.uk


  Abstract

In the present battle against the rising tide of resistance, several interventions have been proposed to help control the situation. One of these is a process of planned antibiotic restriction, introduced through cycling drug selection based on local surveillance. Although such antibiotic cycling has been the subject of much discussion for 20 years, there are relatively few data available to assess its worth. A recent systematic review found only four studies worthy of inclusion and concluded that antibiotic cycling could not, at present, be promoted as a methodology to control resistance. This paper considers the complete literature and through demonstrating consistent benefits across the breadth and depth of the findings, suggests that whereas further work is required, nevertheless antibiotic cycling--as part of a suite of control measures--is a valid option.

Keywords: resistance; nosocomial infections; prescribing practice.
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