The emerging global problem of antimicrobial resistance has multiple aspects and involves multiple pathogens. One common theme is that antimicrobial drug use exerts selective pressure favoring the emergence of resistance. Strategies to prevent the development and spread of antimicrobial resistance depend on the pathogens. For bacterial respiratory tract pathogens (eg, Streptococcus pneumoniae), controlling outpatient antimicrobial use is crucial1-3; for some enteric pathogens (eg, Salmonella), limiting antimicrobial use in animals is important4,5; and, for pathogens that cause nosocomial infections, improving inpatient antimicrobial use and infection control practices is necessary.6 Addressing antimicrobial use and resistance is one of the most urgent priorities in confronting emerging infectious disease threats.7,8
See also p 901.
Respiratory infections account for more than three quarters of the antimicrobial drug prescriptions written annually in physicians' offices.9 In this issue of JAMA, Gonzales et al10 identify antibiotic prescribing for adults with colds, nonspecific
Schwartz B, Bell DM, Hughes JM. Preventing the Emergence of Antimicrobial ResistanceA Call for Action by Clinicians, Public Health Officials, and Patients. JAMA. 1997;278(11):944-945. doi:10.1001/jama.1997.03550110082041