Implementation of strategies to control antimicrobial resistance

Antimicrobial resistance has emerged as a major public health issue in rece nt years. A steady increase in resistance continues despite the introductio n of new antibiotics, and resistant bacteria have been associated with incr eased patient morbidity and mortality as well as with increased costs. Addr essing the problem of antimicrobial resistance requires both infection cont rol and regulation of antibiotic use; addressing either alone is insufficie nt, Mounting evidence shows that control of the use of broad-spectrum antib iotics (especially vancomycin and third-generation cephalosporins) and impl ementation of infection control measures can result in decreased incidence of antibiotic-resistant bacteria such as vancomycin-resistant enterococci a nd extended-spectrum beta -lactamase-producing Escherichia coli and Klebsie lla. Recent reports from professional organizations and a consensus of expe rts have outlined strategies for the control of resistance in hospitals, wi th specific measures identified for antibiotic control and infection contro l, These reports have emphasized the importance of a multidisciplinary appr oach in tackling this problem in hospitals and have suggested that a qualit y-improvement model be used to address antimicrobial resistance, A close co llaboration among the disciplines of infectious diseases, microbiology, hos pital epidemiology; pharmacy, and nursing, with particular emphasis in ICUs , and with strong support from hospital leadership, can result in an effect ive program that can be readily incorporated into the quality-improvement g oals of any health-care organization.