Promoting appropriate antimicrobial drug use: Perspective from the Centersfor Disase Control and Prevention

Extending the useful life of antimicrobial drugs through appropriate use-th at is, use that maximizes therapeutic impact while minimizing toxicity and the development of resistance-is an important component of efforts to preve nt and control the emerging threat of antimicrobial resistance. The major p aradigms of antimicrobial drug use involve acute infections in outpatients, acute infections in inpatients, chronic infections, and agriculture/veteri nary medicine. The factors that influence drug use and the challenges that need to be addressed in promoting more appropriate use are different in eac h of these paradigms. For acute respiratory infections in outpatients, data from intervention trials suggest that concurrent multifaceted intervention s may be effective in promoting appropriate drug prescribing. The next chal lenge is to extend these interventions to larger populations by incorporati ng them into routine medical practice.