Antimicrobial resistance: a plan of action for community practice.
Antibiotic resistance was once confined primarily to hospitals but is becoming increasingly prevalent in family practice settings, making daily therapeutic decisions more challenging. Recent reports of pediatric deaths and illnesses in communities in the United States have raised concerns about the implications and future of antibiotic resistance. Because 20 percent to 50 percent of antibiotic prescriptions in community settings are believed to be unnecessary, primary care physicians must adjust their prescribing behaviors to ensure that the crisis does not worsen. Clinicians should not accommodate patient demands for unnecessary antibiotics and should take steps to educate patients about the prudent use of these drugs. Prescriptions for targeted-spectrum antibiotics, when appropriate, can help preserve the normal susceptible flora. Antimicrobials intended for the treatment of bacterial infections should not be used to manage viral illnesses. Local resistance trends may be used to guide prescribing decisions.
University of Washington School of Medicine, Seattle, USA. apua@opal.tufts.edu
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D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003154:Community Medicine / Q000592:standards; D004352:Drug Resistance, Microbial; D004363:Drug Utilization / Q000592:standards*; D005194:Family Practice / Q000592:standards*; D006300:Health Services Misuse; D006801:Humans; D010033:Otitis Media / Q000188:drug therapy; D010353:Patient Education as Topic; D018579:Patient Selection; D010818:Practice Patterns, Physicians'; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000821:virology; D014552:Urinary Tract Infections / Q000188:drug therapy
D000900:Anti-Bacterial Agents