Controlling antimicrobial resistance in hospitals: infection control and use of antibiotics.
Antimicrobial-drug resistance in hospitals is driven by failures of hospital hygiene, selective pressures created by overuse of antibiotics, and mobile genetic elements that can encode bacterial resistance mechanisms. Attention to hand hygiene is constrained by the time it takes to wash hands and by the adverse effects of repeated handwashing on the skin. Alcohol-based hand rubs can overcome the time problem and actually improve skin condition. Universal glove use could close gaps left by incomplete adherence to hand hygiene. Various interventions have been described to improve antibiotic use. The most effective have been programs restricting use of antibiotics and computer-based order forms for health providers.
Weinstein
R A
RA
Cook County Hospital and Rush Medical College, Chicago, Illinois 60612, USA. rweinste@rush.edu
D000438:Alcohols / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy / Q000517:prevention & control*; D011307:Drug Prescriptions; D004352:Drug Resistance, Microbial; D004360:Drug Therapy, Computer-Assisted; D017575:Gloves, Protective; D006235:Hand Disinfection; D006801:Humans; D017053:Infection Control / Q000379:methods*
D000438:Alcohols; D000900:Anti-Bacterial Agents