Have guidelines had an impact on antimicrobial resistance?
Treatment guidelines can influence and improve clinical practice. Originally, guidelines did not specifically address the problem of antibiotic resistance. A number of studies have shown a reduction in the frequency of antibiotic resistance after the implementation of programs for reduced antibiotic consumption. In future guidelines, reduction of antibiotic resistance should be 1 of the primary objectives to be achieved. It will be critical to better define when not to use antimicrobials and to create graded recommendations (strong evidence vs weak evidence) of the different antibiotic options for a given indication with respect to their eradicating power. Also, pharmacokinetics/pharmacodynamics parameters should be used to design the optimal dosing and dosing intervals. Duration of therapy should become an important consideration not only from the pharmacoeconomic point of view but also from an ecologic one. Finally, appropriate endpoints to measure the impact of the intervention should be included.
Garau
J
J
Department of Medicine, Hospital Mutua de Terrassa, University of Barcelona, Barcelona, Spain. jgarau@retemail.es
D004352:Drug Resistance, Microbial; D006801:Humans; D017410:Practice Guidelines as Topic; D013296:Streptococcus pneumoniae / Q000187:drug effects*