Antibiotic policy.
There is a clear association between antibiotic use and resistance both on individual and population levels. In the European Union, countries with large antibiotic consumption have higher resistance rates. Antibiotic resistance leads to failed treatments, prolonged hospitalisations, increased costs and deaths. With few new antibiotics in the Research & Development pipeline, prudent antibiotic use is the only option to delay the development of resistance. Antibiotic policy consists of prescribing strategies to optimise the indication, selection, dosing, route of administration, duration and timing of antibiotic therapy to maximise clinical cure or prevention of infection whilst limiting the unintended consequences of antibiotic use, including toxicity and selection of resistant microorganisms. A secondary goal is to reduce healthcare costs without adversely affecting the quality of care. The purpose of this paper is to provide the evidence base of prudent antibiotic policy. Special emphasis is placed on urinary tract infections. The value and support of antibiotic committees, guidelines, ID consultants and/or antimicrobial stewardship teams to prolong the efficacy of available antibiotics will be discussed.
Nijmegen Institute for Infection, Inflammation, and Immunity (N4i) and Department of Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. i.gyssens@aig.umcn.nl
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D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000191:economics / Q000592:standards*; D024881:Drug Resistance, Bacterial; D004358:Drug Therapy / Q000191:economics / Q000379:methods* / Q000592:standards*; D004363:Drug Utilization / Q000191:economics / Q000592:standards*; D005062:European Union; D017048:Health Care Costs; D006291:Health Policy; D006801:Humans; D016134:Organizational Policy; D014552:Urinary Tract Infections / Q000188:drug therapy*
D000900:Anti-Bacterial Agents