title: Strategies to minimize antibiotic resistance.
abstract: Antibiotic resistance can be reduced by using antibiotics prudently based on guidelines of antimicrobial stewardship programs (ASPs) and various data such as pharmacokinetic (PK) and pharmacodynamic (PD) properties of antibiotics, diagnostic testing, antimicrobial susceptibility testing (AST), clinical response, and effects on the microbiota, as well as by new antibiotic developments. The controlled use of antibiotics in food animals is another cornerstone among efforts to reduce antibiotic resistance. All major resistance-control strategies recommend education for patients, children (e.g., through schools and day care), the public, and relevant healthcare professionals (e.g., primary-care physicians, pharmacists, and medical students) regarding unique features of bacterial infections and antibiotics, prudent antibiotic prescribing as a positive construct, and personal hygiene (e.g., handwashing). The problem of antibiotic resistance can be minimized only by concerted efforts of all members of society for ensuring the continued efficiency of antibiotics.
authors.affiliation: Department of Biological Sciences, Myongji University, 116 Myongjiro, Yongin, Gyeonggido 449-728, Korea. crlee@mju.ac.kr
authors.forename: Chang-Ro
authors.initials: CR
authors.lastname: Lee
authors.forename: Ill Hwan
authors.initials: IH
authors.lastname: Cho
authors.forename: Byeong Chul
authors.initials: BC
authors.lastname: Jeong
authors.forename: Sang Hee
authors.initials: SH
authors.lastname: Lee
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001419:Bacteria / Q000187:drug effects; D001424:Bacterial Infections / Q000188:drug therapy; D004352:Drug Resistance, Microbial; D006266:Health Education; D006282:Health Personnel / Q000193:education; D006801:Humans; D006920:Hygiene; D010353:Patient Education as Topic; D010818:Practice Patterns, Physicians'; D014730:Veterinary Medicine
chemical_list: D000900:Anti-Bacterial Agents
references.citation: Science. 2011 Nov 4;334(6056):670-4
references.pmid: 22053049
references.citation: FEMS Microbiol Ecol. 2010 Sep;73(3):601-10
references.pmid: 20579100
references.citation: J Crit Care. 2010 Mar;25(1):69-77
references.pmid: 19427167
references.citation: Infect Control Hosp Epidemiol. 2003 Oct;24(10):765-8
references.pmid: 14587940
references.citation: BMJ. 2010 May 18;340:c2115
references.pmid: 20483950
references.citation: Infect Control Hosp Epidemiol. 2009 Oct;30(10):931-8
references.pmid: 19712032
references.citation: Virulence. 2013 Feb 15;4(2):192-202
references.pmid: 23361336
references.citation: Clin Infect Dis. 2004 May 1;38(9):1279-86
references.pmid: 15127341
references.citation: Antimicrob Agents Chemother. 2006 Feb;50(2):596-9
references.pmid: 16436715
references.citation: Clin Infect Dis. 2006 Jan 15;42 Suppl 2:S82-9
references.pmid: 16355321
references.citation: Int J Infect Dis. 2005 Jan;9(1):3-14
references.pmid: 15603990
references.citation: FEMS Microbiol Rev. 2011 Sep;35(5):977-91
references.pmid: 21722146
references.citation: Eur J Clin Microbiol Infect Dis. 2012 Nov;31(11):3079-83
references.pmid: 22722765
references.citation: Infect Control Hosp Epidemiol. 2012 Apr;33(4):374-80
references.pmid: 22418633
references.citation: Environ Microbiol. 2006 Jul;8(7):1137-44
references.pmid: 16817922
references.citation: Cell Host Microbe. 2008 Oct 16;4(4):337-49
references.pmid: 18854238
references.citation: Curr Opin Microbiol. 2003 Oct;6(5):427-30
references.pmid: 14572532
references.citation: Clin Infect Dis. 2001 Sep 15;33 Suppl 3:S147-56
references.pmid: 11524712
references.citation: Pediatr Crit Care Med. 2009 May;10(3):360-3
references.pmid: 19325501
references.citation: Pediatrics. 2000 Feb;105(2):311-5
references.pmid: 10654947
references.citation: J Antimicrob Chemother. 2011 Jan;66(1):205-9
references.pmid: 21059617
references.citation: Mucosal Immunol. 2010 Mar;3(2):148-58
references.pmid: 19940845
references.citation: J Infect Dis. 1981 Jan;143(1):42-50
references.pmid: 7217711
references.citation: Eur J Clin Microbiol Infect Dis. 2012 Feb;31(2):173-8
references.pmid: 21594713
references.citation: Surg Infect (Larchmt). 2013 Apr;14(2):203-8
references.pmid: 23540793
references.citation: J Antimicrob Chemother. 2011 Jun;66 Suppl 5:v3-12
references.pmid: 21680584
references.citation: Ned Tijdschr Geneeskd. 2005 Nov 5;149(45):2501-7
references.pmid: 16304887
references.citation: Curr Drug Targets. 2012 Mar;13(3):373-87
references.pmid: 22206258
references.citation: Int J Antimicrob Agents. 2012 Jun;40 Suppl:S4-10
references.pmid: 22749058
references.citation: Sci Am. 1998 Mar;278(3):46-53
references.pmid: 9487702
references.citation: Infect Control Hosp Epidemiol. 2012 Apr;33(4):338-45
references.pmid: 22418628
references.citation: J Antimicrob Chemother. 2009 Nov;64(5):885-8
references.pmid: 19729376
references.citation: J Clin Gastroenterol. 2010 May-Jun;44(5):354-60
references.pmid: 20048681
references.citation: Infect Control Hosp Epidemiol. 2006 Feb;27(2):155-69
references.pmid: 16465632
references.citation: Am J Infect Control. 2005 Sep;33(7):392-7
references.pmid: 16153485
references.citation: Infect Control Hosp Epidemiol. 2003 Sep;24(9):699-706
references.pmid: 14510254
references.citation: Nat Rev Drug Discov. 2007 Jan;6(1):29-40
references.pmid: 17159923
references.citation: Infect Control Hosp Epidemiol. 2009 May;30(5):415-9
references.pmid: 19344264
references.citation: Am J Infect Control. 2007 Dec;35(10 Suppl 2):S165-93
references.pmid: 18068814
references.citation: Future Microbiol. 2011 Jul;6(7):715-20
references.pmid: 21797685
references.citation: Int J Antimicrob Agents. 2012 Jun;40 Suppl:S37-43
references.pmid: 22749057
references.citation: J Antimicrob Chemother. 2013 Feb;68(2):478-80
references.pmid: 23034713
references.citation: Am J Infect Control. 2009 Dec;37(10):827-34
references.pmid: 20004812
references.citation: Respir Med. 2010 Nov;104(11):1729-35
references.pmid: 20605087
references.citation: Ann N Y Acad Sci. 2010 Dec;1213:81-91
references.pmid: 21175677
references.citation: Crit Care Med. 2006 Feb;34(2):329-36
references.pmid: 16424711
references.citation: Microb Biotechnol. 2009 Nov;2(6):601-12
references.pmid: 21255295
references.citation: J Clin Microbiol. 2013 Jul;51(7):2018-24
references.pmid: 23486706
references.citation: Annu Rev Microbiol. 1956;10:85-114
references.pmid: 13363356
references.citation: Antimicrob Agents Chemother. 2002 Jun;46(6):1619-28
references.pmid: 12019066
references.citation: Indian J Med Res. 2011 Nov;134(5):611-20
references.pmid: 22199099
references.citation: Clin Infect Dis. 2002 Feb 15;34(4):499-503
references.pmid: 11797177
references.citation: PLoS One. 2013;8(1):e54190
references.pmid: 23372683
references.citation: Am J Respir Crit Care Med. 2005 Feb 15;171(4):388-416
references.pmid: 15699079
references.citation: Pharmacotherapy. 2010 May;30(5):453-62
references.pmid: 20411997
references.citation: J Antimicrob Chemother. 2004 Aug;54(2):306-10
references.pmid: 15231764
references.citation: Int J Environ Health Res. 2008 Oct;18(5):357-64
references.pmid: 18821374
references.citation: Clin Infect Dis. 2011 May;52(10):1232-40
references.pmid: 21507920
references.citation: Infect Immun. 2009 Jun;77(6):2367-75
references.pmid: 19307217
references.citation: J Surg Res. 2012 Aug;176(2):e73-8
references.pmid: 22445457
references.citation: Nat Rev Microbiol. 2011 Apr;9(4):233-43
references.pmid: 21358670
references.citation: J Trauma. 2007 Aug;63(2):307-11
references.pmid: 17693828
references.citation: Lancet Infect Dis. 2005 Jul;5(7):450-9
references.pmid: 15978531
references.citation: J Hosp Infect. 2009 Dec;73(4):305-15
references.pmid: 19720430
references.citation: Anim Health Res Rev. 2008 Dec;9(2):187-99
references.pmid: 19102790
references.citation: Diagn Microbiol Infect Dis. 2011 May;70(1):150-3
references.pmid: 21398070
references.citation: Am J Infect Control. 2008 Jun;36(5):381-4
references.pmid: 18538706
references.citation: New Microbiol. 2007 Jul;30(3):332-9
references.pmid: 17802921
references.citation: PLoS One. 2010 Mar 24;5(3):e9836
references.pmid: 20352091
references.citation: Prev Vet Med. 1997 Jul;31(1-2):95-112
references.pmid: 9234429
references.citation: Recent Pat Antiinfect Drug Discov. 2012 Dec 1;7(3):182-8
references.pmid: 23016758
references.citation: Clin Infect Dis. 2007 Jan 15;44(2):159-77
references.pmid: 17173212
references.citation: Trends Pharmacol Sci. 2010 Nov;31(11):509-15
references.pmid: 20843562
references.citation: PLoS Biol. 2008 Nov 18;6(11):e280
references.pmid: 19018661
references.citation: Clin Microbiol Infect. 2004 Nov;10 Suppl 4:18-22
references.pmid: 15522036
references.citation: Infect Control Hosp Epidemiol. 2005 Jan;26(1):81-7
references.pmid: 15693413
references.citation: Science. 2011 May 20;332(6032):970-4
references.pmid: 21596990
references.citation: JAMA. 1976 Oct 18;236(16):1857-60
references.pmid: 989536
references.citation: Expert Rev Anti Infect Ther. 2012 Dec;10(12):1375-7
references.pmid: 23253315
references.citation: J Manag Care Pharm. 2009 Mar;15(2 Suppl):S18-23
references.pmid: 19236137
references.citation: Pharmacotherapy. 2010 Feb;30(2):119-26
references.pmid: 20099986
references.citation: Math Biosci Eng. 2010 Oct;7(4):923-33
references.pmid: 21077716
references.citation: Infect Control Hosp Epidemiol. 1995 Jul;16(7):405-11
references.pmid: 7673646
references.citation: Clin Infect Dis. 2006 Jun 1;42(11):1552-60
references.pmid: 16652312
references.citation: J Clin Microbiol. 1998 Jul;36(7):1938-41
references.pmid: 9650940
references.citation: Infect Control Hosp Epidemiol. 2007 Jun;28(6):641-6
references.pmid: 17520534
references.citation: J Antimicrob Chemother. 2008 Sep;62(3):601-7
references.pmid: 18468995
references.citation: Infect Control Hosp Epidemiol. 2001 Sep;22(9):560-4
references.pmid: 11732785
references.citation: J Antimicrob Chemother. 2007 Aug;60 Suppl 1:i27-32
references.pmid: 17656378
references.citation: Am J Infect Control. 1989 Dec;17(6):330-9
references.pmid: 2596730
references.citation: Pharmacotherapy. 2012 Aug;32(8):677-87
references.pmid: 23307517
references.citation: Chest. 2011 Sep;140(3):643-651
references.pmid: 21659436
references.citation: Infect Control Hosp Epidemiol. 2006 May;27(5):479-83
references.pmid: 16671029
references.citation: J Antimicrob Chemother. 2011 Apr;66(4):689-92
references.pmid: 21393184
references.citation: J Hosp Infect. 2001 Jul;48(3):238-41
references.pmid: 11439013
references.citation: Lancet Infect Dis. 2010 Jan;10(1):17-31
references.pmid: 20129146
references.citation: Infect Control Hosp Epidemiol. 2012 Apr;33(4):398-400
references.pmid: 22418636
references.citation: Drug Resist Updat. 2011 Apr;14(2):118-24
references.pmid: 21435939
references.citation: Int J Antimicrob Agents. 2010 Nov;36 Suppl 3:S15-8
references.pmid: 21129627
references.citation: Anim Health Res Rev. 2008 Dec;9(2):217-25
references.pmid: 19102792
references.citation: Drugs. 2009 Oct 1;69(14):1879-901
references.pmid: 19747006
references.citation: Eur J Clin Microbiol Infect Dis. 2010 Jun;29(6):633-41
references.pmid: 20300949
references.citation: Appl Environ Microbiol. 2011 Jun;77(11):3715-9
references.pmid: 21478314
references.citation: J Hosp Infect. 2010 May;75(1):28-32
references.pmid: 20346536
references.citation: Antimicrob Agents Chemother. 1996 Nov;40(11):2605-9
references.pmid: 8913473
references.citation: Lancet Infect Dis. 2008 Mar;8(3):159-66
references.pmid: 18291338
references.citation: Nat Rev Genet. 2013 Apr;14(4):243-8
references.pmid: 23419278
references.citation: J Nutr. 1992 Dec;122(12):2383-90
references.pmid: 1453223
references.citation: J Antimicrob Chemother. 2013 Dec;68(12):2710-7
references.pmid: 23818283
references.citation: Infect Control Hosp Epidemiol. 2008 Oct;29 Suppl 1:S81-92
references.pmid: 18840091
references.citation: Am J Med. 1991 Nov;91(5):479-83
references.pmid: 1951409
references.citation: J Antimicrob Chemother. 2006 Jul;58(1):205-10
references.pmid: 16717055
references.citation: Lancet. 1994 Nov 12;344(8933):1329-32
references.pmid: 7968028
references.citation: J Antimicrob Chemother. 2006 Jun;57(6):1197-204
references.pmid: 16565158
references.citation: Vet Dermatol. 2012 Aug;23(4):299-304, e59-60
references.pmid: 22409347
references.citation: Clin Infect Dis. 2009 Oct 15;49(8):1248-53
references.pmid: 19772389
references.citation: J Infect. 2011 Apr;62(4):280-91
references.pmid: 21382411
references.citation: J Antimicrob Chemother. 2010 Dec;65(12):2674-84
references.pmid: 20956353
references.citation: Clin Infect Dis. 2010 Apr 15;50(8):1081-3
references.pmid: 20214473
references.citation: Curr Opin Infect Dis. 2009 Jun;22(3):316-25
references.pmid: 19352176
references.citation: J Antimicrob Chemother. 2011 Jul;66(7):1417-30
references.pmid: 21558086
references.citation: Am J Infect Control. 2007 Dec;35(10 Suppl 2):S65-164
references.pmid: 18068815
references.citation: Crit Care Med. 2004 Dec;32(12):2450-6
references.pmid: 15599150
references.citation: Ann Intern Med. 1980 Oct;93(4):526-32
references.pmid: 6904159
references.citation: Clin Infect Dis. 2006 Jan 15;42 Suppl 2:S90-5
references.pmid: 16355322
references.citation: Int J Antimicrob Agents. 2012 Jun;40 Suppl:S1-3
references.pmid: 22749052
references.citation: Proc Natl Acad Sci U S A. 2004 Sep 7;101(36):13285-90
references.pmid: 15308772
references.citation: Gut. 2009 Jun;58(6):771-6
references.pmid: 19174417
references.citation: Expert Opin Drug Discov. 2008 May;3(5):487-500
references.pmid: 23484922
references.citation: Infect Control Hosp Epidemiol. 2008 Jul;29(7):593-9
references.pmid: 18624666
references.citation: Crit Care Med. 2000 Apr;28(4):977-83
references.pmid: 10809269
references.citation: Eur J Clin Microbiol Infect Dis. 2007 Apr;26(4):277-80
references.pmid: 17342461
references.citation: BMC Infect Dis. 2006 Aug 16;6:130
references.pmid: 16914034
references.citation: Clin Microbiol Infect. 2006 Sep;12(9):826-36
references.pmid: 16882287
references.citation: Rev Sci Tech. 2001 Dec;20(3):829-39
references.pmid: 11732425
references.citation: J Infect. 2011 Aug;63(2):114-23
references.pmid: 21669223
references.citation: Lancet Infect Dis. 2010 Apr;10(4):227-39
references.pmid: 20334846
references.citation: Clin Infect Dis. 2004 Jul 1;39(1):31-7
references.pmid: 15206050
references.citation: Antimicrob Agents Chemother. 2007 Jul;51(7):2597-9
references.pmid: 17502408
references.citation: Poult Sci. 2007 Nov;86(11):2466-71
references.pmid: 17954599
references.citation: Antimicrob Agents Chemother. 2010 Jan;54(1):164-9
references.pmid: 19901088
references.citation: Front Microbiol. 2013 May 14;4:96
references.pmid: 23675371
references.citation: Am J Respir Crit Care Med. 2005 Mar 1;171(5):480-7
references.pmid: 15516540
references.citation: PLoS One. 2013;8(2):e56040
references.pmid: 23418506
references.citation: J Antimicrob Chemother. 2012 Jul;67(7):1793-5
references.pmid: 22454489
references.citation: Infect Control Hosp Epidemiol. 2006 Feb;27(2):127-32
references.pmid: 16465628
references.citation: Math Biosci Eng. 2010 Jul;7(3):527-52
references.pmid: 20578784
references.citation: Anim Biotechnol. 2006;17(2):239-50
references.pmid: 17127534
references.citation: Nat Rev Drug Discov. 2009 Jan;8(1):10
references.pmid: 19116620
references.citation: Infect Control Hosp Epidemiol. 2009 Jul;30(7):611-22
references.pmid: 19508124
references.citation: Curr Infect Dis Rep. 2012 Dec;14(6):592-600
references.pmid: 22961224
references.citation: J Hosp Infect. 1999 May;42(1):27-35
references.pmid: 10363208
references.citation: Crit Care. 2010;14(3):R113
references.pmid: 20546564
references.citation: Am J Infect Control. 2001 Jun;29(3):133-8
references.pmid: 11391273
references.citation: Infect Control Hosp Epidemiol. 2006 Mar;27(3):287-93
references.pmid: 16532417
references.citation: BMC Microbiol. 2011 Jan 24;11(1):19
references.pmid: 21261985
references.citation: Annu Rev Public Health. 2008;29:151-69
references.pmid: 18348709
references.citation: Transpl Infect Dis. 2013 Apr;15(2):142-9
references.pmid: 23279656
references.citation: Clin Microbiol Rev. 2009 Oct;22(4):664-89
references.pmid: 19822894
references.citation: Infect Control Hosp Epidemiol. 2003 May;24(5):362-86
references.pmid: 12785411
references.citation: Infect Control Hosp Epidemiol. 2007 Nov;28(11):1267-74
references.pmid: 17926278
references.citation: Crit Rev Food Sci Nutr. 2013;53(1):11-48
references.pmid: 23035919
references.citation: Annu Rev Phytopathol. 2002;40:443-65
references.pmid: 12147767
references.citation: Poult Sci. 2003 Apr;82(4):622-6
references.pmid: 12710483
references.citation: J Antimicrob Chemother. 2003 Aug;52(2):159-61
references.pmid: 12837737
references.citation: Ann Emerg Med. 2007 Jul;50(1):34-41
references.pmid: 17161501
references.citation: Lancet. 1998 Jan 17;351(9097):186-7
references.pmid: 9449879
references.citation: Lancet Infect Dis. 2007 Mar;7(3):210-7
references.pmid: 17317602
references.citation: J Clin Microbiol. 1989 Oct;27(10):2386-7
references.pmid: 2685035
references.citation: Environ Sci Technol. 2012 Aug 21;46(16):8672-9
references.pmid: 22823142
references.citation: J Infect Dis. 2010 Feb 15;201(4):534-43
references.pmid: 20064069
references.citation: Ann Intern Med. 2003 Sep 16;139(6):483-7
references.pmid: 13679325
references.citation: PLoS Pathog. 2011 Jul;7(7):e1002158
references.pmid: 21811410
references.citation: Arch Dis Child. 2007 Jul;92(7):594-7
references.pmid: 17369279
references.citation: Nat Rev Microbiol. 2009 Jan;7(1):81-7
references.pmid: 19079354
references.citation: Lancet. 2000 Oct 14;356(9238):1307-12
references.pmid: 11073019
references.citation: Appl Environ Microbiol. 2000 Sep;66(9):3883-90
references.pmid: 10966404
references.citation: Lancet Infect Dis. 2004 Jan;4(1):44-53
references.pmid: 14720568
references.citation: Clin Infect Dis. 2006 Sep 1;43 Suppl 2:S82-8
references.pmid: 16894520
references.citation: J Antimicrob Chemother. 2007 Aug;60 Suppl 1:i63-8
references.pmid: 17656386
references.citation: Diagn Microbiol Infect Dis. 2008 May;61(1):110-28
references.pmid: 18384997
references.citation: J Infect Public Health. 2013 Feb;6(1):27-34
references.pmid: 23290090
references.citation: Epidemiol Infect. 2009 Dec;137(12):1679-83
references.pmid: 19874637
references.citation: Clin Infect Dis. 2001 Mar 1;32(5):826-9
references.pmid: 11229854
references.citation: Public Health Rep. 2007 Mar-Apr;122(2):160-6
references.pmid: 17357358
references.citation: Pneumologie. 2005 Sep;59(9):612-64
references.pmid: 16170727
references.citation: J Med Chem. 2008 May 22;51(10):2871-8
references.pmid: 18260614
references.citation: Int J Med Microbiol. 2010 Feb;300(2-3):109-17
references.pmid: 20005777
references.citation: J Infect. 2009 Aug;59(2):95-103
references.pmid: 19564044
references.citation: Med Res Rev. 2012 Jan;32(1):216-32
references.pmid: 20577973
references.citation: Int J Antimicrob Agents. 2010 Nov;36(5):408-14
references.pmid: 20728316
references.citation: Surg Infect (Larchmt). 2012 Aug;13(4):194-202
references.pmid: 22913313
references.citation: J Antimicrob Chemother. 2007 Nov;60(5):913-20
references.pmid: 17848376
references.citation: Antimicrob Agents Chemother. 2009 Aug;53(8):3280-4
references.pmid: 19506060
references.citation: Lancet Infect Dis. 2011 Mar;11(3):181-9
references.pmid: 21256086
references.citation: Infect Drug Resist. 2010;3:25-33
references.pmid: 21694891
references.citation: Nat Rev Immunol. 2009 May;9(5):313-23
references.pmid: 19343057
references.citation: PLoS Pathog. 2009 Mar;5(3):e1000221
references.pmid: 19325878
references.citation: BMC Med. 2009 Jun 08;7:28
references.pmid: 19505316
references.citation: Clin Infect Dis. 2008 Jan 15;46(2):155-64
references.pmid: 18171244
references.citation: Poult Sci. 2003 Apr;82(4):640-7
references.pmid: 12710486
references.citation: Microb Drug Resist. 2003 Winter;9(4):373-9
references.pmid: 15000744
references.citation: Nat Rev Microbiol. 2005 Sep;3(9):711-21
references.pmid: 16138099
references.citation: Clin Infect Dis. 2006 Feb 1;42(3):385-8
references.pmid: 16392086
references.citation: Anaerobe. 2008 Jun;14(3):157-60
references.pmid: 18434218
references.citation: J Antimicrob Chemother. 2012 Jul;67 Suppl 1:i11-8
references.pmid: 22855873
references.citation: Am J Infect Control. 2010 Jun;38(5 Suppl 1):S25-33
references.pmid: 20569853
references.citation: Pediatrics. 2007 Aug;120(2):e382-90
references.pmid: 17664257
references.citation: Chest. 2009 Mar;135(3):633-640
references.pmid: 19017892
references.citation: Gut Microbes. 2010 Jul;1(4):279-284
references.pmid: 20953272
references.citation: Recent Pat Antiinfect Drug Discov. 2012 Dec 1;7(3):175-81
references.pmid: 23061790
references.citation: Crit Care Med. 2010 Sep;38(9):1773-85
references.pmid: 20639750
references.citation: Prev Vet Med. 2004 Dec 15;66(1-4):49-62
references.pmid: 15579334
references.citation: Lancet. 1948 Oct 23;2(6530):641-4
references.pmid: 18890505