Antibiotic resistance is a serious and growing problem. A range of interventions have been developed in various countries to improve the use of antimicrobials. Previous reviews have analysed the evidence on the success of interventions to improve the use of medicines in primary care settings in developing countries (Ross-Degnan et al., 1997), to improve the use of antimicrobials in developing countries (WHO, 2001) and to improve antibiotic prescribing in ambulatory care (Arnold and Straus, 2005). In 2004, the second International Conference on Improving Use of Medicines (ICIUM) was held in Chiang Mai, Thailand, and many papers were presented on antimicrobial use.
The aims of this analysis were to:
• identify papers presented at ICIUM 2004 related to improving antimicrobial use
• review well-designed evaluations of interventions to determine what these add to previous reviews
• review other papers presented at ICIUM looking at the extent and nature of irrational use of antibiotics, the range of interventions being developed around the world and factors which might foster or hinder the success of interventions.