Antibacterial Drug Resistance (Background Document for the WHO Project: Priority Medicines for Europe and the World)
(2005; 40 pages)


A potential post-antibiotic era is threatening present and future medical advances. The current worldwide increase in resistant bacteria and, simultaneously, the downward trend in the development of new antibiotics have serious health and economic implications. Resistant bacteria dramatically reduce the possibilities of treating infectious diseases eff ectively and increase the risk of complications and fatal outcome for patients with severe infections. Th e current rising trends in antibiotic resistance suggest that the real problems are still ahead of us.

Globally there is an extensive overuse of antibiotics, e.g. use based on incorrect medical indications as well as misuse by using the wrong agent, administration route, dose and treatment duration. At the same time, there is a lack of access to eff ective antibiotics in some developing countries where the need for essential drugs is most immediate. In industrialized countries, around 80-90% of antibiotic use for humans occurs in the community and at least half of this is considered to be based on incorrect indications, mostly viral infections. Improved diagnostic tools to discriminate between viral and bacterial infections and to rapidly detect resistance in clinical samples would be important steps to reduce unnecessary antibiotic use in viral infections and to limit the use of broad-spectrum antibiotics. Development of new bacterial vaccines may also be necessary to control the spread of certain microorganisms between individuals and to reduce the number of carriers of these pathogens.

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