Antimicrobial Prescribing in the United States: Good News, Bad News

Editorials1 April 2003Antimicrobial Prescribing in the United States: Good News, Bad NewsRichard E. Besser, MDRichard E. Besser, MDFrom Centers for Disease Control and Prevention; Atlanta, GA 30333Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-7-200304010-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Antimicrobial resistance is a global public health problem facing both the developed and developing world (1). It affects our ability to treat infections of major international importance, such as HIV infection, tuberculosis, and malaria, as well as common infections primary care physicians face daily, such as otitis media, sinusitis, and pneumonia. During the 1990s, pneumococcal drug resistance rose dramatically. By 1998, 24% of invasive isolates in the United States were resistant to penicillin and 14% were resistant to three or more drug classes (2).Antimicrobial resistance is promoted by antimicrobial use, whether that use is appropriate or inappropriate (3). The ...References1. Institute of Medicine. Emerging Infections: Microbial Threats to the Health of the United States. Washington, DC: National Academy Pr; 1994. Google Scholar2. Whitney CG, Farley MM, Hadler J, Harrison LH, Lexau C, Reingold A, et al. . Increasing prevalence of multidrug-resistant Streptococcus pneumoniae in the United States. N Engl J Med. 2000;343:1917-24. [PMID: 11136262] CrossrefMedlineGoogle Scholar3. Lipsitch M, Samore MH. Antimicrobial use and antimicrobial resistance: a population perspective. Emerg Infect Dis. 2002;8:347-54. [PMID: 11971765] CrossrefMedlineGoogle Scholar4. McCaig LF, Hughes JM. Trends in antimicrobial drug prescribing among office-based physicians in the United States. JAMA. 1995;273:214-9. [PMID: 7807660] CrossrefMedlineGoogle Scholar5. Emmer C, Besser R. Combating antimicrobial resistance: intervention programs to promote appropriate antibiotic use. Infections in Medicine. 2002;19:160-73. Google Scholar6. Dowell SF. Principles of judicious use of antimicrobial agents for pediatric upper respiratory tract infections. Pediatrics. 1998;101:S163-84. Google Scholar7. Gonzales R, Bartlett JG, Besser RE, Cooper RJ, Hickner JM, Hoffman JR, et al. . Principles of appropriate antibiotic use for treatment of acute respiratory tract infections in adults: background, specific aims, and methods. Ann Intern Med. 2001;134:479-86. [PMID: 11255524] LinkGoogle Scholar8. Dowell SF, Butler JC, Giebink GS, Jacobs MR, Jernigan D, Musher DM, et al. . Acute otitis media: management and surveillance in an era of pneumococcal resistancea report from the Drug-resistant Streptococcus pneumoniae Therapeutic Working Group. Pediatr Infect Dis J. 1999;18:1-9. [PMID: 9951971] CrossrefMedlineGoogle Scholar9. Bartlett JG, Dowell SF, Mandell LA, File TM, Musher DM, Fine MJ. Practice guidelines for the management of community-acquired pneumonia in adults. Infectious Diseases Society of America. Clin Infect Dis. 2000;31:347-82. [PMID: 10987697] CrossrefMedlineGoogle Scholar10. McCaig LF, Besser RE, Hughes JM. Trends in antimicrobial prescribing rates for children and adolescents. JAMA. 2002;287:3096-102. [PMID: 12069672] CrossrefMedlineGoogle Scholar11. Steinman MA, Gonzales R, Linder JA, Landefeld CS. Changing use of antibiotics in community-based outpatient practice, 19911999. Ann Intern Med. 2003;138:525-33. LinkGoogle Scholar12. Bisno AL, Gerber MA, Gwaltney JM, Kaplan EL, Schwartz RH. Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. Infectious Diseases Society of America. Clin Infect Dis. 2002;35:113-25. [PMID: 12087516] CrossrefMedlineGoogle Scholar13. Schwartz B, Marcy SM, Phillips WR, Gerber MA, Dowell SF. Pharyngitisprinciples of judicious use of antimicrobial agents. Pediatrics. 1998;101:171-4. Google Scholar14. Cooper RJ, Hoffman JR, Bartlett JG, Besser RE, Gonzales R, Hickner JM, et al. . Principles of appropriate antibiotic use for acute pharyngitis in adults: background. Ann Intern Med. 2001;134:509-17. [PMID: 11255530] LinkGoogle Scholar15. Martin JM, Green M, Barbadora KA, Wald ER. Erythromycin-resistant group A streptococci in schoolchildren in Pittsburgh. N Engl J Med. 2002;346:1200-6. [PMID: 11961148] CrossrefMedlineGoogle Scholar16. Niederman MS, Mandell LA, Anzueto A, Bass JB, Broughton WA, Campbell GD, et al. . Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention. Am J Respir Crit Care Med. 2001;163:1730-54. [PMID: 11401897] CrossrefMedlineGoogle Scholar17. Hyde TB, Gay K, Stephens DS, Vugia DJ, Pass M, Johnson S, et al. . Macrolide resistance among invasive Streptococcus pneumoniae isolates. JAMA. 2001;286:1857-62. [PMID: 11597287] CrossrefMedlineGoogle Scholar18. Ho PL, Yung RW, Tsang DN, Que TL, Ho M, Seto WH, et al. . Increasing resistance of Streptococcus pneumoniae to fluoroquinolones: results of a Hong Kong multicentre study in 2000. J Antimicrob Chemother. 2001;48:659-65. [PMID: 11679555] CrossrefMedlineGoogle Scholar19. Levin BR. Minimizing potential resistance: a population dynamics view. Clin Infect Dis. 2001;33 Suppl 3 S161-9. [PMID: 11524714] CrossrefMedlineGoogle Scholar20. Petersen M. Less return in marketing of medicines, a study says. The New York Times. 2002; 12 December:C5. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Centers for Disease Control and Prevention; Atlanta, GA 30333Corresponding Author: Richard E. Besser, MD, Respiratory Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road (MS C23), Atlanta, GA 30333; e-mail, [email protected]gov. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoChanging Use of Antibiotics in Community-Based Outpatient Practice, 19911999 Michael A. Steinman , Ralph Gonzales , Jeffrey A. Linder , and C. 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