Surveying the literature from animal experiments

Resistance to multiple antibiotics in S aureus is a problem that all prescribers should consider if we are to preserve our capability to treat infections. However, we need to understand that what we are trying to control is the spread of the bacteria, which are already resistant to most antibiotics, rather than the initial emergence of resistance. With that in mind, prescription must be part of a package that includes infection control and the implementation of hygiene barriers that prevent the cross infection of patients. Only then would we have any prospect to reduce resistance sufficiently to allow us to reintroduce the antibiotics we used earlier. We also need to remember that antibiotic treatment for Gram positive bacteria is often less effective at controlling Gram negative bacteria. Some strains are pan-resistant and are now at least as difficult to control as MRSA, and it would be ironical if we defer one problem only to have to confront a worse one.