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Pathogens 2013, 2(2), 422-435; doi:10.3390/pathogens2020422
Review

Can We Prevent Antimicrobial Resistance by Using Antimicrobials Better?

1
, 2
 and 2,*
Received: 23 April 2013; in revised form: 24 May 2013 / Accepted: 1 June 2013 / Published: 10 June 2013
(This article belongs to the Special Issue Pathogen Infection Models)
View Full-Text   |   Download PDF [334 KB, uploaded 10 June 2013]
Abstract: Since their development over 60 years ago, antimicrobials have become an integral part of healthcare practice worldwide. Recently, this has been put in jeopardy by the emergence of widespread antimicrobial resistance, which is one of the major problems facing modern medicine. In the past, the development of new antimicrobials kept us one step ahead of the problem of resistance, but only three new classes of antimicrobials have reached the market in the last thirty years. A time is therefore approaching when we may not have effective treatment against bacterial infections, particularly for those that are caused by Gram-negative organisms. An important strategy to reduce the development of antimicrobial resistance is to use antimicrobials more appropriately, in ways that will prevent resistance. This involves a consideration of the pharmacokinetic and pharmacodynamics properties of antimicrobials, the possible use of combinations, and more appropriate choice of antimicrobials, which may include rapid diagnostic testing and antimicrobial cycling. Examples given in this review include Mycobacterium tuberculosis, Gram-negative and Gram-positive organisms. We shall summarise the current evidence for these strategies and outline areas for future development.
Keywords: antimicrobial resistance; pharmacokinetics; pharmacodynamics; minimum inhibitory concentration (MIC); mutant prevention concentration (MPC); microbiota; colonisation resistance; antibiotic combination; bacteria-antimicrobial pairing; antimicrobial cycling antimicrobial resistance; pharmacokinetics; pharmacodynamics; minimum inhibitory concentration (MIC); mutant prevention concentration (MPC); microbiota; colonisation resistance; antibiotic combination; bacteria-antimicrobial pairing; antimicrobial cycling
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MDPI and ACS Style

Soothill, G.; Hu, Y.; Coates, A. Can We Prevent Antimicrobial Resistance by Using Antimicrobials Better? Pathogens 2013, 2, 422-435.

AMA Style

Soothill G, Hu Y, Coates A. Can We Prevent Antimicrobial Resistance by Using Antimicrobials Better? Pathogens. 2013; 2(2):422-435.

Chicago/Turabian Style

Soothill, Germander; Hu, Yanmin; Coates, Anthony. 2013. "Can We Prevent Antimicrobial Resistance by Using Antimicrobials Better?" Pathogens 2, no. 2: 422-435.



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