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Volume 11, Number 6—June 2005


Antimicrobial Resistance Determinants and Future Control

Stephan Harbarth*Comments to Author  and Matthew H. Samore†
Author affiliations: *University of Geneva Hospitals, Geneva, Switzerland; †VA Salt Lake City Health Care System, Salt Lake City, Utah, USA

Main Article

Table 1

Potential determinants influencing future dissemination and control of antimicrobial resistance

Dimension Determinant Potential control measures and interventions
Pathogen and microbial ecology Evolution
Survival fitness
Commensal flora
Laboratory detection and identification Evolutionary engineering
Inhibition of microbial gene expression
Antibodies, antipathogenicity drugs, biologic response modifiers
Improved rapid diagnostic tests
Physician's prescribing practice Antimicrobial drug usage pattern
Diversity of antimicrobial drug prescribing
Training and knowledge Multimodal interventions
Decision support tools
Academic detailing and educational campaigns
Population characteristics Migration, travel, and globalization
Case mix and host susceptibility to infections
Antimicrobial demand and health beliefs
Transmission and infection rates Screening and improved surveillance
Immunization; better control of chronic diseases
Public information campaigns
Hand hygiene and barrier precautions
Politics and healthcare policy Healthcare policy
Promotional activities by industry
Technologic development Change in reimbursement patterns
New prevention and treatment approaches

Main Article