Volume 11, Number 6—June 2005
Perspective
Antimicrobial Resistance Determinants and Future Control
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 Virulence Commensal flora Laboratory detection and identification | Evolutionary engineering Inhibition of microbial gene expression Antibodies, antipathogenicity drugs, biologic response modifiers Probiotics 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 Regulation New prevention and treatment approaches |