Volume 11, Number 6—June 2005
Perspective
Antimicrobial Resistance Determinants and Future Control
Stephan Harbarth*
and Matthew H. Samore†
and Matthew H. Samore†
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 |
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