Promoting appropriate antimicrobial drug use: perspective from the Centers for Disease Control and Prevention.

Extending the useful life of antimicrobial drugs through appropriate use-that is, use that maximizes therapeutic impact while minimizing toxicity and the development of resistance-is an important component of efforts to prevent and control the emerging threat of antimicrobial resistance. The major paradigms of antimicrobial drug use involve acute infections in outpatients, acute infections in inpatients, chronic infections, and agriculture/veterinary medicine. The factors that influence drug use and the challenges that need to be addressed in promoting more appropriate use are different in each of these paradigms. For acute respiratory infections in outpatients, data from intervention trials suggest that concurrent multifaceted interventions may be effective in promoting appropriate drug prescribing. The next challenge is to extend these interventions to larger populations by incorporating them into routine medical practice.