Antimicrobial resistance: paradox, actions and economics.

The threat from antimicrobial-resistant organisms is accumulating and accelerating. One strand of the action that an adequate response to this threat demands is good clinical governance through management and audit of antimicrobial prescribing in hospitals. This is the subject of another article in this issue of the Journal, which describes the guidelines developed by the Scottish Medicines Consortium and Scottish Health Executive to tackle this problem. However, the problems posed by resistant organisms are wider still. In a period of increased threat, innovation (new drugs and technologies) seems to be in decline. There are grounds for serious concern that the current economic model is not capable of responding adequately. Governments need to acknowledge and address this fact. Patient outcomes will suffer increasingly if governments do not act to change the status quo.