Control of antibiotic-resistant bacteria: memorandum from a WHO meeting.

Control of the prevalence of antibiotic-resistant bacteria is essential for the appropriate use of antibiotics for prophylaxis and treatment of infections. Hospitals are regarded as the place where antibiotic-resistant bacteria might often develop. Control of antibiotic use in hospitals is therefore one of the most important measures for effective control of antibiotic resistance. Another effective means to control antibiotic resistance is to develop a surveillance programme on a national, and international scale. This would be of great assistance, especially for forecasting future changes in the resistance of bacteria. The prevention of disease by measures other than the use of antibiotics could also reduce antibiotic resistance.This Memorandum of the WHO Scientific Working Group on Antibiotic Resistance describes the measures for controlling the prevalence of antibiotic-resistant bacteria by (a) the surveillance of antibiotic resistance, including surveillance of resistance in human pathogens and resistance determinants in the general population, and (b) control of antibiotic use in hospitals, the essential elements of which are the establishment of appropriate hospital antibiotic policy, elaboration of general strategy, and the monitoring of antibiotic use. Further research needs are also described and a number of areas are indicated where research might lead to improvements in antibiotic use and in methods for the containment of resistance. Guidelines for the appropriate use of antibiotics are presented in an Annex.