BMJ 1998;317:663-665 ( 5 September )

Education and debate

Regulating the use of antibiotics in the community

Claude Carbon, chief of internal medicine, ^a Richard P Bax, director of research and development. ^b

^a Hospital Bichat, Claude Bernard, 75877 Paris Cedex 18, France, ^b SmithKline Beecham Pharmaceuticals, New Frontiers Science Park South, Harlow, Essex CM19 5AW

Correspondence to: Professor Carbon claude.carbon@bch.ap-hop.paris.fr

The first 150 words of the full text of this article appear below.

All parties perceive antibiotic resistance as a global threat.¹ We examined the literature on the use of antibiotics in the community to establish how the issue of antibiotic resistance might be managed. We chose illustrative examples from recent important publications.

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	Costs

The world market for antibiotics in 1997 was $17bn (£10.6bn), of which $12bn was for community use, with about 818 billion prescriptions for respiratory tract infections. Although the value is rising (the 1993 market was $15bn), the number of prescriptions is now static. From 1980 to 1991, however, the overall increase in prescriptions for antibiotics in England was 46%but still below the rate of growth over the same period in France. ^{2 3}

Several factors may influence the increase in antibiotic costs. ^{1 3 4} Recently, two characteristics of antibiotics prescribingthat is, use of doses that are too small or treatments that are too longhave been shown to increase the risk of selection of resistance.⁵ The ecological . . . [Full text of this article]

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