BMJ  2004;328:1270-1271 (29 May), doi:10.1136/bmj.328.7451.1270

Editorial

Antibiotics, resistance, and clinical outcomes

Data at the individual level are needed to direct policies

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

Concern exists worldwide about the threat posed to human health by antibiotic resistance in common microbial pathogens. In response the World Health Organization has launched a global strategy for containment of antimicrobial resistance and the United Kingdom has an antimicrobial resistance strategy and action plan.^{1 2} Fundamental to any action is an accurate understanding of the relation between prescribing and resistance. This is especially important where most prescribing occurs—in the community.

At the level of individual patients a link between prescribing and resistance has been found for many bacteria.³ In the United Kingdom, data about antibiotic prescribing are usually available only at the practice level. These have been investigated in relation to bacterial resistance to antibiotics, with only a weak association found.⁴ The validity of such analysis can be questioned, however, because exposure and outcome in any one individual are not linked and controls are not available. These potential flaws can . . . [Full text of this article]

Department of Respiratory Medicine, Manchester Royal Infirmary, Manchester M13 9WL (mark.woodhead@cmmc.nhs.uk)

Research Unit, Royal College of General Practitioners, Birmingham B17 9DB

Department of Microbiology, City Hospital NHS Trust, Birmingham B18 7QH

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This article has been cited by other articles:

• Winchester, C. C., Macfarlane, T. V., Thomas, M., Price, D. (2009). Antibiotic Prescribing and Outcomes of Lower Respiratory Tract Infection in UK Primary Care. Chest 135: 1163-1172 [Abstract] [Full text]  
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• Fleming, D. M. (2007). The state of play in the battle against antimicrobial resistance: a general practitioner perspective. J Antimicrob Chemother 60: i49-i52 [Abstract] [Full text]  
• Johnson, A. P., Pearson, A., Duckworth, G. (2005). Surveillance and epidemiology of MRSA bacteraemia in the UK. J Antimicrob Chemother 56: 455-462 [Abstract] [Full text]  
• Hay, A. D., Thomas, M., Montgomery, A., Wetherell, M., Lovering, A., McNulty, C., Lewis, D., Carron, B., Henderson, E., MacGowan, A. (2005). The relationship between primary care antibiotic prescribing and bacterial resistance in adults in the community: a controlled observational study using individual patient data. J Antimicrob Chemother 56: 146-153 [Abstract] [Full text]  
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Rapid Responses:

Read all Rapid Responses

Prescribing and antibiotic resistance :laymans' perspective!

Dr.Naseem A. Qureshi MD, IMAPA, LMIPS
bmj.com, 31 May 2004 [Full text]

Anribiotic use and outcomes in the community

Thomas Mike, et al.
bmj.com, 5 Jun 2004 [Full text]

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