Urgent efforts needed globally to combat the spread of antimicrobial resistance, says WHOBMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d2205 (Published 07 April 2011) Cite this as: BMJ 2011;342:d2205
All rapid responses
Zarocostas refers to a global action plan released by the World
Health Organization, which underlines that antimicrobial resistance is
becoming more dangerous, and urgent efforts are needed worldwide to halt
its spread. 1 The action plan endorses the judicious use of available
antibacterial drugs and fostering innovation and development of new
products for enhancing infection prevention and the control of treatment
Development of resistance in bacteria is not only linked to improper use
of antibacterial drugs, but also due to misuse of disinfecting agents.
Disinfecting agents are broad-spectrum antimicrobial agents, widely used
to disinfect environmental surfaces in clinical and industrial settings.
During the last decades a number of disinfecting agents have been included
in many commercial consumer products. However, the potential role of these
agents for preventing/minimizing the spread of infectious diseases has not
been established. 2
Development of resistance towards disinfecting agents in bacteria has been
regarded as minimal under the condition of normal use in consumer
products. However, disinfectant-containing products leave residues which
may be diluted to sub-inhibitory concentrations that may contribute to
development of resistance in bacteria. 3
Widespread use of disinfecting agents, as in consumer products, may
contribute to development of disinfectant resistance in bacteria, which
are usually associated with concomitant resistance against clinically
important antibacterials. 2, 4, 5 Consequently, when considering public
health, the use of disinfecting agents should be restricted to purposes
where its desired effect is required.
Not only misuse and overuse of antimicrobial drugs, but also unrestricted
use of disinfecting agents in consumer products contribute to development
of antibacterial resistance. Therefore, the inappropriate use of these
agents in contemporary consumer products should also be evaluated by
international institutions, like WHO.
Siamak Yazdankhah, Senior adviser, PhD1
Liv Mathiesen, Head of section, PhD1
1Norwegian Medicines Agency, Sven Oftedals vei 6, N-0950 Oslo, Norway
1. Zarocostas J. Urgent efforts needed globally to combat the spread
of antimicrobial resistance, says WHO. BMJ 2011; 342:d2205. (7 April.)
2. Carson RT., Larson E, Levy SB, Marshall BM, Aiello AE. Use of
antibactertial consumer products containing quaternayt ammnonium compounds
and drug resistance in the community. J. Antimicrob. Chemother. 2008; 62:
3. Levy SB. Antimicrobial consumer products: where's the benefit?
What's the risk? Arch. Dermatol. 2002; 138: 1087-1088.
4. Yazdankhah SP, Scheie AA, H?iby EA, Lunestad BT, Heir E, Fotland
T?, Naterstad K, Kruse H. Triclosan and antimicrobial resistance in
bacteria: an overview. Microb. Drug Resist. 2006; 12: 83-90.
5. Hegstad K, Langsrud S, Lunestad BT, Scheie AA, Sunde M, Yazdankhah
Does the wide use of quaternary ammonium compounds enhance the selection
and spread of antimicrobial resistance and thus threaten our health?
Microb Drug Resist. 2010;16: 91-104.
Competing interests: No competing interests