Regulating the use of antibiotics in the community

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. #### Summary points 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 prescribing — that is, use of doses that are too small or treatments that are too long — have been shown to increase the risk of selection of resistance.5 The ecological impact of poor compliance or of the use of highly selective agents remains to be established. Respiratory tract infection accounts for …