Antimicrobial Use and Antimicrobial Resistance: A Population Perspective

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Antimicrobial Use and Antimicrobial Resistance: A Population Perspective

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Title: Antimicrobial Use and Antimicrobial Resistance: A Population Perspective
Author: Samore, Matthew H.; Lipsitch, Marc

Note: Order does not necessarily reflect citation order of authors.

Citation: Lipsitch, Marc, and Matthew H. Samore. 2002. Antimicrobial Use and Antimicrobial Resistance: A Population Perspective. Emerging Infectious Diseases 8(4): 347-354.
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Abstract: The need to stem the growing problem of antimicrobial resistance has prompted multiple, sometimes conflicting, calls for changes in the use of antimicrobial agents. One source of disagreement concerns the major mechanisms by which antibiotics select resistant strains. For infections like tuberculosis, in which resistance can emerge in treated hosts through mutation, prevention of antimicrobial resistance in individual hosts is a primary method of preventing the spread of resistant organisms in the community. By contrast, for many other important resistant pathogens, such as penicillin-resistant Streptococcus pneumoniae, methicillin-resistant Staphylococcus aureus, and vancomycin-resistant Enterococcus faecium resistance is mediated by the acquisition of genes or gene fragments by horizontal transfer; resistance in the treated host is a relatively rare event. For these organisms, indirect, population-level mechanisms of selection account for the increase in the prevalence of resistance. These mechanisms can operate even when treatment has a modest, or even negative, effect on an individual host’s colonization with resistant organisms.
Published Version: doi:10.3201/eid0804.010312
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730242/pdf/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:4553777

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