This article examines the rising rate of antibiotic resistance, and proposes action to reverse the trend. The authors call for leadership at international and national levels, a change in the behaviour of consumers and providers, and the development of antibacterial agents to match existing public health needs.

They suggest that international bodies such as the WHO should provide coordination and resources for generating key information on the burden of antibiotic resistance, and call for individual governments to set up multidisciplinary action programmes. They also examine the methods needed to better inform the public and discuss alternative approaches to developing new antibacterials, including product development partnerships and gap analyses.

Antibiotics are used to prevent or treat disease or to encourage growth in animals intended for human consumption. Opinion is divided over the potential of the practice to cause health problems in people. This forum presents different perspectives from human and animal medicine experts.

The remarkable variation of views indicates the complexity of the debate. For some, there is no doubt that antibiotic use in animals causes resistance in people; for others, the link is present but unclear; and for the rest, not nearly enough is known to start taking action, and they suggest monitoring the situation. All agree, though, that whether in animals or people, antibiotics should be used with caution.

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