At WHO's behest, the Alliance for the Prudent Use of Antibiotics (APUA) undertook a review of 25 key reports on antibiotic resistance to identify areas of consensus in expert recommendations and to suggest ways of translating the advice into action.

The reports were chosen because they were highly cited in medical literature and had input from a wide variety of expert policy groups. The review authors separated their comments into five areas: surveillance; education of patients and providers; prevention; R&D; and antibiotic use in animals.

Education, says the review, needs to happen in medical schools and among the general public. Surveillance of antibiotic resistance occurs but is fragmented – coordinated local surveillance networks could do much to tackle resistance before it spreads. Healthcare institutions need committees to assess antibiotic use data and enforce infection control measures. In terms of use in animals, the review recommends that farmers prevent infection with good hygiene and not just antimicrobials, and calls for the reduced use of antibiotics as growth promoters.


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