WGO Practice Guideline - Strategies for Reducing the Prevalence of Antimicrobial Resistance
Title: Strategies for Reducing the Prevalence of Antimicrobial Resistance
Introduction
Suggestions for strategies that may reduce the emergence of resistance of pathogenic microorganisms to antimicrobial agents focus in part on issues specific to gastroenterological practice; in large part, however, they are generic suggestions appropriate for the practice of any field of medicine. The microbiologic ecology does not allow for clinical divisions in medicine. Indeed, because the gut is by far the largest repository of microorganisms in humans, it also serves as the largest reservoir of antimicrobial resistance. Because almost all orally administered antimicrobial agents are only incompletely absorbed from the upper gut, drug concentrations in the colon are usually high. This in turn presents a strong selective pressure for antimicrobial-resistant strains in the gut lumen. Many parenterally administered agents also achieve high concentrations in the gut lumen because of active excretion into the gut, either via the bile or by other excretion mechanisms from plasma. [read more in guideline]
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