Antimicrobial Resistance: Issues and Options -- Copyright -- Preface -- THE FORUM -- THE REPORT AND ITS ORGANIZATION -- ACKNOWLEDGMENTS -- NOTES -- Contents -- Workshop Summary -- Introduction -- ISSUSE AND OPTIONS -- Workshop Report -- INTRODUCTION -- The Topic -- The Workshop -- THE COSTS OF ANTIMICROBIAL RESISTANCE -- Background -- Recent Case Material -- TRACKING THE PROBLEM: CURRENT APPROACHES TO SURVEILLANCE -- Characteristics of an Ideal Resistance Surveillance System -- Local-Level Surveillance -- National Systems
The United States Centers for Disease Control and PreventionThe Surveillance Network -- The Canadian System -- The Icelandic Surveillance System -- International Systems -- CEM/NET -- World Health Organization (WHO) Initiatives -- SENTRY -- Surveillance and the Laboratory -- What Is Needed -- System Design Issues -- Funding for Surveillance -- HOW CAN THE SCIENCES HELP? -- Implications of Mapping the Genome -- Molecular Detection of Genes Associated with Antimicrobial Resistance -- Limitations of Phenotype-Based Detection Methods
Knowledge About the Genetic Basis of ResistanceAdvantages and Limitations of Genotype-Based Antimicrobial Resistance Detection -- High-Density Oligonucleotide Arrays -- Applications of Genomics and Bioinformatics to the Development of Anti-Infectives -- A Role for New Therapeutic Approaches in Combating Antimicrobial Resistance -- Applications of Field Surveillance in the United States and Globally -- What Is Needed -- SOURCES OF RESISTANCE AND ANTIBIOTIC USE -- Sources of Resistance -- Antibiotic Use -- The Hospital -- The Community -- The Farm
Factors in Inappropriate Use of AntibioticsStrategies for Judicious Antibiotic Use -- RESISTANCE AND FOOD PRODUCTION: ISSUES AND NEEDS -- Concerns and Perspectives from Producers -- A National Surveillance System -- Strengthened Professional and Public Education -- Increased Research -- The Ecology of Resistance on the Farm -- U.S. Department of Agriculture -- U.S. Environmental Protection Agency -- Areas for Consideration and Action in Food Production -- Collaboration -- Research -- Education -- LEGAL AND REGULATORY CONCERNS
Matters of Law and Possible ResponsesSurveillance -- Rational Use of Antimicrobial Drugs -- Research and Development -- Intellectual Property Protection -- New Products -- Existing Products and Compounds -- Targeted Drug Development -- Collaborative Research and Development -- Regulatory FDA Responses to Antimicrobial Resistance -- Restricted Distribution -- SUMMARY OF AREAS FOR CONSIDERATION -- Surveillance -- Information Systems -- Laboratory Systems -- Law and Regulation -- Response: Prolonging Effectiveness -- Education -- Law and Regulation
