FACTORS CONTRIBUTING TO RESISTANCE: Several factors contribute to the spread of resistance (international travel, grouping together severely ill patients, etc.) and others contribute to the emergence of resistance (e.g., catheters for S. epidermidis). The effect of these different factors on the spread and expression of resistance cannot be predicted. How can antibiotic efficacy be preserved? Less overuse of antibiotics, for example for bronchial infections, would be helpful. Educational programs, for patients and physicians alike, is also a crucial point, although its impact has been somewhat disappointing. OTHER ATTITUDES COULD ALSO BE IMPLEMENTED: Use of the most powerful member of a given antibiotic family, overall restriction on antibiotic use, improved diagnostic and laboratory methods. All of these propositions must be examined in light of real experience.
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