Antibiotic resistance surveillance: action for international studies

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Abstract
Ten years ago O'Brien et al.1 described the position on antibiotic resistance surveillance as follows: ‘There are no reliable data in this area—simply fragments of information and anecdotes that we use to draw an overall picture’. Recent reviews on this topic point to much activity but suggest that in many areas little has changed.2– 7 At the start of the 21st century one of the most pressing medical problems is the rise of antimicrobial resistance, and surveillance is generally seen as being a principal weapon in the global response to this threat. However, if surveillance is to make such a contribution it needs to resolve its organizational and scientific difficulties. Recent definitions of surveillance in public health8 and antimicrobial resistance9 settings have failed to address these and have ignored the essential aspect of drug usage. Although much contemporary work has focused on international programmes, antimicrobial resistance surveillance remains peppered with numerous disparate local as well as multinational studies. This paper will review how such efforts can be improved and a better fit obtained to serve the key purpose of surveillance in controlling the evolution and spread of resistance.

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