The development of resistant microorganisms is a problem whenever antimicrobial agents are used. The increase in high risk populations who frequently require antimicrobial therapy, including immunocompromised patients, those undergoing invasive medical interventions, and patients with chronic debilitating diseases has amplified the problem.

In addition, substantial misuse and overuse of antimicrobial agents has exacerbated the problem by adding selection pressures to microbial populations that favor mutation to antibiotic resistance. This includes inappropriate prescribing of antibacterial prophylactics and/or treatment of bacterial infections by physicians, poor compliance with antimicrobial regimens by patients, and the availability of antimicrobial agents without a prescription in many developing countries.

Recommendations:

1. The World Medical Association and its member national medical associations should encourage the World Health Organization (WHO) and individual governments to cooperate with and enhance the effectiveness of the WHO's global network of antimicrobial resistance surveillance.
   
   
2. National medical associations should encourage their governments to fund more basic and applied research directed toward the development of innovative antimicrobial agents and vaccines, and on the appropriate and safe use of such therapeutic tools.
   
   
3. The pharmaceutical industry should be encouraged to pursue research and development programs leading to the availability of innovative antimicrobial agents and vaccines.
   
   
4. National medical associations should urge their governments to require antimicrobial agents to be available only through prescription by licensed qualified health care and veterinary professionals.
   
   
5. National medical associations should encourage medical schools and continuing medical education programs to educate physicians about appropriate use of antimicrobial agents.
   
   
6. Physicians, especially trained in infectious diseases and clinical microbiology, should assume leadership roles in their local hospitals and communities regarding appropriate antimicrobial agent usage and antimicrobial resistance prevention and control programs.
   
   
7. Physicians should raise awareness amongst their patients of their antimicrobial therapy, the risks and benefits, the importance of compliance with the prescribed regimen, and the problem of antimicrobial resistance.
   
   
8. Governments, medical associations, and physicians should educate the public in the appropriate use of antimicrobial agents and increase the awareness of the problem of antimicrobial resistance.
   
   
9. National medical associations in collaboration with veterinary authorities should encourage their governments to restrict the use of antimicrobial agents as feed additives for animals strictly to those which are not used for humans.