Antibiotic resistance is an international pandemic that compromises the treatment of all infectious diseases. The reasons behind the establishment and spread of resistance are complex, mostly multifactorial, and mostly unknown. More research bridging medical, chemical, and environmental disciplines is needed now, according to the report "Antibiotic Resistance: an Ecological Perspective on an Old Problem," issued by the American Academy of Microbiology.

The report is based on a colloquium convened by the Academy in October 2008. It states that resistance development is founded in the inevitability of microbial evolution. The rate of antibiotic resistance emergence is related to all uses of drugs, not just misuse, and the total amount of antibiotics used and the environment also play roles. The main driving factor behind resistance may actually be a lack of adequate hygiene and sanitation, which enables rapid proliferation and spread of pathogens.

According to the report, it is possible to coexist with resistance by developing new strategies to prevent resistance from spreading and, where it already exists, identifying the strains we need to protect against; finding new ways to treat resistant infections effectively in patients; and managing reservoirs of antibiotic strains in the environment. The report summarizes the current scientific understanding of antibiotic resistance, the scope of the problem, and methods at our disposal for detecting emergence and preventing spread. The knowledge gaps about the prevalence of resistant strains and resistant infections are highlighted, as are the unique problems and challenges in developing countries.

A full copy of the report and further recommendations can be found on the Academy website at http://academy.asm.org/index.php?option_com_content&task_view&id_296&Itemid_66.