Given that it’s hard, slow and expensive to develop antibiotics, and it is virtually inevitable that genetic diversity will generate antibiotic resistance, trying to maintain the usefulness of the antibiotics and reduce the prevalence of resistance is a global health priority.

This principle is called antibiotic stewardship and involves:

• Appropriate use of antibiotics
• Selecting the most appropriate antibiotic for a given infection (narrow spectrum where possible)
• Not relying excessively on in vitro measures of antibiotic effectiveness (MIC etc) if a narrow spectrum antibiotic clinically effective – or maximising the effectiveness of a narrow spectrum antibiotic by choosing a particular dosing regimen or route
• Surveillance for resistance

The UK has set (2025) primary care targets (90% of amoxicillin prescriptions will be for 5 day course rather than longer, less than 3% of all antibiotics will be for co-amoxiclav and cipro combined, for example), and secondary care targets:

• IV antibiotic prescribing will be 10% lower by 2029 than 10 years previously
• 95% of antimicrobial prescriptions will have an indication recorded by 2029