Strategies for preventing and reversing antimicrobial resistances: The role of antibiotic cycling

The main forces driving the increase in antimicrobial-resistant bacteria are poor infection control practices and inappropriate use of antibiotics. Once these factors are addressed, specific antibiotic utilization strategies may help decrease or prevent the emergence of resistance. These strategies include antibiotic restriction, combination therapy, and antibiotic cycling. Many factors can affect the outcome of cycling programs. The optimal antibiotics to cycle, order in which to cycle them, and length of each cycle are still unknown, and these factors may need to be adjusted for the particular institutional setting.