Resistant bacteria are bacteria not killed by usual doses of antibiotics. Resistant bacteria emerge because of the misuse of antibiotics. Once bacteria develop resistance to an antibiotic, they can continue to live and/or multiply even in the presence of antibiotic treatment. Prior to 1988, more than 99% of all bacterial infections caused by Strep pneumoniae bacteria were effectively treated with penicillin. Due to antibiotics being misused, the level of resistant infections in California has increased to 30% of infections in 2000. Making the problem even more serious, one-third of those resistant infections are highly resistant, forcing doctors to use 'last resort' antibiotics to treat them. High-level resistance to penicillin was extremely rare in California just eight years ago. According to the CDC, up to 50% of antibiotic use may be inappropriate. Most of this misuse is for illness due to viruses that antibiotics cannot treat. Antibiotic resistant bacteria cause infections that are more difficult to treat, result in longer and costlier hospitalizations, and must be treated with stronger antibiotics that may cause side effects that are more serious. We cannot depend on a ready supply of newly created, stronger antibiotics. Time and money make the discovery and creation of new antibiotics a difficult and time-consuming process. It is very important to do what we can to slow resistance now. The best way to do that is to stop antibiotic misuse.

Habits that lead to inappropriate antibiotic use include: Insisting on a prescription for an antibiotic when your doctor says no. Not taking your prescribed antibiotic for the full course of treatment. Using antibiotics without a doctor's care or using leftover antibiotics. Decreasing misuse of antibiotics is the best way to stop antibiotic resistance.

AWARE Organization The California Medical Association Foundation has initiated a long-term, statewide effort to promote the appropriate use of antibiotics called, Alliance Working for Antibiotic Resistance Education, (AWARE). AWARE is a partnership that includes physician organizations, healthcare providers, health systems, health plans, public health agencies, consumer and community based health organizations, federal, state and local government representatives and the pharmaceutical industry. AWARE's goal is to increase the appropriate use of antibiotics and decrease the spread of antibiotic resistance. We will accomplish this through education efforts geared to healthcare providers and consumers. We will mobilize communities to take action to address antibiotic resistance and develop a mechanism to track changes in the number of prescriptions written.