Nonetheless, the prevalence of such antibiotic-resistant bacteria has increased dramatically worldwide, and caution should be exercised. Studies in North, Central, and South America, Asia, and southern Europe report that more than half of Streptococcus pneumoniae bacteria are now resistant to many standard antibiotics, and most of these are also resistant to other, less commonly prescribed antibiotics. Even higher resistance rates are found in children, people who use antibiotics heavily, those who have not responded to antibiotic therapy, and during the winter months. New antibiotics may combat bacteria that have become resistant to standard drugs, although repeated exposure to even these antibiotics can eventually result in bacterial resistance. In general, regions and institutions with the highest rate of resistance are those in which antibiotics are heavily prescribed.
Major efforts are underway to combat the problem.
The best approach is to use antibiotics conservatively. A program in Finland, for example, nearly halved the incidence of erythromycin-resistant bacteria by limiting the use of this and similar antibiotics. Physicians in Scandinavian countries, in order to prevent overuse of antibiotics, recommend prescribing penicillin for only two days and only for selected cases of acute sinusitis. In general, if a patient with acute sinusitis lives in a region where resistance to standard antibiotics is still low, it is probably safe to start with a less expensive antibiotic and switch over to a more powerful drug if the infection does not clear up. The most common side effect for nearly all antibiotics is gastrointestinal distress.