ABSTRACT
This chapter presents the nomenclature and definitions used in antimicrobial cycling programs. It discusses the different studies on antibiotic cycling published in the literature, beginning with the accidental discovery of the effects of antimicrobial switching made by D. N. Gerding et al. The chapter considers the utility and feasibility of future antimicrobial cycling programs. Antimicrobial cycling in the strictest sense of the word has been described as the “deliberate, scheduled removal and substitution of specific antimicrobials or classes of antimicrobials within an institutional environment to avoid or reverse the development of antimicrobial resistance”. Antimicrobial cycling has potential as a method to decrease antimicrobial resistance rates because of its theoretical ease of implementation. Mathematical modeling studies simulating the development of antimicrobial resistance in the hospital setting also support this finding. Since antimicrobial cycling requires that different antimicrobial classes be initiated as empiric therapy, it is important that the antimicrobial cycling regimens be as structurally and mechanistically different as possible.
