TY - JOUR T1 - The proposed Drug Resistance Index (DRI) is not a good measure of antibiotic effectiveness in relation to drug resistance JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2019-001838 VL - 4 IS - 4 SP - e001838 AU - Christina M J E Vandenbroucke-Grauls AU - Gunnar Kahlmeter AU - Jan Kluytmans AU - Marjolein Kluytmans-van den Bergh AU - Dominique L Monnet AU - Gunnar Skov Simonsen AU - Robert L Skov AU - Ute Wolff Sönksen AU - Andreas Voss Y1 - 2019/08/01 UR - http://gh.bmj.com/content/4/4/e001838.abstract N2 - Summary boxThe Drug Resistance Index (DRI) is proposed as measure of antibiotic effectiveness in a given country, by combining, in a single metric the use of various antibiotic groups and the resistance proportions of several pathogens.The DRI is a complicated measure that gives results that cannot be understood by common knowledge and logic.The DRI conveys a wrong message. A low DRI is meant to represent good antibiotic efficacy, but a low DRI may be the result of unnecessary, excessive use of too broad-spectrum antibiotics.Restrictive use of antibiotics is one of the cornerstones in the fight against antimicrobial resistance, therefore the DRI, whose interpretation may promote the opposite, should not be used.The issue of antimicrobial resistance for humankind does not need any introduction anymore. It is a widely recognised global health threat, that has sparked increasing attention, as acknowledged at the World Health Assembly at its 68th meeting in May 2015, and at the General Assembly of the United Nations (UNGA) in September 2016.1 2 The World Health Assembly adopted a Global Action Plan on Antimicrobial Resistance that was endorsed by the UNGA. The plan formulates five key objectives; we draw attention to two of these. In its first objective, the Global Action Plan calls for improving ‘awareness and understanding of antimicrobial resistance through effective communication, education and training’. The fourth objective aims at ‘optimising the use of antimicrobial medicines in human and animal health’.In their recent publication, Klein and coworkers state, in line with the first objective of the plan, that it is important to communicate trends in antibiotic resistance to a broad audience, and that this should be done in a clear and unambiguous way.3 To this purpose, they propose to use … ER -