SUMMARY
Bacterial resistance to antibiotics is a growing clinical problem and
public health threat. Antibiotic use is a known risk factor for the
emergence of antibiotic resistance, but demonstrating the causal
link between antibiotic use and resistance is challenging. This review
describes different study designs for assessing the association
between antibiotic use and resistance and discusses strengths and
limitations of each. Approaches to measuring antibiotic use and
antibiotic resistance are presented. Important methodological issues
such as confounding, establishing temporality, and control
group selection are examined.