Antibiotics are the cornerstone of therapy for infectious diseases affecting people living worldwide. The ability of these agents to cure infections, with little if any harm to the host, has helped to propagate their designation as "miracle drugs". This idea has continued throughout the past four decades and into the present one. To a large extent, this concept has led to the inappropriate use of these agents. The consequence of this misuse affects not only the individuals taking antibiotics, but indirectly others who may subsequently need antibiotics, but find that the infecting pathogen is resistant. This phenomenon results from the strong selective environmental effect of these drugs for resistant bacteria. Resistant pathogens have emerged and spread worldwide. In response to this global health problem, the Alliance for the Prudent Use of Antibiotics was established. This international network of concerned prescribers and users aims to improve antibiotic use and eliminate inappropriate use worldwide. Prudent use of antibiotics will not only curtail health care costs and the potential side effects to the individual taking these drugs, but also diminish the wide ecologic effects leading to selection of antibiotic resistant forms of common disease-causing agents.