Strategies to improve antimicrobial utilization with a special focus on developing countries

Godman, Brian and Egwuenu, Abiodum and Haque, Mainul and Malande, Oliver and Schellack, Natalie and Kumar, Santosh and Saleem, Zikria and Sneddon, Jacqui and Hoxha, Iris and Islam, Salequl and Mwita, Julius and Nascimento, Renata Cristina Rezende Macedo do and Godói, Isabella Piassi Dias and Lum Niba, Loveline and Amu, Adefolarin A. and Acolatse, Joseph and Incoom, Robert and Sefah, Israel Abebrese and Opanga, Sylvia and Kurdi, Amanj and Chikowe, Ibrahim and Khuluza, Felix and Kibuule, Dan and Ogunleye, Olayinka O. and Olalekan, Adesola and Markovic-Pekovic, Vanda and Meyer, Johanna and Alfadl, Abubakr and Phuong, Thuy Nguyen Thi and Kalungia, Aubrey C. and Campbell, Stephen and Pisana, Alice and Wale, Janney and Seaton, R. Andrew (2021) Strategies to improve antimicrobial utilization with a special focus on developing countries. Life, 11 (6). 528. ISSN 2075-1729 (https://doi.org/10.3390/life11060528)

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Abstract

Antimicrobial resistance (AMR) is a high priority across countries as it increases morbidity, mortality and costs. Concerns with AMR have resulted in multiple initiatives internationally, na-tionally and regionally to enhance appropriate antibiotic utilization across sectors to reduce AMR, with the overuse of antibiotics exacerbated by the COVID-19 pandemic. Effectively tackling AMR is crucial for all countries. Principally a narrative review of ongoing activities across sectors was undertaken to improve antimicrobial use and address issues with vaccines including COVID-19. Point prevalence surveys have been successful in hospitals to identify areas for quality improvement programs, principally centering on antimicrobial stewardship programs. These include reducing prolonged antibiotic use to prevent surgical site infections. Multiple activities centering on education have been successful in reducing inappropriate prescribing and dispensing of antimicrobials in ambulatory care for essentially viral infections such as acute respiratory infections. It is imperative to develop new quality indicators for ambulatory care given current concerns, and instigate programs with clear public health messaging to reduce misinformation, essential for pandemics. Regular access to effective treatments is needed to reduce resistance to treatments for HIV, malaria and tuberculosis. Key stakeholder groups can instigate multiple initiatives to reduce AMR. These need to be followed up.