Global Strategies to Combat Antimicrobial Resistance: A One Health Perspective

Pharmacology &amp Pharmacy, Journal Year: 2023, Volume and Issue: 14(08), P. 271 - 328

Published: Jan. 1, 2023

Background: Antimicrobial resistance (AMR) is a global health challenge that has escalated due to the inappropriate use of antimicrobials in humans, animals, and environment. Developing implementing strategies reduce combat AMR critical. Purpose: This study aimed highlight some can be implemented address using One Health approach. Methods: employed narrative review design included studies published from January 2002 July 2023. The searched for literature on antimicrobial stewardship (AMS) PubMed Google Scholar 2020 PRISMA guidelines. Results: reveals remains significant public problem. Its severity been markedly exacerbated by broader ecological Several have developed AMR, including Global Action Plan (GAP), National Plans (NAPs), AMS programs, implementation AWaRe classification antimicrobials. These also involve strengthening surveillance consumption resistance, encouraging development new antimicrobials, enhancing regulations around prescribing, dispensing, usage. Additional measures include promoting partnerships, combating substandard falsified advocating vaccinations, sanitation, hygiene biosecurity, as well exploring alternatives However, these faces various challenges. challenges low awareness knowledge shortage human resources capacity building AMS, adequate funding initiatives, limited laboratory capacities surveillance, behavioural change issues, ineffective leadership multidisciplinary teams. Conclusion: In conclusion, this established prevalent among Successfully addressing calls collaborative, multifaceted Despite this, gaps remain effectively currently recommended AMR. As result, it essential reinforce are deployed counter across human, animal, environmental sectors.

Language: Английский

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Current rates of purchasing of antibiotics without a prescription across sub-Saharan Africa; rationale and potential programmes to reduce inappropriate dispensing and resistance

Expert Review of Anti-infective Therapy, Journal Year: 2023, Volume and Issue: 21(10), P. 1025 - 1055

Published: Sept. 23, 2023

ABSTRACTIntroduction Antimicrobial resistance (AMR) is a global concern. Currently, the greatest mortality due to AMR in Africa. A key driver continues be high levels of dispensing antibiotics without prescription.Areas covered need document current rates dispensing, their rationale and potential ways forward including antimicrobial stewardship programmes (ASPs). narrative review was undertaken. The highest antibiotic purchasing were Eritrea (up 89.2% dispensed), Ethiopia 87.9%), Nigeria 86.5%), Tanzania 92.3%) Zambia 100% pharmacies prescription). However, considerable variation seen with no minority countries situations. Key drivers self-purchasing included co-payment for physician consultations costs, travel convenience pharmacies, patient requests, limited knowledge weak enforcement. ASPs have been introduced some African along quality targets reduce inappropriate centering on educating pharmacists patients.Expert Opinion ASP activities accelerating among community alongside targets, greater monitoring pharmacists' dispensing. Such activities, patients healthcare professionals, should enhance appropriate AMR.KEYWORDS: Africaantibioticsantimicrobial resistanceantimicrobial programmesAWaRe classificationcommunity pharmaciesover-the-counter purchasingquality indicatorsutilization patterns Article highlights There still prescription across Africa, prescriptionHowever, vary considerably both within countries. It important address typically self-limiting conditions AMR, which major issue sub-Saharan Africa (currently continent prevalence rate globally) an part National Action Plan AMRHigh are exacerbated by issues affordability (cost medicines costs as well facilities) population possible loss earnings long waiting times see professional facilities. Community more convenientEducating can antibiotics. instigation indicators also helps dispensingWith publication AWaRe book, it increasingly likely that future will based its content. Alongside this, there increasing use information technology mobile telephones monitor against agreed indicatorsThe curricula universities professionals upgraded make sure they fully competent appropriately counsel optimal management infectious disease/those children post qualification, backed up continuous development activitiesDeclaration interestA Cook C Moore funded Welcome Trust (222051/Z/20/Z) ADILA project. E Yeika, SA. Opanga, ZU Mustafa, V Marković-Peković, Kurdi, BD Anand Paramadhas, Wesangula, Hango, N Schellack, S Mudenda, I Hoxha JC Meyer either worked national or regional government agenices advisers them surrounding NAPs. In addition, Opanga received grant from Kenya AIDS Vaccine Institute -Institute Clinical Research Institut Merieux tackling GM Rwegerera works Destiny Medical Solutions Proprietary Limited, Gaborone, Botswana. authors other relevant affiliations financial involvement any organization entity interest conflict subject matter materials discussed manuscript apart those disclosed.Reviewer disclosuresPeer reviewers this relationships disclose.Supplementary materialSupplemental data article accessed online at https://doi.org/10.1080/14787210.2023.2259106Additional informationFundingThis paper not funded.

Language: Английский

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Knowledge, Attitudes, Motivations, Expectations, and Systemic Factors Regarding Antimicrobial Use Amongst Community Members Seeking Care at the Primary Healthcare Level: A Scoping Review

Antibiotics, Journal Year: 2025, Volume and Issue: 14(1), P. 78 - 78

Published: Jan. 13, 2025

Background/Objectives: Antimicrobial resistance (AMR) is a major global health challenge, particularly in low- and middle-income countries (LMICs). Understanding the knowledge, attitudes, motivations, expectations of community members regarding antimicrobial use essential for effective stewardship interventions. This scoping review aimed to identify key themes relating critical areas among primary healthcare (PHC), with particular focus on LMICs. Methods: OVID Medline, PubMed, CINAHL databases were searched using Boolean operators Medical Subject Headings (MeSH) terms relevant behaviors. The Population, Intervention, Comparison, Outcome, Study Design (PICOS) framework guided study selection, which focused seeking care PHC Data management extraction facilitated Covidence platform, Critical Appraisal Skills Programme (CASP) qualitative checklist applied studies. A narrative synthesis identified grouped sub-themes. Results: search 497 sources, 59 met inclusion criteria, 75% studies conducted outpatient settings. Four identified: (1) ’patient’ theme, highlighting beliefs, expectations, was most prominent (40.5%); (2) ’provider’ emphasizing challenges related clinical decision-making, knowledge gaps, adherence guidelines; (3) ’healthcare systems’ resource limitations, lack infrastructure, policy constraints; (4) ‘intervention/uptake’ strategies improve future antibiotic enhance access quality healthcare. Conclusions: Stewardship programs settings LMICs should be designed context-specific, community-engaged, accessible individuals varying levels understanding, involving information literacy effectively reduce AMR.

Language: Английский

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Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

World Journal of Emergency Surgery, Journal Year: 2023, Volume and Issue: 18(1)

Published: Oct. 16, 2023

Abstract Antibiotics are recognized widely for their benefits when used appropriately. However, they often inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component universal healthcare, and it a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive develop new antibiotics due scientific, regulatory, financial barriers, further emphasizing To address this issue, Global Alliance Infections in Surgery established international multidisciplinary task force 295 experts from 115 countries with different backgrounds. The developed position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness antimicrobial resistance improving prescribing practices worldwide. outlined 10 axioms, or “golden rules,” that all healthcare workers should consistently adhere

Language: Английский

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Current Antibiotic Use Among Hospitals in the sub-Saharan Africa Region; Findings and Implications

Infection and Drug Resistance, Journal Year: 2023, Volume and Issue: Volume 16, P. 2179 - 2190

Published: April 1, 2023

Background: The rapid rise in antimicrobial resistance (AMR) globally, impacting on morbidity, mortality and costs with sub-Saharan African countries reporting the greatest burden is a concern. Instigation of stewardship programs (ASPs) can improve antibiotic use hospitals reduce AMR. Implementing ASPs requires knowledge utilization against agreed quality indicators data obtained from point prevalence surveys (PPS), hence need to document patterns Africa. Methods: A narrative review current patterns, challenges, across Africa based previous reviews by authors, supplemented considerable experience co-authors. Results: Results multiple PPS studies showed high among hospitals, mostly over 50%. Prevalence rates ranged as low 37.7% South 80.1% Nigeria. There was also prescribing broad-spectrum antibiotics which could be due lack facilities within alongside concerns co-payments perform microbiological tests, resulting empiric prescribing. This concern guidelines or adherence guidelines, 4% one study. Another extended prophylaxis prevent surgical site infections (SSIs), often prescribed for longer than 24 hours, usually doses. Several have been used evaluate providing exemplars future. Among initiatives being instigated use, proved effective. For successful objectives must agreed, regular audits undertaken. Conclusion: Antibiotic characterised prevalence, empirical. Various are employed assess shown direction Keywords: Africa, surveys, indicators, infections,

Language: Английский

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Community antibiotic consumption and associated factors in Lusaka district of Zambia: findings and implications for antimicrobial resistance and stewardship

JAC-Antimicrobial Resistance, Journal Year: 2024, Volume and Issue: 6(2)

Published: March 5, 2024

Antimicrobial resistance (AMR) is a global public health crisis. This study assessed the general public's consumption of antibiotics and associated factors in Lusaka district Zambia.

Language: Английский

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Antimicrobial resistance profiles of Escherichia coli isolated from clinical and environmental samples: findings and implications

JAC-Antimicrobial Resistance, Journal Year: 2024, Volume and Issue: 6(2)

Published: March 5, 2024

Abstract Background The overuse and misuse of antimicrobials has worsened the problem antimicrobial resistance (AMR) globally. This study investigated AMR profiles Escherichia coli isolated from clinical environmental samples in Lusaka, Zambia. Methods was a cross-sectional conducted February 2023 to June using 450 samples. VITEK® 2 Compact used identify E. perform susceptibility testing. Data analysis done WHONET 2022 SPSS version 25.0. Results Of samples, 66.7% (n = 300) were whereas 33.3% 150) Overall, 47.8% 215) (37.8% 10% environmental) tested positive for coli. 215 isolates, 66.5% MDR 42.8% ESBL-producers. Most isolates resistant ampicillin (81.4%), sulfamethoxazole/trimethoprim (70.7%), ciprofloxacin (67.9%), levofloxacin (64.6%), ceftriaxone (62.3%) cefuroxime (62%). Intriguingly, highly susceptible amikacin (100%), imipenem (99.5%), nitrofurantoin (89.3%), ceftolozane/tazobactam (82%) gentamicin (72.1%). Conclusions found high some antibiotics that are commonly humans. isolation ESBL-producing is public health concern requires urgent action. Therefore, there need instigate strengthen interventional strategies including stewardship programmes combat

Language: Английский

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Assessment of antimicrobial resistance laboratory-based surveillance capacity of hospitals in Zambia: findings and implications for system strengthening

Journal of Hospital Infection, Journal Year: 2024, Volume and Issue: 148, P. 129 - 137

Published: April 15, 2024

BackgroundA well-established antimicrobial resistance (AMR) laboratory-based surveillance (LBS) is of utmost importance in a country like Zambia which bears significant proportion the world's communicable disease burden. This study assessed capacity laboratories selected hospitals to conduct AMR Zambia.MethodsThis cross-sectional exploratory was conducted among eight (8) purposively between August 2023 and December 2023. Data were collected using self-scoring Laboratory Assessment Antibiotic Resistance Testing Capacity (LAARC) tool.FindingsOf facilities, none had full with varying capacities ranging from moderate [63% (5/8)] low [38% (3/8)]. Some barriers AMR-LBS lack electronic laboratory information system (LIS) locally generated antibiograms [75% (6/8)]. Quality control for susceptibility testing (AST), pathogen identification media preparation lowest overall score all facilities 14%, 20% 44% respectively. The highest scores specimen processing (79%), data management (78%), collection, transport, (71%) safety (70%). Most standard operating procedures (SOPs) place but lacked specimen-specific SOPs.ConclusionThe absence hinders efforts combat further complicates treatment outcomes infectious diseases. Establishing strengthening LBS systems are essential quantifying burden supporting development local guidelines.

Language: Английский

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Surveillance of Antibiotic Use and Adherence to the WHO/INRUD Core Prescribing Indicators at a Primary Healthcare Hospital in Southern Zambia: Opportunities for Antimicrobial Stewardship Programs

Pharmacology &amp Pharmacy, Journal Year: 2025, Volume and Issue: 16(01), P. 1 - 19

Published: Jan. 1, 2025

Background: The irrational use of medicines remains a key health problem in many developing countries. overuse antibiotics is driver antimicrobial resistance (AMR). This study surveyed antibiotic and adherence to the World Health Organization (WHO) prescribing indicators at Request Muntanga Hospital Kalomo District Southern Province, Zambia. Materials Methods: cross-sectional was conducted from July 2023 September Zambia reviewed 600 medical record prescriptions which were issued 1, 2022 June 30, using WHO indicators. collected data analyzed Statistical Package for Social Sciences version 23.0. Results: From sampled, 1246 prescribed, with making up 86.7% encounters. Additionally, average number drugs prescribed per encounter 2.1 prevalence polypharmacy 61.3%. Further, 17.8% as injectables. Furthermore, 76.7% Essential Medicines List 38.9% by generic names. Conclusions: found high deviations WHO/International Network Rational Use Drugs (INRUD) core indicating non-adherence There need promote WHO/INRUD rational prevent emergence spread AMR.

Language: Английский

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Knowledge, attitudes, motivations and expectations regarding antimicrobial use among community members seeking care at the primary healthcare level: a scoping review protocol

BMJ Open, Journal Year: 2025, Volume and Issue: 15(1), P. e088769 - e088769

Published: Jan. 1, 2025

Introduction Inappropriate antibiotic use in (primary healthcare, PHC) settings fuels antimicrobial resistance (AMR), threatens patient safety and burdens healthcare systems. Patients’ knowledge, attitudes, motivations expectations play a crucial role behaviour, especially low-income middle-income countries including South Africa. There is need to ensure measures of use, interventions future guidance reflect cultural, community demographic issues associated with views reduce inappropriate antibiotics AMR. The objective this scoping review identify key themes surrounding among patients members regarding PHC countries. Methods analysis This employs comprehensive search strategy across multiple electronic databases, OVID, Medline, PubMed CINHAL, studies addressing or seeking care at facilities exploring drivers use. Covidence web-based platform will be used for literature screening data extraction the Critical Appraisal Skills Programme qualitative checklist assess quality papers. Anticipated results provide an overview current evidence base, enabling identification knowledge gaps. A narrative synthesis findings summarise patterns patients’ related while considering methodological diversity limitations. Ethics dissemination approval not required review. disseminated through publication peer-reviewed journal, presentation relevant conferences workshops, collaboration policy-makers stakeholders.

Language: Английский

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