Antibiotic stewardship in low- and middle-income countries: the same but different?

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dc.contributor.authorCox, Janneke Arnoldine
dc.contributor.authorVlieghe, Erika
dc.contributor.authorMendelson, Marc
dc.contributor.authorWertheim, Heiman
dc.contributor.authorNdegwa, L.
dc.contributor.authorVillegas, María Virginia
dc.contributor.authorGould, Ian Malcolm
dc.contributor.authorLevy-Hara, Gabriel
dc.contributor.orcidVillegas, María Virginia [0000-0003-1898-9067]
dc.date.accessioned2020-07-10T21:05:03Z
dc.date.available2020-07-10T21:05:03Z
dc.date.issued2017
dc.description.abstractenglishBackground Antibiotic resistance (ABR) is a quickly worsening problem worldwide, also in low- and middle-income countries (LMICs). Appropriate antibiotic use in humans and animals, i.e. antibiotic stewardship (ABS), is one of the cornerstones of the World Health Organization's global action plan for ABR. Many LMICs are in the process of developing stewardship programs. Aims We highlight challenges for ABS initiatives in LMICs, give an outline of (inter)national recommendations and demonstrate examples of effective, contextualized stewardship interventions. Sources We searched PubMed for articles on ABS interventions in humans in LMICs. Relevant websites and experts were consulted for additional sources. Content Evidence on effective and feasible stewardship interventions in LMICs is limited, and challenges for implementation of interventions are numerous. Nevertheless, several initiatives at the international and local levels in Latin America, Africa and Asia have shown that ABS effective interventions are feasible in LMICs, although contextualization is essential. Implications Specific guidance for setting up antimicrobial stewardship programs in LMICs should be developed. Strategic points might need to be progressively addressed in LMICs, such as (a) ensuring availability of diagnostic testing, (b) providing dedicated education in ABR both for healthcare workers and the general public, (c) creating or strengthening (inter)national agencies towards better regulations and audit on production, distribution and dispensing of drugs, (d) strengthening healthcare facilities, (e) exploring a broader synergism between policy makers, academia, professional bodies and civil society and (f) designing and studying easy and scalable ABS interventions for both hospital and community settings.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://dx.doi.org/10.1016/j.cmi.2017.07.010
dc.identifier.instnameinstname:Universidad El Bosquespa
dc.identifier.issn1469-0691
dc.identifier.reponamereponame:Repositorio Institucional Universidad El Bosquespa
dc.identifier.repourlhttps://repositorio.unbosque.edu.co
dc.identifier.urihttps://hdl.handle.net/20.500.12495/3463
dc.language.isoeng
dc.publisherElsevierspa
dc.publisher.journalClinical microbiology and infectionspa
dc.relation.ispartofseriesClinical microbiology and infection, 1469-0691, Vol. 23, Nro. 11, 2017, p. 812-818spa
dc.relation.urihttps://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(17)30365-8/fulltext
dc.rights.accessrightshttps://purl.org/coar/access_right/c_abf2
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.accessrightsAcceso abierto
dc.rights.creativecommons2017-07-14
dc.rights.localAcceso abiertospa
dc.subject.decsSalud públicaspa
dc.subject.decsAntibacterianosspa
dc.subject.decsPaíses en desarrollospa
dc.subject.keywordsAntibiotic resistancespa
dc.subject.keywordsAntibiotic stewardshipspa
dc.subject.keywordsGuidelinesspa
dc.titleAntibiotic stewardship in low- and middle-income countries: the same but different?spa
dc.title.translatedAntibiotic stewardship in low- and middle-income countries: the same but different?spa
dc.type.coarhttps://purl.org/coar/resource_type/c_6501
dc.type.driverinfo:eu-repo/semantics/article
dc.type.hasversioninfo:eu-repo/semantics/publishedVersion
dc.type.localArtículo de revista

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