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Antimicrobial resistance in developing countries. Part II: strategies for containment.
- Source :
-
The Lancet. Infectious diseases [Lancet Infect Dis] 2005 Sep; Vol. 5 (9), pp. 568-80. - Publication Year :
- 2005
-
Abstract
- The growing threat from resistant organisms calls for concerted action to prevent the emergence of new resistant strains and the spread of existing ones. Developing countries have experienced unfavourable trends in resistance-as detailed in part I, published last month--and implementation of many of the containment strategies recommended by WHO is complicated by universal, as well as developing country-specific, factors. The control of selective pressure for resistance could potentially be addressed through educational and other interventions for orthodox and unorthodox prescribers, distributors, and consumers of antimicrobials. At national levels, the implementation of drug use strategies--eg, combination therapy or cycling--may prove useful to lengthen the lifespan of existing and future agents. Programmes such as the Integrated Management of Childhood Illnesses (IMCI) and directly observed short-course therapy (DOTS) for tuberculosis are prescriber-focused and patient-focused, respectively, and have both been shown to positively influence factors that contribute to the selective pressure that affects resistance. The institution of interventions to prevent the transmission of infectious diseases could also lead to beneficial effects on the prevalence of resistance, as has vaccination against Haemophilus influenzae type B and Streptococcus pneumoniae. There has been an upsurge in the number of organisations and programmes that directly address issues of resistance, and collaboration could be one way to stem the dire trend. Additional factors such as unregulated drug availability, inadequate antimicrobial drug quality assurance, inadequate surveillance, and cultures of antimicrobial abuse must be addressed to permit a holistic strategy for resistance control.
- Subjects :
- Communicable Diseases, Emerging transmission
Drug and Narcotic Control
Global Health
Humans
International Cooperation
Population Surveillance
Risk Factors
Anti-Bacterial Agents adverse effects
Anti-Bacterial Agents supply & distribution
Anti-Bacterial Agents therapeutic use
Communicable Diseases, Emerging prevention & control
Developing Countries
Drug Resistance, Bacterial drug effects
Drug Resistance, Bacterial physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1473-3099
- Volume :
- 5
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- The Lancet. Infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 16122680
- Full Text :
- https://doi.org/10.1016/S1473-3099(05)70217-6