Keywords:
antimicrobial resistance, healthcare, sanitation, hygiene, prescription
Abstract
Antimicrobial resistance (AMR), in which microbes adapt to and resist current therapies, is a well-recognised global problem that threatens to reverse gains made by modern medicine in the last decades. AMR is a complex issue; however, at its core, it is driven by the overuse and inappropriate use of antimicrobials. Socioeconomic factors have been identified as significant contributors to the emergence and exacerbation of AMR, especially in populations facing inadequate access to healthcare, poor sanitation services and high morbidity and mortality rates. Weak healthcare systems and water, sanitation and hygiene have been highlighted as fundamental risk factors for AMR emergence and transmission. Behavioural factors, such as purchasing antibiotics without a prescription from a registered healthcare professional, not completing the prescribed course or overly prolonged courses of antibiotics, using antibiotics to treat viral infections, lack of access to quality antibiotics, and the proliferation of substandard or falsified (SF) drugs, have also been identified as significant contributors to AMR. Low- and middle-income countries have a higher incidence of antibiotics being dispensed without a prescription than higher-income countries.
Author Biographies
A Brink, University of Cape Town
Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town and National Health Laboratory Service, Groote Schuur Hospital, Cape Town and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
A Kgasi, University of Pretoria
Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, South Africa
A Musyoki, Sefako Makgatho Health Sciences University
Department of Microbiological Pathology, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa
B Kagina, University of Cape Town
Vaccines for Africa and NITAGs Support Hub, School of Public Health, Faculty of Health Sciences, University of Cape Town, South Africa
C Feldman, University of the Witwatersrand
Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
D Reddy, University of the Witwatersrand
Vaccines and Infectious Diseases Analytics Research Unit (Wits-VIDA) and Division of Infectious Diseases, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa
E du Toit, One Health Trust
One Health Trust, Washington DC, USA
E Kalanxhi, One Health Trust
One Health Trust, Washington DC, USA
J Meyer, Sefako Makgatho Health Sciences University
Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University and South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Pretoria, South Africa
I Impalli, One Health Trust
One Health Trust, Washington DC, USA
M Schönfeldt, National Department of Health
Child, Youth and School Health Directorate, National Department of Health, Pretoria, South Africa
M Sibanda, Sefako Makgatho Health Sciences University
Department of Clinical Pharmacy, School of Pharmacy, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa
N Schellack, University of Pretoria
Department of Pharmacology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa
P Skosana, University of Pretoria
Department of Pharmacology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa
S Essack, University of KwaZulu-Natal
Antimicrobial Research Unit, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
S Dlamini, University of Cape Town
Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, South Africa
Y Ramsamy, University of KwaZulu-Natal
Division of Medical Microbiology, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
