A current perspective on antimicrobial resistance in Southeast Asia

Zellweger, Raphaël M.; Carrique-Mas, Juan; Limmathurotsakul, Direk; Day, Nicholas P. J.; Thwaites, Guy; Baker, Stephen

doi:10.1093/jac/dkx260

Cited by 145 publications

(130 citation statements)

References 64 publications

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Section: Introductionmentioning

confidence: 99%

“…Poor hygiene and infection control, lack of sanitation, weak or unenforced medicines regulation, and sub-standard quality drugs have been suggested as some of the main drivers of AMR in SE Asia (Zellweger et al, 2017). In addition, intensification of agriculture and aquaculture may contribute to AMR owing to increased and unregulated use of antibiotics in these sectors as therapeutic, prophylactic, metaphylactic, and growth promotion agents (Zellweger et al, 2017). Acknowledging the diversity of these drivers, a One Health approach to tackling AMR has been encouraged (Robinson et al, 2016), and there is much work to be done to understand clearly the links between agriculture, humans, and the environment in the development and spread of AMR.…”

Section: Introductionmentioning

confidence: 99%

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Antimicrobial resistance in Cambodia: a review

Reed

Krang

Miliya

et al. 2019

International Journal of Infectious Diseases

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Objectives: Following the launch of the Global Antimicrobial Resistance Surveillance System (GLASS), antimicrobial resistance (AMR) rates in many countries remain poorly described. This review provides an overview of published AMR data from Cambodia in the context of recently initiated national human and food-animal surveillance. Methods: PubMed and the Cochrane Database of Systematic Reviews were searched for articles published from 2000 to 2018, which reported antimicrobial susceptibility testing (AST) data for GLASS specific organisms isolated from Cambodia. Articles were screened using strict inclusion/exclusion criteria. AST data was extracted, with medians and ranges of resistance rates calculated for specific bug-drug combinations. Results: Twenty-four papers were included for final analysis, with 20 describing isolates from human populations. Escherichia coli was the most commonly described organism, with median resistance rates from human isolates of 92.8% (n = 6 articles), 46.4% (n = 4), 55.4% (n = 8), and 46.4% (n = 5) to ampicillin, 3 rd generation cephalosporins, fluoroquinolones, and gentamicin respectively. Conclusions: Whilst resistance rates are high for several GLASS organisms, there were insufficient data to draw robust conclusions about the AMR situation in Cambodia. The recently implemented national AMR surveillance systems will begin to address this data gap.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Antimicrobial resistance in Cambodia: a review

Reed

Krang

Miliya

et al. 2019

International Journal of Infectious Diseases

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“…The lack of basic knowledge among public, stimulates irrational demand for antimicrobials and/or treatment non-adherence, which are two key factors of AMR. 5 Free Full Text Articles are Available at www.jnma.com.np…”

Section: Introductionmentioning

confidence: 99%

Knowledge of Use of Antibiotic, Its Resistance and Consequences Among Students in Private Schools.

Deo

Rijal²,

Kunwar³

et al. 2018

J Nepal Med Assoc

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Introduction: Self-medication among adolescents has become a serious global problem that plays an important role in irrational use of medication and tends to increase with the age of adolescents. Limited research has been done in Nepal regarding antibiotic knowledge among non-medical students. Hence, this study aims to assess the knowledge of higher secondary non-science students regarding antibiotic use, resistance and its consequences. Methods: A cross-sectional descriptive study was done during antibiotic awareness week 2017 among 471 grade 11 and 12 non-science students of private schools in Kathmandu. Convenience sampling technique was used. Data was collected through self-administered questionnaires. Descriptive statistics was utilised to find out the knowledge level of the students. Results: The mean age of the students 245 (52%) male, 226 (48%) female) was 17.19 years and 335 (71.1%) were from grade 12. Approximately all 462 (98.1%) the participants had inadequate knowledge regarding antibiotic and their knowledge mean score was 5.8±2.56. More than half 277 (58.8%) of the students had not heard about antibiotic resistance, among those who have heard 113 (24%) said that doctor and nurses were the source of information. Conclusions: Almost all of the participating students lacked adequate knowledge regarding antibiotic. Thus, it is imperative to create school and community based awareness programs by policy makers for adolescents to upgrade their knowledge on safe use of antibiotics as well as to prevent the consequences of antibiotic resistance during their adult life.

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“…Using data generated from a diarrheal cohort study and the simulated client method, we 289 estimated the number (95% CI) of diarrhoea episodes in children aged 1 to 5 years that would receive 290 antimicrobial treatment from a pharmacy in district 8 Antimicrobial resistant infections are increasingly throughout Asia, and are likely being driven in part 297 by ease of access to antimicrobials. This factor is likely more relevant in a setting with a high burden 298 of infectious diseases, low diagnostic capacity, and a large urbanizing population [24][25][26] . Vietnam is the 299 world's fifteenth most populous country, with >96 million people in 2017 and urbanization increased 300 from 28% in 2014 to 34.9% in 2017 27 .…”

Section: Diarrheal Treatment Seeking Behaviour By Caregivers In the Cmentioning

confidence: 99%

Quantifying antimicrobial access and practices for paediatric diarrheal disease in an urban community setting in Southeast Asia

Ltq

Lam

et al. 2017

Preprint

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30Antimicrobial-resistant infections are increasing across Asia. Aiming to evaluate antimicrobial access 31 and practices in Ho Chi Minh City (HCMC) of Vietnam, we mapped pharmacy locations and used a 32 simulated client method to calculate antimicrobial sales for paediatric diarrheal disease. We 33 additionally evaluated healthcare choices for parents and caregivers when their children experienced 34 diarrhoea. District 8 (population 396,175) of HCMC had 301 pharmacies (one for every 1,316 people), 35 with a density of 15.8 pharmacies/km 2 . A wide range of different treatments (n=57) were sold for 36 paediatric diarrheal disease, with 8% (3/37) and 22% (8/37) of the sampled pharmacies selling 37 antimicrobials for watery and mucoid diarrhoea, respectively. Despite the apparent abundance of 38 pharmacies, the majority of caregivers chose to take their child to a specialized hospital, with 81% 39 (319/396) and 88% (347/396) of responders selecting this as their first, second, or third choice for 40 watery and mucoid diarrhoea, respectively. Lastly, by combining denominators derived from 41 caregiver interviews and diarrheal incidence figures, we calculated that 16% (2,359/14,427) of watery 42 or mucoid diarrhoea episodes of the District 8 population aged 1 to <5 years would receive an 43 antimicrobial for diarrhoea annually, but antimicrobial prescribing was almost ten times greater in 44 hospitals than in the community. Our novel mixed-methods approach found that, whilst antimicrobials 45 are commonly available for paediatric diarrhoea in the community of HCMC, usage is greater in 46 hospitals. The observed non-standardized approach to diarrheal treatments is indicative of poor 47 recommendations. We advocate better guidelines, training and dissemination of information regarding 48 antimicrobials and their use in this location. 49 50 51 52 53 54 55 56 57 Committee (OxTREC approval 5110-16) and the local Institutional Review Board (IRB) of the 102 University of Medicine and Pharmacy at HCMC (No. 220/DHYD-HD). Written informed consent 103 was obtained from all participants over 18 years of age, or from parents and guardians if participant 104 was under 18 years. 105 106 Study setting and design 107With an estimated population of >8 million people, HCMC is the largest city in southern Vietnam 17 . 108

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A current perspective on antimicrobial resistance in Southeast Asia

Cited by 145 publications

References 64 publications

Antimicrobial resistance in Cambodia: a review

Antimicrobial resistance in Cambodia: a review

Knowledge of Use of Antibiotic, Its Resistance and Consequences Among Students in Private Schools.

Quantifying antimicrobial access and practices for paediatric diarrheal disease in an urban community setting in Southeast Asia

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