Antimicrobial Stewardship in Resource-Limited Settings

Abstract

Antimicrobials are very important for the treatment of patients. With decades of haphazard prescription and inappropriate use, antimicrobial resistance (AMR) has emerged as a global public health threat. In resource-limited settings, besides AMR, there is also the issue of access to antibiotics and increased healthcare costs. In the past, the discovery of new drugs and the modification of older ones helped to counter antimicrobial resistance. Since the 1970s, only a handful of new agents (a few of which are novel) have been introduced into clinical practice periodically. This makes the existing antibiotics to be a limited resource. Antibiotics must, therefore, be used more responsibly and managed carefully to extend their usefulness while being made available to the patients who truly need them. Antimicrobial stewardship (AMS) refers to systematic actions or interventions that inculcate sustainable, rational, and evidence-based antibiotic prescription and use patterns in healthcare institutions. Implementation of AMS programmes would be an appropriate step towards improving patient outcomes, reducing AMR and its adverse economic impact, and building the best-practices capacity of healthcare professionals, among others. Despite these seemingly beneficial benefits, the implementation of antimicrobial stewardship programmes (ASPs) remains relatively limited and faces complex challenges in resource-poor healthcare settings.