Closing the GAP in Antimicrobial Resistance Policy in Benin and Burkina Faso

Sariola, Salla; Butcher, Andrea; Cañada, José A.; Aïkpé, Mariette; Compaoré, Adélaïde

doi:10.1128/msystems.00150-22

Cited by 6 publications

(1 citation statement)

References 20 publications

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“…It was also seen to be important to standardize the practices at the national level to improve the quality of microbiological testing. In Benin it is a common, but unofficial, practice that nurses rather than medical doctors prescribe antibiotics (25), which the pharmacists indicated as a major problem due to the insufficient training of nurses. Thus, in future studies exploring the prescription of antibiotics and in training programs, it would be important to include nurses as well as physicians.…”

Section: Skills Improvement Neededmentioning

confidence: 99%

Assessment of blood cultures and antibiotic susceptibility testing for bacterial sepsis diagnosis and utilization of results by clinicians in Benin: A qualitative study

Lègba

Dougnon

Koudokpon

et al. 2023

Front. Public Health

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ObjectivesWe assessed the current status of blood culture and antibiotic susceptibility testing (AST) practices in clinical laboratories in Benin, and how the laboratory results are used by physicians to prescribe antibiotics.MethodsThe qualitative study covered twenty-five clinical laboratories with a bacteriology unit and associated hospitals and pharmacies. Altogether 159 laboratory staff, physicians and pharmacists were interviewed about their perceptions of the state of laboratory diagnostics related to sepsis and the use of antibiotics. Face-to-face interviews based on structured questionnaires were supported by direct observations when visiting five laboratories in across the country.ResultsOnly 6 laboratories (24%) conducted blood cultures, half of them with a maximum of 10 samples per month. The most common gram-negative bacteria isolated from blood cultures were: Escherichia coli, Salmonella spp. and Salmonella enterica serovar Typhi while the most common gram-positives were Enterococcus spp. and Staphylococcus aureus. None of the laboratories listed Klebsiella pneumoniae among the three most common bacteria isolated from blood cultures, although other evidence indicates that it is the most common cause of sepsis in Benin. Due to limited testing capacity, physicians most commonly use empirical antibiotic therapy.ConclusionsMore resources are needed to develop laboratory testing capacity, technical skills in bacterial identification, AST, quality assurance, and communication of results must be strengthened.

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Section: Skills Improvement Neededmentioning

confidence: 99%

Assessment of blood cultures and antibiotic susceptibility testing for bacterial sepsis diagnosis and utilization of results by clinicians in Benin: A qualitative study

Lègba

Dougnon

Koudokpon

et al. 2023

Front. Public Health

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Soft governance against superbugs: How effective is the international regime on antimicrobial resistance?

Heinzel,

Koenig-Archibugi

2023

Rev Int Organ

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Antimicrobial resistance (AMR) and the declining effectiveness of antibiotic medicines due to misuse are among the biggest threats to global health and a major challenge for global governance in this century. Since drug-resistant bacteria spread easily across borders, government policies that exacerbate or mitigate AMR affect other countries. International organizations and governments addressed the global public good of maintaining antimicrobial protection by creating a soft governance regime largely devoid of legally binding rules and enforcement mechanisms. This article presents a cross-national empirical assessment of the effectiveness of the international AMR regime combining novel data on national action plans and data on antibiotic consumption in 191 countries between 2000 and 2018. We find that the regime sets ambitious goals and achieves broad participation, substantial implementation, and meaningful change in the use of antibiotics. The involvement of the largest consumers of antibiotics has been crucial for both effectiveness and equity.

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The Antibiocene – towards an eco-social analysis of humanity’s antimicrobial footprint

Kirchhelle

2023

Humanit Soc Sci Commun

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Over eight decades of mass antimicrobial exposures have changed microbial populations and genes at a global level. This thought piece argues that adequately responding to the anthropogenic transformation of the microbial commons requires reframing antimicrobial resistance (AMR) as the pheno- and genotypic signal of a new geological era – an Antibiocene. Thinking through the multiple spatiotemporal, biological, and social scales of this Antibiocene opens important perspectives on the long-term goals of (anti)microbial stewardship, the injustices connected with unequal antimicrobial exposures, and the scale of necessary changes to health, food production, and waste disposal systems. Conceptualising AMR within an Antibiocene also necessitates shifting the political gaze from the clinic and sites of food production to the hitherto neglected environmental domain of One Health, whose terrestrial and aquatic milieus act as crucial reservoirs for antimicrobial substances, antimicrobial resistance genes, and resistant organisms. Finally, disentangling the human and non-human dimensions of the Antibiocene requires working across the humanities, social-, environmental, and biomedical sciences. The thought piece ends by proposing comparative research on particularly contaminated sites as a promising way of reconstructing the microbial, biochemical, and societal fallouts of chronic antimicrobial exposures as well as already existing societal adaptations. Resulting findings will provide orientation for emerging debates on the preservation of our microbial commons and the development of new forms of ‘eubiotic governance’.

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Closing the GAP in Antimicrobial Resistance Policy in Benin and Burkina Faso

Abstract: The burden of antimicrobial resistance (AMR) is unequally distributed across the globe. Low-income countries face a more severe AMR situation and have fewer means to solve the problem.

Cited by 6 publications

References 20 publications

Assessment of blood cultures and antibiotic susceptibility testing for bacterial sepsis diagnosis and utilization of results by clinicians in Benin: A qualitative study

Assessment of blood cultures and antibiotic susceptibility testing for bacterial sepsis diagnosis and utilization of results by clinicians in Benin: A qualitative study

Soft governance against superbugs: How effective is the international regime on antimicrobial resistance?

The Antibiocene – towards an eco-social analysis of humanity’s antimicrobial footprint

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