Antimicrobial resistance in developing countries. Part II: strategies for containment

Area of Science:

• Microbiology and Infectious Diseases
• Public Health Policy
• Pharmacology

Background:

• Antimicrobial resistance (AMR) poses a significant global health threat, with developing nations facing particularly unfavorable trends.
• Implementation of AMR containment strategies is hindered by universal and country-specific challenges.
• The World Health Organization (WHO) has recommended various containment strategies.

Discussion:

• Controlling selective pressure for resistance can be achieved through interventions targeting prescribers, distributors, and consumers of antimicrobials.
• National-level drug use strategies, such as combination therapy or cycling, can extend the efficacy of existing and future antimicrobial agents.
• Programs like Integrated Management of Childhood Illnesses (IMCI) and Directly Observed Short-Course Therapy (DOTS) positively influence resistance-driving factors.

Key Insights:

• Preventing infectious disease transmission, including vaccination against *Haemophilus influenzae* type B and *Streptococcus pneumoniae*, can reduce AMR prevalence.
• Increased organizational focus on AMR necessitates enhanced collaboration to mitigate the escalating trend.
• Addressing unregulated drug availability, inadequate quality assurance, poor surveillance, and antimicrobial abuse is crucial for a comprehensive resistance control strategy.

Outlook:

• A multi-faceted approach is essential to combat the growing threat of antimicrobial resistance.
• Continued research and development of new antimicrobial agents are necessary.
• Global cooperation and policy implementation are vital for effective AMR containment.