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J Glob Infect Dis. 2019 Jan-Mar;11(1):36-42. doi: 10.4103/jgid.jgid_110_18.

Global Contributors to Antibiotic Resistance.

Author information

1
Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
2
Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
3
Department of Pharmacy, University Hospital, Newark, New Jersey, USA.

Abstract

Introduction:

Antibiotic-resistant infections have become increasingly prevalent nowadays. As a result, it is essential to examine the key socioeconomic and political factors which contribute to the rise in the prevalence of antibiotic resistance in developing and developed nations. This study aims to identify the various contributors to the development of antibiotic resistance in each type of nation.

Methods:

PUBMED was used to identify primary research, systematic reviews, and narrative reviews published before Jan 2017. Search terms included antibiotic resistance, antimicrobial resistance, superbugs, multidrug-resistant organisms, developing countries, developed countries. Publications from different countries were included to ensure generalizability. Publications were excluded if they didn't mention factors causing resistance, focused on the molecular basis of resistance, or if they were case reports. Publicly available reports from national and international health agencies were used.

Results:

In developing countries, key contributors identified included: (1) Lack of surveillance of resistance development, (2) poor quality of available antibiotics, (3) clinical misuse, and (4) ease of availability of antibiotics. In developed countries, poor hospital-level regulation and excessive antibiotic use in food-producing animals play a major role in leading to antibiotic resistance. Finally, research on novel antibiotics is slow ing down due to the lack of economic incentives for antibiotic research.

Conclusion:

Overall, multiple factors, which are distinct for developing and developed countries, contribute to the increase in the prevalence of antibiotic resistance globally. The results highlight the need to improve the regulatory framework for antibiotic use and research globally.

KEYWORDS:

Antibiotic resistance; developed countries; developing countries; socioeconomic driving forces

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