Advocacy for Increased International Efforts for Antimicrobial Stewardship Actions in Low-and Middle-Income Countries on Behalf of Alliance for the Prudent Use of Antimicrobials (APUA), Under the Auspices of the International Society of Antimicrobial Chemotherapy (ISAC)
Antimicrobial stewardship (AMS) is a set of coordinated strategies to improve the use of antimicrobials, to enhance patient outcomes, reduce antimicrobial resistance, and decrease unnecessary costs. The pioneer years of AMS were restricted to high-income countries (HIC), where overconsumption of ant...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-08-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fmed.2020.00503/full |
| _version_ | 1818531261607575552 |
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| author | Pierre Tattevin Gabriel Levy Hara Adnene Toumi Mushira Enani Geoffrey Coombs Andreas Voss Andreas Voss Heiman Wertheim Armel Poda Ziad Daoud Ramanan Laxminarayan Dilip Nathwani Ian Gould |
| author_facet | Pierre Tattevin Gabriel Levy Hara Adnene Toumi Mushira Enani Geoffrey Coombs Andreas Voss Andreas Voss Heiman Wertheim Armel Poda Ziad Daoud Ramanan Laxminarayan Dilip Nathwani Ian Gould |
| author_sort | Pierre Tattevin |
| collection | DOAJ |
| description | Antimicrobial stewardship (AMS) is a set of coordinated strategies to improve the use of antimicrobials, to enhance patient outcomes, reduce antimicrobial resistance, and decrease unnecessary costs. The pioneer years of AMS were restricted to high-income countries (HIC), where overconsumption of antibiotics was associated with emergence of multidrug-resistant (MDR) bacteria. AMS in low- and middle-income countries (LMIC) is also necessary. However, programs effective in HIC may not perform as well in LMIC, because (i) While decreased consumption of antibiotics may be an appropriate target in overconsuming HIC, this may be dangerous in LMIC, where many patients die from the lack of access to antibiotics; (ii) although AMS programs in HIC can be designed and monitored through laboratory surveillance of resistance, surveillance programs are not available in many LMIC; (iii) the heterogeneity of health care systems implies that AMS programs must be carefully contextualized. Despite the need to individually tailor AMS programs in LMIC, international collaborations remain highly valuable, through the dissemination of high-quality documents and educational material, that may be shared, adapted where needed, and adopted worldwide. This process, facilitated by modern communication tools, combines many benefits, including: (i) saving time, a precious dimension for health care workers, by avoiding the duplication of similar works in different settings; (ii) taking advantage of colleagues skills, and initiatives, through open access to the work performed in other parts of the world; (iii) sharing experiences, so that we all learn from each others' successes and failures. |
| first_indexed | 2024-12-11T17:30:10Z |
| format | Article |
| id | doaj.art-e05dcc4ea0df403ab13e6c9a0386ba1d |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-11T17:30:10Z |
| publishDate | 2020-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-e05dcc4ea0df403ab13e6c9a0386ba1d2022-12-22T00:56:51ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2020-08-01710.3389/fmed.2020.00503527243Advocacy for Increased International Efforts for Antimicrobial Stewardship Actions in Low-and Middle-Income Countries on Behalf of Alliance for the Prudent Use of Antimicrobials (APUA), Under the Auspices of the International Society of Antimicrobial Chemotherapy (ISAC)Pierre Tattevin0Gabriel Levy Hara1Adnene Toumi2Mushira Enani3Geoffrey Coombs4Andreas Voss5Andreas Voss6Heiman Wertheim7Armel Poda8Ziad Daoud9Ramanan Laxminarayan10Dilip Nathwani11Ian Gould12Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital Center, Rennes, FranceInfectious Diseases Unit, Hospital Carlos G. Durand, Buenos Aires, ArgentinaInfectious Diseases Department, Monastir University Hospital, Monastir, TunisiaFaculty of Medicine, King Fahad Medical City, Riyadh, Saudi ArabiaAntimicrobial Resistance and Infectious Diseases Research Laboratory, Murdoch University, Perth, WA, AustraliaDepartment of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, NetherlandsRadboudumc, Department of Medical Microbiology and Radboud Center for Infectious Diseases, Nijmegen, NetherlandsRadboudumc, Department of Medical Microbiology and Radboud Center for Infectious Diseases, Nijmegen, NetherlandsInfectious Diseases Department, Sourô Sanou University Hospital, Bobo-Dioulasso, Burkina FasoClinical Microbiology, Saint George Hospital-UMC and University of Balamand, Beirut, Lebanon0Center for Disease Dynamics, Economics and Policy (CDDEP), New Delhi, India1Ninewells Hospital and Medical School, Dundee, United Kingdom2Aberdeen Royal Infirmary, Aberdeen, United KingdomAntimicrobial stewardship (AMS) is a set of coordinated strategies to improve the use of antimicrobials, to enhance patient outcomes, reduce antimicrobial resistance, and decrease unnecessary costs. The pioneer years of AMS were restricted to high-income countries (HIC), where overconsumption of antibiotics was associated with emergence of multidrug-resistant (MDR) bacteria. AMS in low- and middle-income countries (LMIC) is also necessary. However, programs effective in HIC may not perform as well in LMIC, because (i) While decreased consumption of antibiotics may be an appropriate target in overconsuming HIC, this may be dangerous in LMIC, where many patients die from the lack of access to antibiotics; (ii) although AMS programs in HIC can be designed and monitored through laboratory surveillance of resistance, surveillance programs are not available in many LMIC; (iii) the heterogeneity of health care systems implies that AMS programs must be carefully contextualized. Despite the need to individually tailor AMS programs in LMIC, international collaborations remain highly valuable, through the dissemination of high-quality documents and educational material, that may be shared, adapted where needed, and adopted worldwide. This process, facilitated by modern communication tools, combines many benefits, including: (i) saving time, a precious dimension for health care workers, by avoiding the duplication of similar works in different settings; (ii) taking advantage of colleagues skills, and initiatives, through open access to the work performed in other parts of the world; (iii) sharing experiences, so that we all learn from each others' successes and failures.https://www.frontiersin.org/article/10.3389/fmed.2020.00503/fullantimicrobial stewardshiplow- and middle- income countriesantibioticsresistanceeducation |
| spellingShingle | Pierre Tattevin Gabriel Levy Hara Adnene Toumi Mushira Enani Geoffrey Coombs Andreas Voss Andreas Voss Heiman Wertheim Armel Poda Ziad Daoud Ramanan Laxminarayan Dilip Nathwani Ian Gould Advocacy for Increased International Efforts for Antimicrobial Stewardship Actions in Low-and Middle-Income Countries on Behalf of Alliance for the Prudent Use of Antimicrobials (APUA), Under the Auspices of the International Society of Antimicrobial Chemotherapy (ISAC) Frontiers in Medicine antimicrobial stewardship low- and middle- income countries antibiotics resistance education |
| title | Advocacy for Increased International Efforts for Antimicrobial Stewardship Actions in Low-and Middle-Income Countries on Behalf of Alliance for the Prudent Use of Antimicrobials (APUA), Under the Auspices of the International Society of Antimicrobial Chemotherapy (ISAC) |
| title_full | Advocacy for Increased International Efforts for Antimicrobial Stewardship Actions in Low-and Middle-Income Countries on Behalf of Alliance for the Prudent Use of Antimicrobials (APUA), Under the Auspices of the International Society of Antimicrobial Chemotherapy (ISAC) |
| title_fullStr | Advocacy for Increased International Efforts for Antimicrobial Stewardship Actions in Low-and Middle-Income Countries on Behalf of Alliance for the Prudent Use of Antimicrobials (APUA), Under the Auspices of the International Society of Antimicrobial Chemotherapy (ISAC) |
| title_full_unstemmed | Advocacy for Increased International Efforts for Antimicrobial Stewardship Actions in Low-and Middle-Income Countries on Behalf of Alliance for the Prudent Use of Antimicrobials (APUA), Under the Auspices of the International Society of Antimicrobial Chemotherapy (ISAC) |
| title_short | Advocacy for Increased International Efforts for Antimicrobial Stewardship Actions in Low-and Middle-Income Countries on Behalf of Alliance for the Prudent Use of Antimicrobials (APUA), Under the Auspices of the International Society of Antimicrobial Chemotherapy (ISAC) |
| title_sort | advocacy for increased international efforts for antimicrobial stewardship actions in low and middle income countries on behalf of alliance for the prudent use of antimicrobials apua under the auspices of the international society of antimicrobial chemotherapy isac |
| topic | antimicrobial stewardship low- and middle- income countries antibiotics resistance education |
| url | https://www.frontiersin.org/article/10.3389/fmed.2020.00503/full |
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