Environmental impacts of mass drug administration programs: exposures, risks, and mitigation of antimicrobial resistance
Abstract Mass drug administration (MDA) of antimicrobials has shown promise in the reduction and potential elimination of a variety of neglected tropical diseases (NTDs). However, with antimicrobial resistance (AMR) becoming a global crisis, the risks posed by widespread antimicrobial use need to be...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | Infectious Diseases of Poverty |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40249-022-01000-z |
| _version_ | 1817976521967534080 |
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| author | Joanna K. Konopka Pranab Chatterjee Connor LaMontagne Joe Brown |
| author_facet | Joanna K. Konopka Pranab Chatterjee Connor LaMontagne Joe Brown |
| author_sort | Joanna K. Konopka |
| collection | DOAJ |
| description | Abstract Mass drug administration (MDA) of antimicrobials has shown promise in the reduction and potential elimination of a variety of neglected tropical diseases (NTDs). However, with antimicrobial resistance (AMR) becoming a global crisis, the risks posed by widespread antimicrobial use need to be evaluated. As the role of the environment in AMR emergence and dissemination has become increasingly recognized, it is likewise crucial to establish the role of MDA in environmental AMR pollution, along with the potential impacts of such pollution. This review presents the current state of knowledge on the antimicrobial compounds, resistant organisms, and antimicrobial resistance genes in MDA trials, routes of these determinants into the environment, and their persistence and ecological impacts, particularly in low and middle-income countries where these trials are most common. From the few studies directly evaluating AMR outcomes in azithromycin MDA trials, it is becoming apparent that MDA efforts can increase carriage and excretion of resistant pathogens in a lasting way. However, research on these outcomes for other antimicrobials used in MDA trials is sorely needed. Furthermore, while paths of AMR determinants from human waste to the environment and their persistence thereafter are supported by the literature, quantitative information on the scope and likelihood of this is largely absent. We recommend some mitigative approaches that would be valuable to consider in future MDA efforts. This review stands to be a valuable resource for researchers and policymakers seeking to evaluate the impacts of MDA. Graphical Abstract |
| first_indexed | 2024-04-13T22:04:41Z |
| format | Article |
| id | doaj.art-f7f794fa950a40f9b6bbc8af9d35ca46 |
| institution | Directory Open Access Journal |
| issn | 2049-9957 |
| language | English |
| last_indexed | 2024-04-13T22:04:41Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Diseases of Poverty |
| spelling | doaj.art-f7f794fa950a40f9b6bbc8af9d35ca462022-12-22T02:27:59ZengBMCInfectious Diseases of Poverty2049-99572022-06-0111111410.1186/s40249-022-01000-zEnvironmental impacts of mass drug administration programs: exposures, risks, and mitigation of antimicrobial resistanceJoanna K. Konopka0Pranab Chatterjee1Connor LaMontagne2Joe Brown3The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of MedicineDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins UniversityDepartment of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel HillDepartment of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel HillAbstract Mass drug administration (MDA) of antimicrobials has shown promise in the reduction and potential elimination of a variety of neglected tropical diseases (NTDs). However, with antimicrobial resistance (AMR) becoming a global crisis, the risks posed by widespread antimicrobial use need to be evaluated. As the role of the environment in AMR emergence and dissemination has become increasingly recognized, it is likewise crucial to establish the role of MDA in environmental AMR pollution, along with the potential impacts of such pollution. This review presents the current state of knowledge on the antimicrobial compounds, resistant organisms, and antimicrobial resistance genes in MDA trials, routes of these determinants into the environment, and their persistence and ecological impacts, particularly in low and middle-income countries where these trials are most common. From the few studies directly evaluating AMR outcomes in azithromycin MDA trials, it is becoming apparent that MDA efforts can increase carriage and excretion of resistant pathogens in a lasting way. However, research on these outcomes for other antimicrobials used in MDA trials is sorely needed. Furthermore, while paths of AMR determinants from human waste to the environment and their persistence thereafter are supported by the literature, quantitative information on the scope and likelihood of this is largely absent. We recommend some mitigative approaches that would be valuable to consider in future MDA efforts. This review stands to be a valuable resource for researchers and policymakers seeking to evaluate the impacts of MDA. Graphical Abstracthttps://doi.org/10.1186/s40249-022-01000-zAntibioticsMass drug administrationEnvironmentAntimicrobial resistance |
| spellingShingle | Joanna K. Konopka Pranab Chatterjee Connor LaMontagne Joe Brown Environmental impacts of mass drug administration programs: exposures, risks, and mitigation of antimicrobial resistance Infectious Diseases of Poverty Antibiotics Mass drug administration Environment Antimicrobial resistance |
| title | Environmental impacts of mass drug administration programs: exposures, risks, and mitigation of antimicrobial resistance |
| title_full | Environmental impacts of mass drug administration programs: exposures, risks, and mitigation of antimicrobial resistance |
| title_fullStr | Environmental impacts of mass drug administration programs: exposures, risks, and mitigation of antimicrobial resistance |
| title_full_unstemmed | Environmental impacts of mass drug administration programs: exposures, risks, and mitigation of antimicrobial resistance |
| title_short | Environmental impacts of mass drug administration programs: exposures, risks, and mitigation of antimicrobial resistance |
| title_sort | environmental impacts of mass drug administration programs exposures risks and mitigation of antimicrobial resistance |
| topic | Antibiotics Mass drug administration Environment Antimicrobial resistance |
| url | https://doi.org/10.1186/s40249-022-01000-z |
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