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Global Strategies to Combat Antimicrobial Resistance: A One Health Perspective

Pharmacology & Pharmacy 2023年第8期14卷 271-328页

作者： Steward Mudenda Billy Chabalenge Victor Daka Ruth Lindizyani Mfune kyembe ignitius salachi Shafiq Mohamed Webrod Mufwambi Maisa Kasanga Scott Kaba Matafwali Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia Department of Medicines Control Zambia Medicines Regulatory Authority Lusaka Zambia Department of Public Health Michael Chilufya Sata School of Medicine Copperbelt University Ndola Zambia Medicines Management and Pharmacy Services St James University Hospital Leeds Teaching Hospitals NHS Trust Leeds UK Department of Epidemiology and Biostatistics School of Public Health Zhengzhou University Zhengzhou China Clinical Research Department Faculty of Infectious and Tropical Diseases London School of Hygiene & Tropical Medicine London UK

Background: Antimicrobial resistance (AMR) is a global health challenge that has escalated due to the inappropriate use of antimicrobials in humans, animals, and the environment. Developing and implementing strategies to reduce and combat AMR is critical. Purpose: This study aimed to highlight some global strategies that can be implemented to address AMR using a One Health approach. Methods: This study employed a narrative review design that included studies published from January 2002 to July 2023. The study searched for literature on AMR and antimicrobial stewardship (AMS) in PubMed and Google Scholar using the 2020 PRISMA guidelines. Results: This study reveals that AMR remains a significant global public health problem. Its severity has been markedly exacerbated by inappropriate use of antimicrobials in humans, animals, and the broader ecological environment. Several strategies have been developed to address AMR, including the Global Action Plan (GAP), National Action Plans (NAPs), AMS programs, and implementation of the AWaRe classification of antimicrobials. These strategies also involve strengthening surveillance of antimicrobial consumption and resistance, encouraging the development of new antimicrobials, and enhancing regulations around antimicrobial prescribing, dispensing, and usage. Additional measures include promoting global partnerships, combating substandard and falsified antimicrobials, advocating for vaccinations, sanitation, hygiene and biosecurity, as well as exploring alternatives to antimicrobials. However, the implementation of these strategies faces various challenges. These challenges include low awareness and knowledge of AMR, a shortage of human resources and capacity building for AMR and AMS, in adequate funding for AMR and AMS initiatives, limited laboratory capacities for surveillance, behavioural change issues, and ineffective leadership and multidisciplinary teams. Conclusion: In conclusion, this study established that AMR is prevale

关键词： Antimicrobial Resistance Antimicrobial Stewardship AWaRe Classification One Health Approach One Health Perspective Strategies Surveillance

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