How can we tackle the overuse of antibiotics in low- and middle-income countries?

ABSTRACT

Introduction

Antibiotic overuse is a pressing global health concern, particularly in low- and middle-income countries (LMICs) where there is limited access to quality healthcare and insufficient regulation of antibiotic dispensation. This perspective piece highlights the challenges of antibiotic overuse in LMICs and provides insights into potential solutions to address this issue.

Areas covered

This perspective explores key factors contributing to antibiotic overuse in LMICs, encompassing weak healthcare infrastructure, limited access to quality services, and deficiencies in diagnostic capabilities. It discusses regulatory frameworks to curb non-prescription sales, the role of accessible point-of-care diagnostic tools, challenges in implementing effective stewardship programs, the expanded use of vaccines, and the importance of health systems, hygiene, and sanitation.

Expert opinion

In this article, we emphasize the need for a comprehensive approach involving collaboration among healthcare professionals, policymakers, researchers, and educators. We underscore the importance of improving healthcare infrastructure, enhancing access to quality services, and strengthening diagnostic capabilities. The article also highlights the significance of education and awareness in promoting responsible antibiotic use, the role of regulatory measures, the expanded utilization of vaccines, and the need for international collaboration to address the challenges of antibiotic overuse in LMICs.

KEYWORDS:

• Antimicrobial resistance
• LMICs
• antibiotic prescribing
• antibiotic dispensing
• inappropriate antibiotic use

Article highlights

• Antibiotic overuse in low- and middle-income countries (LMICs) is driven by several factors, including weak healthcare infrastructures, limited access to quality services, and deficiencies in diagnostic capabilities.

• Regulatory frameworks, when accompanied by strict enforcement, can effectively reduce non-prescription antibiotic sales in LMICs, but unintended consequences must be considered.

• Accessible point-of-care diagnostic tools have the potential to aid in diagnosing infections, guiding appropriate treatment decisions, and reducing unnecessary antibiotic use.

• Scalable antibiotic stewardship programs in both hospital and non-hospital settings are crucial for reducing antibiotic consumption and improving appropriate prescribing practices.

• The expanded use of vaccines can prevent illnesses, reduce the need for antibiotics, and yield cost savings, making it an important strategy in LMICs.

• Strengthening health systems, improving hygiene and sanitation, and promoting education and awareness about responsible antibiotic use are essential in combating antibiotic overuse in LMICs.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or mending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.