Antimicrobial Drug Resistance: A Systematic Review and Assessment of Resistant Pathogen Infection Prevention and Control

Abstract

A significant proportion of antibacterial drug prescriptions in both inpatient and outpatient healthcare are inappropriate. Sub-therapeutic use of antibiotics during therapy does not destroy the causative pathogen or resolve clinical symptoms but enhances the emergence of resistant organisms. Prescription and dispensing procedures based on diagnoses, microbiology reports, guidelines and recommendations for drug use and the knowledge of local resistance patterns determine to some extent the clinical benefits that may result from the administered drug. Antibacterial consumption patterns are not usually driven by changes in demographic and disease patterns. Economic, cultural and microbiological factors form the basis for the use of antimicrobials. Differences in the extent of disease, the pathogenicity of the infecting organism, the effectiveness of cellular and humoral immunity and the period before therapy are initiated all influence the outcome of treatment. The variety of patients and infections lead to diverse variations in both the pharmacokinetics and pharmacodynamics profiles of antimicrobial drugs. Therefore, most government health system models are usually interventions to compensate for the market's reluctance to ensure the inclusion of the most vulnerable groups. Inequalities in antibacterial access are preventable through proper policies that address socioeconomic inequalities. The multifactorial nature of antimicrobial resistance demands the expertise and resources of the different service chains as well as comprehensiveness in policy coordination and integration. Therefore, antimicrobial stewardship is needed in training programs for health professionals to reduce the improper use of antimicrobials.