Prevention of antibiotic resistance – an epidemiological scoping review to identify research categories and knowledge gaps

Abstract

Background: Antibiotics have become the cornerstone for the treatment of infectious diseases and contributed significantly to the dramatic global health development during the last 70 years. Millions of people now survive what were previously life-threatening infections. But antibiotics are finite resources and misuse has led to antibiotic resistance and reduced efficacy within just a few years of introduction of each new antibiotic. The World Health Organization rates antibiotic resistance as a 'global security threat' impacting on global health, food security and development and as important as terrorism and climate change. Objectives: This paper explores, through a scoping review of the literature published during the past 20 years, the magnitude of peer-reviewed and grey literature that addresses antibiotic resistance and specifically the extent to which "prevention" has been at the core. The ultimate aim is to identify know-do gaps and strategies to prevent ABR. Methods: The review covers four main data bases, Web of Science, Medline, Scopus and Ebsco searched for 2000-17. The broader research field "antibiotic OR antimicrobial resistance" gave 431,335 hits. Narrowing the search criteria to "Prevention of antibiotic OR antimicrobial resistance" resulted in 1062 remaining titles. Of these, 622 were unique titles. After screening of the 622 titles for relevance, 420 abstracts were read, and of these 282 papers were read in full. An additional 53 references were identified from these papers, and 64 published during 2018 and 2019 were also included. The final scoping review database thus consisted of 399 papers. Results: A thematic structure emerged when categorizing articles in different subject areas, serving as a proxy for interest expressed from the research community. The research area has been an evolving one with about half of the 399 papers published during the past four years of the study period. Epidemiological modelling needs strengthening and there is a need for more and better surveillance systems, especially in lower-and middle-income countries. There is a wealth of information on the local and national uses and misuses of antibiotics. Educational and stewardship programmes basically lack evidence. Several studies address knowledge of the public and prescribers. The lessons for policy are conveyed in many alarming reports from national and international organizations. Conclusions: Descriptive rather than theoretical ambitions have characterized the literature. If we want to better understand and explain the antibiotic situation from a behavioural perspective, the required approaches are lacking. A framework for an epidemiological causal web behind ABR is suggested and may serve to identify entry points for potential interventions.

Rural community perceptions of antibiotic access and understanding of antimicrobial resistance: qualitative evidence from the Health and Demographic Surveillance System site in Matlab, Bangladesh

“…Sustainable solutions will require multi-sector national action plans with clear targets and lines of accountability to ensure that political will translates to effective action [ 8 ]. Accountability for AMR lies with governments and global authorities both within and beyond the health sector [ 18 , 52 ].…”

The Effect of Iodine-Containing Nano-Micelles, FS-1, on Antibiotic Resistance, Gene Expression and Epigenetic Modifications in the Genome of Multidrug Resistant MRSA Strain Staphylococcus aureus ATCC BAA-39

“…The misuse of antibiotics, as well as inappropriate prescription and overuse, has led to strong selective pressure, resulting in the survival and wide distribution of drug-resistant pathogens that threaten the public health system globally (Barbosa and Levy, 2000;Ventola, 2015). Acquired drug resistance to antimicrobial agents has been a widely recognized problem (Tenover, 2001;Spellberg et al, 2004;Wall, 2019;Rocha-Granados et al, 2020). Bacteria can respond rapidly to environmental changes owing to their short growth cycles, which enable them to evolve and adapt rapidly and survive under unfavorable conditions (Clatworthy et al, 2007).…”

Pengetahuan, Sikap, dan Praktik Peternak dalam Penggunaan Antibiotik pada Ayam Broiler di Kabupaten Subang

“…Penelitian Nuangmek et al (2018) menemukan sebagian besar peternak yang disurvei memiliki tingkat pengetahuan yang rendah, sikap netral, dan praktik menggunakan antimikroba yang buruk. Orang yang memiliki pengetahuan dan kesadaran yang kurang akan cenderung melakukan pengobatan sendiri yang kemudian dapat memicu terjadinya resistansi antbiotik (Wall, 2019).…”