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Antimicrobial Resistance

Driving down inappropriate antibiotic prescribing globally


Dr Diane Ashiru-Oredope

Pharmacist Lead, Antimicrobial Resistance and Stewardship and HCAI, Public Health England

Monitoring antimicrobial use and development of antimicrobial stewardship programmes is essential for tackling AMR globally.

Driving down inappropriate antibiotic prescribing

Antibiotic resistance is a global problem that requires global action, but the capacity for surveillance of antibiotic use and antibiotic resistant infections and stewardship in many low- and middle-income countries (LMICs) is low.

Antimicrobial Stewardship – the responsible use of antibiotics to reduce inappropriate prescribing – is essential in the global battle to tackle antibiotic resistance. An international survey of antimicrobial stewardship (AMS) programmes from 660 hospitals in 67 countries across six continents highlighted the positive impact of antimicrobial stewardships programmes. Where programmes were evaluated, organisations reported that the programme was associated with reductions in inappropriate prescribing (96%); the use of broad spectrum antibiotics (86%); expenditure on antibiotics (80%); the incidence of healthcare-acquired infections (71%); hospital  length of stay (65%) and bacterial resistance (58%)1.

Over the next 20 months,
UK infection and pharmacy experts will help institutions in Ghana, Tanzania and Uganda.

Supporting antimicrobial stewardship initiatives globally

Countries with well-established AMS programmes should have a key role in supporting the development of these programmes. However, it is important that programmes have thorough situational assessments and understanding of the behavioural drivers and context in each country2.

The UK is increasing its global support, including the PHE International Health Regulations (IHR) strengthening programme, which provides technical support for AMR surveillance, guideline development and improving stewardship in LMICs partner countries; alongside supporting and strengthening their health systems, and compliance with the International Health Regulations. 

In addition, a new Commonwealth Partnerships for AMS programme (CwPAMS) funded by the Fleming Fund (a UK aid programme in the Department of Health and Social Care) has been launched3. Over the next 20 months, the UK will leverage the expertise of UK health institutions as well as infection and pharmacy experts to strengthen the capacity of the health workforce and institutions in four Commonwealth countries including Ghana, Tanzania and Uganda to develop AMS programmes.

1 Howard, P. et al. An international cross-sectional survey of antimicrobial stewardship programmes in hospitals. J. Antimicrob. Chemother. 70, 1245–1255 (2015).

2 Michie, S. et al. The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implement. Sci. 6, 42 (2011)

3 CwPAMS Programme is led by The Tropical Health Education Trust (THET) and the Commonwealth Pharmacists’ Association (CPA)

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