Strategies to improve antimicrobial utilization with a special focus on developing countries

Brian Godman*, Abiodun Egwuenu, Mainul Haque, Oliver Ombeva Malande, Natalie Schellack, Santosh Kumar, Zikria Saleem, Jacqueline Sneddon, Iris Hoxha, Salequl Islam, Julius Mwita, Renata Cristina Rezende Macedo Do Nascimento, Isabella Piassi Dias Godói, Loveline Lum Niba, Adefolarin A. Amu, Joseph Acolatse, Robert Incoom, Israel Abebrese Sefah, Sylvia Opanga, Amanj KurdiIbrahim Chikowe, Felix Khuluza, Dan Kibuule, Olayinka O. Ogunleye, Adesola Olalekan, Vanda Markovic-Pekovic, Johanna C. Meyer, Abubakr Alfadl, Thuy Nguyen Thi Phuong, Aubrey C. Kalungia, Stephen Campbell, Alice Pisana, Janney Wale, R. Andrew Seaton

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

105 Citations (Scopus)


Antimicrobial resistance (AMR) is a high priority across countries as it increases morbidity, mortality and costs. Concerns with AMR have resulted in multiple initiatives internationally, na-tionally and regionally to enhance appropriate antibiotic utilization across sectors to reduce AMR, with the overuse of antibiotics exacerbated by the COVID-19 pandemic. Effectively tackling AMR is crucial for all countries. Principally a narrative review of ongoing activities across sectors was undertaken to improve antimicrobial use and address issues with vaccines including COVID-19. Point prevalence surveys have been successful in hospitals to identify areas for quality improvement programs, principally centering on antimicrobial stewardship programs. These include reducing prolonged antibiotic use to prevent surgical site infections. Multiple activities centering on education have been successful in reducing inappropriate prescribing and dispensing of antimicrobials in ambulatory care for essentially viral infections such as acute respiratory infections. It is imperative to develop new quality indicators for ambulatory care given current concerns, and instigate programs with clear public health messaging to reduce misinformation, essential for pandemics. Regular access to effective treatments is needed to reduce resistance to treatments for HIV, malaria and tuberculosis. Key stakeholder groups can instigate multiple initiatives to reduce AMR. These need to be followed up.

Original languageEnglish
Article number528
Issue number6
Publication statusPublished - Jun 2021


  • Antimicrobial resistance
  • Antimicrobial stewardship programs
  • Antimicrobials
  • COVID-19
  • Healthcare-associated infections
  • Lower-and middle-income countries
  • Misinformation
  • Patient initiatives
  • Surgical site infections
  • Vaccines


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