Current access, availability and use of antibiotics in primary care among key low- and middle-income countries and the policy implications
No Thumbnail Available
Date
2025-03-20
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Expert review of anti-infective therapy
Abstract
Introduction
Antimicrobial resistance (AMR) poses a significant threat, particularly in low- and middle-income countries (LMICs), exacerbated by inappropriate antibiotic use, access to quality antibiotics and weak antimicrobial stewardship (AMS). There is a need to review current evidence on antibiotic use, access, and AMR, in primary care across key countries.
Areas covered
This narrative review analyzes publications from 2018 to 2024 regarding access, availability, and use of appropriate antibiotics.
Expert opinion
There were very few studies focussing on a lack of access to antibiotics in primary care. However, there was considerable evidence of high rates of inappropriate antibiotic use, including Watch antibiotics, typically for minor infections, across studied countries exacerbated by patient demand. The high costs of antibiotics in a number of LMICs impact on their use, resulting in short courses and sharing of antibiotics. This can contribute to AMR alongside the use of substandard and falsified antibiotics. Overall, limited implementation of national action plans, insufficient resources, and knowledge gaps affects sustainable development goals to provide routine access to safe, effective, and appropriate antibiotics.
Conclusions
There is a clear need to focus health policy on the optimal use of essential AWaRe antibiotics in primary care settings to reduce AMR in LMICs.
Description
Keywords
Antimicrobial stewardship programmes, AWaRe classification, Antibiotics
Citation
Saleem, Z., Mekonnen, B.A., Orubu, E.S., Islam, M.A., Nguyen, T.T.P., Ubaka, C.M., Buma, D., Thuy, N.D.T., Sant, Y., Sono, T.M. and Bochenek, T., 2025. Current access, availability and use of antibiotics in primary care among key low-and middle-income countries and the policy implications. Expert review of anti-infective therapy, pp.1-42.