Antibiotic Resistance: More prevalent in certain countries

While antibiotic resistance (ABR) is recognized as a global issue, it is important to note that ABR is more prevalent in some countries over others. In developed countries, over prescription and use of antibiotics on livestock are overwhelming contributors to ABR; however, ABR in developing countries appears to be virulent. Why are these countries more prone to ABR?

Often, developing countries possess antibiotics readily available to the public. According to an article from the Institute of Medicine Forum on Emerging Infections, antibiotics in many developing countries are available for purchase without a prescription.1 This leads to self-medication where the patient acquires and uses antibiotics without consulting a healthcare professional—something that is often difficult to do in impoverished areas. Epidemiologist Keith Klugman from the Bill & Melinda Gates Foundation states that the problem of ABR is especially prevalent in Brazil, Russia, China, and India. Self-medication promotes the spread of ABR both in patients and the community; the use of antibiotics in this context is often superfluous and unnecessary.2

Another source of ABR in developing countries are in hospitals. The Institute of Medicine Forum on Emerging Infections states that large hospitals must employ antibiotics regularly due to the close proximity of patients increasing their susceptibility of infection1. These antibiotics are often administered without proper diagnosis and foster environments conducive to ABR. Inadequate protocol for or improper practices from healthcare workers increase the likelihood of patients being infected, which ultimately leads to administering more antibiotics. ABR in hospitals is a pronounced problem in developing countries.

So what practices will minimize the spread of ABR? Healthcare infrastructure in developing countries should limit the availability of antibiotics and require prescription and/or consultation with a healthcare professional; antibiotics should only be used when deemed necessary and when proper diagnosis is acquired. Hospitals should develop improved protocol and train healthcare workers in order to minimize the spread of infection and therefore reduce the necessity of antibiotics. Obviously these practices would require extensive logistical planning and associated cost, but initiating a conversation about them is important nonetheless.

References

1“Factors Contributing to the Emergence of Resistance.” NCBI. 2003. Accessed June 10, 2016. http://www.ncbi.nlm.nih.gov/books/NBK97126/.

2Reardon, Sara. “Antibiotic Resistance Sweeping Developing World.” Nature.com. May 06, 2014. Accessed June 10, 2016. http://www.nature.com/news/antibiotic-resistance-sweeping-developing-world-1.15171.

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