Epidemiology of antimicrobial resistance and its clinical, economic and humanistic outcomes in developing countries
Ismail A. Suleiman , Tolulope O. Aremu , Olatunji K. Aremu
1Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy,
Federal University Oye Ekiti
Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy,
Federal University Oye Ekiti.
Corresponding author: Ismail A. Suleiman
E-mail: suleimanismail1@gmail.com
Telephone: +234 (0)8137435064
ABSTRACT
The important therapeutic role played by antimicrobial agents is seriously being threatened by the continually increasing antibacterial resistance (AMR) across the globe.
Efforts at stemming the increment are grossly sub-optimal in most developing countries. Epidemiology of the commonly encountered bacterial isolates and their
respective susceptivity/resistance patterns is highly essential in supply chain decision-making, patient management, and in policy formulation.
The most prevalent resistant bacterial isolates in Nigeria include Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumonia among others. For instance, the incidence of methicillin-resistant S. aureus is skyrocketing. It has increased from less than 2.0% in 2005 to more than 40.0% in 2020 across the country. In addition, resistance to affordable antimicrobial agents is gradually overwhelming the fragile healthcare system mostly being financed from out-of-pocket expenses.
Treatment costs of resistant isolates is huge and not sustainable, apart from their impacts on disease complications, morbidity, mortality, and human capital development. Overall, it grossly reduces health-related quality of life. In consonant with the global pledge of the World Health Assembly, improved awareness and an understanding of its implications should be a priority. Strengthening diagnosis and surveillance activities as related to AMR is imperative.
The primary health care (PHC) basic roles, which include the provision of portable water, sanitation, immunization, and nutrition need to be strengthened as long advocated. Research into new antimicrobial agents as well as evidence-based re-purposing/rational usage of the existing ones should also be topical at all levels. Standard Treatment Guidelines and drug formularies equally need to be reviewed at regular intervals to include updated resistant/susceptibility patterns.
Formulating an adequate legal framework and policy to facilitate the implementation of strategies is of utmost importance as well. And lastly, there should be relevant incentives to encourage the implementation of AMR-related stewardship activities and its sustainability.