TY - JOUR
T1 - Accelerating antibiotic access and stewardship
T2 - a new model to safeguard public health
AU - Cohn, Jennifer
AU - Mendelson, Marc
AU - Kanj, Souha S.
AU - Shafiq, Nusrat
AU - Boszczowski, Icaro
AU - Laxminarayan, Ramanan
N1 - Publisher Copyright:
© 2024 Elsevier Ltd
PY - 2024/9
Y1 - 2024/9
N2 - This Personal View discusses the challenges faced, especially by low-income and middle-income countries (LMICs), in responding to the growing burden of bacterial antimicrobial resistance. Many patients in LMICs lack access to effective and affordable treatments needed to successfully treat patients. Meanwhile, traditional antimicrobial stewardship models face implementation challenges due to financial, health system, and human resource constraints. These constraints call for a paradigm shift from traditional high-income country-style antimicrobial stewardship, which is often resource intensive and aimed at cost containment, to a broader concept of sustainable access. We suggest a model of context-adapted stewardship that continues to emphasise providing the right antibiotic, at the right time, for the right duration, and at an affordable price. Taking lessons from other disease areas, including tuberculosis, we identify interventions such as task shifting to various health-care workers and the implementation of a hub-and-spoke model to support appropriate use of antibiotics, to enable optimal access and maximisation of scarce resources.
AB - This Personal View discusses the challenges faced, especially by low-income and middle-income countries (LMICs), in responding to the growing burden of bacterial antimicrobial resistance. Many patients in LMICs lack access to effective and affordable treatments needed to successfully treat patients. Meanwhile, traditional antimicrobial stewardship models face implementation challenges due to financial, health system, and human resource constraints. These constraints call for a paradigm shift from traditional high-income country-style antimicrobial stewardship, which is often resource intensive and aimed at cost containment, to a broader concept of sustainable access. We suggest a model of context-adapted stewardship that continues to emphasise providing the right antibiotic, at the right time, for the right duration, and at an affordable price. Taking lessons from other disease areas, including tuberculosis, we identify interventions such as task shifting to various health-care workers and the implementation of a hub-and-spoke model to support appropriate use of antibiotics, to enable optimal access and maximisation of scarce resources.
UR - http://www.scopus.com/inward/record.url?scp=85187572017&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85187572017&partnerID=8YFLogxK
U2 - 10.1016/S1473-3099(24)00070-7
DO - 10.1016/S1473-3099(24)00070-7
M3 - Review article
C2 - 38484749
AN - SCOPUS:85187572017
SN - 1473-3099
VL - 24
SP - e584-e590
JO - The Lancet Infectious Diseases
JF - The Lancet Infectious Diseases
IS - 9
ER -