Accelerating antibiotic access and stewardship: a new model to safeguard public health

Jennifer Cohn, Marc Mendelson, Souha S. Kanj, Nusrat Shafiq, Icaro Boszczowski, Ramanan Laxminarayan

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)e584-e590
JournalThe Lancet Infectious Diseases
Volume24
Issue number9
DOIs
StatePublished - Sep 2024
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Infectious Diseases

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