HUMAN-RELATED FACTORS OF ANTIMICROBIAL RESISTANCE
Keywords:
Antimicrobial resistance, antibiotic misuse and overuse, over-prescription of antibiotics
Abstract
The global issue of antimicrobial resistance stems from the irrational use of antibiotics in humans, animals, and agriculture, inadequate sanitation, international travel and trade, and challenges within healthcare organizations including financing of healthcare. Recent literature indicates that antimicrobial resistance spreads between countries faster than previously assumed and the COVID-19 pandemic has just exacerbated this issue. Addressing this problem requires globally coordinated and multisectoral interventions.
The interaction between humans, animals, and the environment is complex, providing numerous pathways for the transmission and spread of antimicrobial resistance. The causes of the resistance that are related to human population could be classified into several categories, such as inappropriate use of antimicrobials in medicine, inadequate sanitation and hygiene, but also the issues of widespread use of cosmetics with antibiotics, detergents, and biocides. Factors contributing to irrational antibiotic use in humans include excessive prescribing in primary healthcare, irrational use in hospitals, and low awareness and knowledge levels regarding rational antibiotic use at the population level. Addressing this necessitates the consideration of a many factors, including the organization of healthcare systems, population demographics, patterns of antibiotics prescription and usage, among others.
This review underscores the complexity of antimicrobial resistance, stressing the need for comprehensive measures across different levels to control and suppress its development and spread. Since antimicrobial resistance puts many of the gains of modern medicine at risk, making infections more complicated to treat and other medical procedures and treatments riskier, urgent attention and action of all public health stakeholders globally is essential.
References
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2. Anderson M, Clift C, Schulze K, Sagan A, Nahrgang S, Ait Ouakrim D, Mossialos E. Averting the AMR crisis: What are the avenues for policy action for countries in Europe? Copenhagen (Denmark): European Observatory on Health Systems and Policies; 2019. PMID: 31287637. Available at: https://www.ncbi.nlm.nih.gov/books/NBK543406/pdf/Bookshelf_NBK543406.pdf Accessed January 22, 2024
3. Alekshun MN, Levy SB. Molecular mechanisms of antibacterial multidrug resistance. Cell. 2007 Mar 23;128(6):1037-50. doi: 10.1016/j.cell.2007.03.004. PMID: 17382878.
4. Davies J, Davies D. Origins and evolution of antibiotic resistance. Microbiol Mol Biol Rev. 2010 Sep;74(3):417-33. doi: 10.1128/MMBR.00016-10. PMID: 20805405; PMCID: PMC2937522.
5. Van Boeckel TP, Brower C, Gilbert M, Grenfell BT, Levin SA, Robinson TP, et al. Global trends in antimicrobial use in food animals. Proc Natl Acad Sci 2015;112:5649–54. https://doi.org/10.1073/pnas.1503141112.
6. Samreen, Ahmad, I., Malak, H. A., & Abulreesh, H. H. Environmental antimicrobial resistance and its drivers: a potential threat to public health. Journal of Global Antimicrobial Resistance, 27, 2021;101–111. doi:10.1016/j.jgar.2021.08.001
7. Ukuhor HO. The interrelationships between antimicrobial resistance, COVID-19, past, and future pandemics. J Infect Public Health. 2021 Jan;14(1):53-60. doi: 10.1016/j.jiph.2020.10.018. Epub 2020 Dec 9. PMID: 33341485; PMCID: PMC7831651.
8. Endale H, Mathewos M, Abdeta D. Potential Causes of Spread of Antimicrobial Resistance and Preventive Measures in One Health Perspective-A Review. Infect Drug Resist. 2023 Dec 8;16:7515-7545. doi: 10.2147/IDR.S428837. PMID: 38089962; PMCID: PMC10715026.
9. Sulayyim HJA, Ismail R, Hamid AA, Ghafar NA. Antibiotic Resistance during COVID-19: A Systematic Review. Int J Environ Res Public Health. 2022 Sep 21;19(19):11931. doi: 10.3390/ijerph191911931. PMID: 36231256; PMCID: PMC9565540.
10. Malik SS, Mundra S. Increasing Consumption of Antibiotics during the COVID-19 Pandemic: Implications for Patient Health and Emerging Anti-Microbial Resistance. Antibiotics (Basel). 2022 Dec 28;12(1):45. doi: 10.3390/antibiotics12010045. PMID: 36671246; PMCID: PMC9855050.
11. Hurtado, I. C., Valencia, S., Pinzon, E. M., Lesmes, M. C., Sanchez, M., Rodriguez, J., et al. Antibiotic resistance and consumption before and during the COVID-19 pandemic in Valle del Cauca, Colombia. Rev Panam Salud Publica. 2023; 47: e10. Published online 2023 Apr 19. doi: 10.26633/RPSP.2023.10
12. Markovskaya Y, Gavioli EM, Cusumano JA, Glatt AE. Coronavirus disease 2019 (COVID-19): Secondary bacterial infections and the impact on antimicrobial resistance during the COVID-19 pandemic. Antimicrob Steward Healthc Epidemiol. 2022 Jul 11;2(1):e114. doi: 10.1017/ash.2022.253. PMID: 36483429; PMCID: PMC9726554.Ventola CL. The antibiotic resistance crisis: part 1: causes and threats. P T. 2015 Apr;40(4):277-83. PMID: 25859123; PMCID: PMC4378521.
13. Michael CA, Dominey-Howes D, Labbate M. The antimicrobial resistance crisis: causes, consequences, and management. Front Public Health. 2014 Sep 16;2:145. doi: 10.3389/fpubh.2014.00145. PMID: 25279369; PMCID: PMC4165128.
14. Nothias LF, Knight R, Dorrestein PC. Antibiotic discovery is a walk in the park. Proc Natl Acad Sci U S A. 2016 Dec 20;113(51):14477-14479. doi: 10.1073/pnas.1618221114. Epub 2016 Dec 9. PMID: 27940910; PMCID: PMC5187748.
15. Baracaldo-Santamaría D, Trujillo-Moreno MJ, Pérez-Acosta AM, Feliciano-Alfonso JE, Calderon-Ospina CA, Soler F. Definition of self-medication: a scoping review. Ther Adv Drug Saf. 2022 Oct 5;13:20420986221127501. doi: 10.1177/20420986221127501. PMID: 36211626; PMCID: PMC9537481.
16. Belamarić G, Bukumirić Z, Vuković M, Spaho RS, Marković M, Marković G, Vuković D. Knowledge, attitudes, and practices regarding antibiotic use among the population of the Republic of Serbia - A cross-sectional study. J Infect Public Health. 2023 Dec;16 Suppl 1:111-118. doi: 10.1016/j.jiph.2023.11.009. Epub 2023 Nov 7. PMID: 37953110.
17. World Health Organization. Guidelines for the regulatory assessment of medicinal products for use in self-medication; 2000. Available from: https://apps.who.int/iris/handle/10665/66154 Accessed August 25, 2023.
18. Public Health Group. Tackling Antimicrobial Resistance 2019– 2024: The UK’s Five-Year National Action Plan. London: HM Government; 2019. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/784894/UK_AMR_5_year_national_action_plan.pdf Accessed August 10, 2021.
19. Papenburg J, Fontela PS, Freitas RR, Burstein B. Inappropriate Antibiotic Prescribing for Acute Bronchiolitis in US Emergency Departments, 2007–2015, Journal of the Pediatric Infectious Diseases Society, Volume 8, Issue 6, December 2019, Pages 567–570, https://doi.org/10.1093/jpids/piy131
20. Thakolkaran N, Shetty AV, D'Souza NDR, Shetty AK. Antibiotic prescribing knowledge, attitudes, and practice among physicians in teaching hospitals in South India. J Family Med Prim Care. 2017 Jul-Sep;6(3):526-532. doi: 10.4103/2249-4863.222057. PMID: 29417002; PMCID: PMC5787949.
21. Rahbi FA, Salmi IA, Khamis F, Balushi ZA, Pandak N, Petersen E, Hannawi S. Physicians' attitudes, knowledge, and practices regarding antibiotic prescriptions. J Glob Antimicrob Resist. 2023 Mar;32:58-65. doi: 10.1016/j.jgar.2022.12.005. Epub 2022 Dec 28. PMID: 36584969.
22. Little P, Stuart B, Francis N, Douglas E, Tonkin-Crine S, Anthierens S, et al. GRACE consortium. Effects of internet-based training on antibiotic prescribing rates for acute respiratory-tract infections: a multinational, cluster, randomised, factorial, controlled trial. Lancet. 2013 Oct 5;382(9899):1175-82. doi: 10.1016/S0140-6736(13)60994-0. Epub 2013 Jul 31. PMID: 23915885; PMCID: PMC3807804.
23. Kronman MP, Gerber JS, Grundmeier RW, Zhou C, Robinson JD, Heritage J, et al. Reducing Antibiotic Prescribing in Primary Care for Respiratory Illness. Pediatrics. 2020 Sep;146(3):e20200038. doi: 10.1542/peds.2020-0038. Epub 2020 Aug 3. PMID: 32747473; PMCID: PMC7461202.
24. Tang KWK, Millar BC, Moore JE. Antimicrobial Resistance (AMR). Br J Biomed Sci. 2023 Jun 28;80:11387. doi: 10.3389/bjbs.2023.11387. PMID: 37448857; PMCID: PMC10336207.
25. Sulis G, Sayood S, Katukoori S, Bollam N, George I, Yaeger LH, Chavez MA, Tetteh E, Yarrabelli S, Pulcini C, Harbarth S, Mertz D, Sharland M, Moja L, Huttner B, Gandra S. Exposure to World Health Organization's AWaRe antibiotics and isolation of multidrug resistant bacteria: a systematic review and meta-analysis. Clin Microbiol Infect. 2022 Sep;28(9):1193-1202. doi: 10.1016/j.cmi.2022.03.014. Epub 2022 Mar 23. PMID: 35339675.
26. 2021 Antibacterial agents in clinical and preclinical development: an overview and analysis. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO. Available at: https://iris.who.int/bitstream/handle/10665/354545/9789240047655-eng.pdf?sequence=1 Accessed 12 November 2023
27. Rödenbeck M, Ayobami O, Eckmanns T, Pletz MW, Bleidorn J, Markwart R. Clinical epidemiology and case fatality due to antimicrobial resistance in Germany: a systematic review and meta-analysis, 1 January 2010 to 31 December 2021. Euro Surveill. 2023 May;28(20):2200672. doi: 10.2807/1560-7917.ES.2023.28.20.2200672. PMID: 37199987; PMCID: PMC10197495.
28. Abban MK, Ayerakwa EA, Mosi L, Isawumi A. The burden of hospital acquired infections and antimicrobial resistance. Heliyon. 2023 Oct 2;9(10):e20561. doi: 10.1016/j.heliyon.2023.e20561. PMID: 37818001; PMCID: PMC10560788.
29. Friedrich AW. Control of hospital acquired infections and antimicrobial resistance in Europe: the way to go. Wien Med Wochenschr. 2019 Feb;169(Suppl 1):25-30. doi: 10.1007/s10354-018-0676-5. Epub 2019 Jan 8. PMID: 30623278; PMCID: PMC6373234.
30. D'Costa VM, McGrann KM, Hughes DW, Wright GD. Sampling the antibiotic resistome. Science. 2006 Jan 20;311(5759):374-7. doi: 10.1126/science.1120800. PMID: 16424339.
31. Rosini R, Nicchi S, Pizza M, Rappuoli R. Vaccines Against Antimicrobial Resistance. Front Immunol. 2020 Jun 3;11:1048. doi: 10.3389/fimmu.2020.01048. Erratum in: Front Immunol. 2020 Jul 21;11:1578. PMID: 32582169; PMCID: PMC7283535.
32. Laxminarayan R, Duse A, Wattal C, Zaidi AK, Wertheim HF, Sumpradit N, et al. Antibiotic resistance-the need for global solutions. Lancet Infect Dis. 2013 Dec;13(12):1057-98. doi: 10.1016/S1473-3099(13)70318-9. Epub 2013 Nov 17. Erratum in: Lancet Infect Dis. 2014 Jan;14(1):11. Erratum in: Lancet Infect Dis. 2014 Mar;14(3):182. PMID: 24252483.
33. WHO One Health. Available at: https://www.who.int/news-room/fact-sheets/detail/one-health Accessed December 3, 2023.
34. Van Boeckel TP, Brower C, Gilbert M, Grenfell BT, Levin SA, Robinson TP, et al. Global trends in antimicrobial use in food animals. Proc Natl Acad Sci U S A. 2015 May 5;112(18):5649-54. doi: 10.1073/pnas.1503141112. Epub 2015 Mar 19. PMID: 25792457; PMCID: PMC4426470.
35. Baltz RH. Marcel Faber Roundtable: is our antibiotic pipeline unproductive because of starvation, constipation or lack of inspiration? J Ind Microbiol Biotechnol. 2006 Jul;33(7):507-13. doi: 10.1007/s10295-005-0077-9. Epub 2006 Jan 18. PMID: 16418869.
36. World Organization for Animal Health (OIE). OIE Annual Report on the Use of Antimicrobial Agents Intended for Use in Animals 6th edition. 2022. Available at: https://www.woah.org/app/uploads/2022/06/a-sixth-annual-report-amu-final.pdf Accessed November 21, 2023.
37. Промет и потрошња ветеринарских лекова (2011 to 2019). Available at: https://www.alims.gov.rs/ciril/oagenciji/publikacije/ Accessed November 22, 2023.
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2025/07/18
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