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Emerging antibiotic resistance: How can resource-limited settings turn the tide?

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Abstract

Antibiotic resistance is a global crisis driven by appropriate and inappropriate antibiotic use. Resistance continues to spread in low-resource settings due to unreliable surveillance data, unfettered antibiotic access, minimal product regulation, lack of prescription oversight, and scarcity of clinical diagnostic tools to support antibiotic de-escalation. Evidence-based strategies from high-resource settings may improve appropriateness of antibiotic use and stop the spread of resistance in resource-poor countries. However, current research and stewardship efforts in low-resource settings are extremely limited, and largely focused intensive care units. Turning the antibiotic resistance tide requires intensifying research, surveillance, antimicrobial stewardship, and developing new bedside diagnostic tools. I will discuss what we know about the state of antimicrobial resistance in resource-limited settings and present original data on antimicrobial resistance from our cohort of 4,231 postpartum women screened for infection while hospitalized at Uganda’s Mbarara Regional Referral Hospital.