Country data on AMR in Brazil in the context of community-acquired respiratory tract infections: links between antibiotic susceptibility, local and international antibiotic prescribing guidelines, access to medicine and clinical outcome.
Journal
The Journal of antimicrobial chemotherapy
ISSN: 1460-2091
Titre abrégé: J Antimicrob Chemother
Pays: England
ID NLM: 7513617
Informations de publication
Date de publication:
06 09 2022
06 09 2022
Historique:
entrez:
6
9
2022
pubmed:
7
9
2022
medline:
9
9
2022
Statut:
ppublish
Résumé
Antimicrobial resistance (AMR) is one of the biggest threats to global public health. Selection of resistant bacteria is driven by inappropriate use of antibiotics, amongst other factors. COVID-19 may have exacerbated AMR due to unnecessary antibiotic prescribing. Country-level knowledge is needed to understand options for action. To review the situation with respect to AMR in Brazil and initiatives addressing it. Identifying areas where more information is required will provide a call to action to minimize any further rises in AMR within Brazil and to improve patient outcomes. National initiatives to address AMR, antibiotic use and prescribing in Brazil, and availability of susceptibility data, particularly for the key community-acquired respiratory tract infections (CA-RTI) pathogens Streptococcus pneumoniae and Haemophilus influenzae, were identified. National and international antibiotic prescribing guidelines for CA-RTIs (community-acquired pneumonia, acute otitis media and acute bacterial rhinosinusitis) commonly used locally were also reviewed, along with local antibiotic availability. In Brazil there have been some initiatives addressing AMR such as the National Action Plan for AMR, established in 2018. Antibiotic consumption in Brazil is high but a ban on over-the-counter sales of antibiotics has led to a decrease in consumption. Local antibiotic susceptibility testing needs to be increased and the Survey of Antibiotic Resistance (SOAR) study in Brazil will provide useful data for pathogens causing CA-RTIs. A more standardized inclusive approach in developing local guidelines, using up-to-date surveillance data of isolates from community-acquired infections in Brazil, could make guideline use more locally relevant for clinicians. This would pave the way for a higher level of appropriate antibiotic prescribing and improved adherence. This would, in turn, potentially limit AMR development and improve clinical outcomes for patients.
Sections du résumé
BACKGROUND
Antimicrobial resistance (AMR) is one of the biggest threats to global public health. Selection of resistant bacteria is driven by inappropriate use of antibiotics, amongst other factors. COVID-19 may have exacerbated AMR due to unnecessary antibiotic prescribing. Country-level knowledge is needed to understand options for action.
OBJECTIVES
To review the situation with respect to AMR in Brazil and initiatives addressing it. Identifying areas where more information is required will provide a call to action to minimize any further rises in AMR within Brazil and to improve patient outcomes.
METHODS
National initiatives to address AMR, antibiotic use and prescribing in Brazil, and availability of susceptibility data, particularly for the key community-acquired respiratory tract infections (CA-RTI) pathogens Streptococcus pneumoniae and Haemophilus influenzae, were identified. National and international antibiotic prescribing guidelines for CA-RTIs (community-acquired pneumonia, acute otitis media and acute bacterial rhinosinusitis) commonly used locally were also reviewed, along with local antibiotic availability.
CONCLUSIONS
In Brazil there have been some initiatives addressing AMR such as the National Action Plan for AMR, established in 2018. Antibiotic consumption in Brazil is high but a ban on over-the-counter sales of antibiotics has led to a decrease in consumption. Local antibiotic susceptibility testing needs to be increased and the Survey of Antibiotic Resistance (SOAR) study in Brazil will provide useful data for pathogens causing CA-RTIs. A more standardized inclusive approach in developing local guidelines, using up-to-date surveillance data of isolates from community-acquired infections in Brazil, could make guideline use more locally relevant for clinicians. This would pave the way for a higher level of appropriate antibiotic prescribing and improved adherence. This would, in turn, potentially limit AMR development and improve clinical outcomes for patients.
Identifiants
pubmed: 36065730
pii: 6692269
doi: 10.1093/jac/dkac215
pmc: PMC9445857
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
i35-i42Subventions
Organisme : GlaxoSmithKline
Informations de copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.
Références
J Antimicrob Chemother. 2022 Sep 6;77(Supplement_1):i2-i9
pubmed: 36065724
J Antimicrob Chemother. 2002 Jan;49(1):31-40
pubmed: 11751764
Clin Infect Dis. 2012 Apr;54(8):e72-e112
pubmed: 22438350
Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67
pubmed: 31573350
Rev Panam Salud Publica. 2020 Aug 06;44:e80
pubmed: 32774349
Clin Infect Dis. 2011 Oct;53(7):e25-76
pubmed: 21880587
Bull World Health Organ. 2018 Feb 1;96(2):135-137
pubmed: 29403117
Cad Saude Publica. 2017 Sep 28;33(9):e00179815
pubmed: 28977283
Clin Microbiol Infect. 2004 Apr;10 Suppl 2:18-27
pubmed: 14759230
J Antimicrob Chemother. 2016 May;71 Suppl 1:i85-91
pubmed: 27048585
J Bras Pneumol. 2018 Sep-Oct;44(5):405-423
pubmed: 30517341
Rev Bras Epidemiol. 2017 May;20Suppl 01(Suppl 01):171-181
pubmed: 28658381
N Engl J Med. 2015 Jul 30;373(5):415-27
pubmed: 26172429
PLoS One. 2016 Dec 12;11(12):e0167885
pubmed: 27941993
J Antimicrob Chemother. 2020 Apr 1;75(Suppl 1):i2-i18
pubmed: 32337595
Front Public Health. 2021 Jan 14;8:575536
pubmed: 33520909
Clin Infect Dis. 2007 Mar 1;44 Suppl 2:S27-72
pubmed: 17278083
Euro Surveill. 2015 May 28;20(21):
pubmed: 26062562
Glob Health Med. 2019 Dec 31;1(2):61-64
pubmed: 33330756
Lancet Infect Dis. 2011 Sep;11(9):692-701
pubmed: 21659004
Proc Natl Acad Sci U S A. 2018 Apr 10;115(15):E3463-E3470
pubmed: 29581252
Clin Microbiol Rev. 2007 Jul;20(3):391-408, table of contents
pubmed: 17630331
Thorax. 2012 Jan;67(1):71-9
pubmed: 20729232
Clin Microbiol Infect. 2019 Jul;25(7):910-911
pubmed: 30910717
Pediatrics. 2013 Mar;131(3):e964-99
pubmed: 23439909