Research Topic

Antimicrobial Stewardship in Low- and Middle-Income Countries

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About this Research Topic

Antimicrobial resistance (AMR) is an increasing threat worldwide, including in low- and middle-income countries (LMICs). Between 2000 and 2015, the antibiotic consumption rate increased 39%, and the increase was mainly driven by LMICs with gross domestic product per capita (GDPPC) growth. Although overall ...

Antimicrobial resistance (AMR) is an increasing threat worldwide, including in low- and middle-income countries (LMICs). Between 2000 and 2015, the antibiotic consumption rate increased 39%, and the increase was mainly driven by LMICs with gross domestic product per capita (GDPPC) growth. Although overall reducing global consumption is needed for reducing antibiotic resistance, reduction of excess must be balanced with delayed or no access in LMICs and take into account local and global resistance patterns.

Antimicrobial stewardship (AS) is a means to achieve responsible use of antimicrobial drugs. The barriers to responsible use are mainly, but not limited to, the lack of microbiological expertise and infrastructure, lack of knowledge in infectious diseases and antimicrobial prescribing. In addition, LMIC settings have unique socioeconomic and cultural challenges. Many AS strategies have been reviewed for evidence in the literature, but the majority of studies have been conducted in high-income countries and may not be applicable in LMICs.

The goal of this Research Topic is to gather evidence on effective and feasible antimicrobial stewardship interventions in LMICs. We are also looking for papers to enhance our understanding on the ‘social aspects’ of antibiotic use in the hospital or community setting. The Research Topic will bundle original contributions to the implementation of AS in LMICS through comparative and evidence-based examples.

We hope therefore to attract an international collection of papers on antimicrobial stewardship that address both national and international factors impacting this subject.
Analysis of challenges for implementation of interventions, barriers, and finally, lessons to be learned for prescribers, stakeholders, and policy makers in LMICs.

This Research Topic encourages original research articles, brief research reports, and innovative methods in the field of antimicrobial stewardship in LMICs.

Topics of interest include, but are not limited to

• Tailored and feasible AS interventions in both hospitals and communities.
• Both quantitative and qualitative work to improve our understanding of antibiotic use in either the hospital or community setting.
• Designing and conducting intervention studies on the availability and use of diagnostic testing.
• National examples of audit on production, distribution, and dispensing of antimicrobial drugs.
• Intervention studies using educational programs on AMR and antimicrobial drug prescribing.
• Intervention studies measuring patient outcomes.


Keywords: antimicrobial stewardship, antimicrobial prescribing, education, audit and feedback, restriction, access


Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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