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An analysis of existing national action plans for antimicrobial resistance-gaps and opportunities in strategies optimising antibiotic use in human populations.
Charani, Esmita; Mendelson, Marc; Pallett, Scott J C; Ahmad, Raheelah; Mpundu, Mirfin; Mbamalu, Oluchi; Bonaconsa, Candice; Nampoothiri, Vrinda; Singh, Sanjeev; Peiffer-Smadja, Nathan; Anton-Vazquez, Vanesa; Moore, Luke S P; Schouten, Jeroen; Kostyanev, Tomislav; Vlahovic-Palcevski, Vera; Kofteridis, Diamantis; Corrêa, Juliana Silva; Holmes, Alison H.
Afiliación
  • Charani E; Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa; National Institute for Health Research Health Protection Research Unit in Healthcare-Associated Infections and Antimicrobial Resistance, Imperial Colleg
  • Mendelson M; Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
  • Pallett SJC; Centre for Defence Pathology, Royal Centre for Defence Medicine, Birmingham, UK; Infection and Immunity Clinical Academic Group, St George's University Hospitals NHS Foundation Trust, London, UK.
  • Ahmad R; National Institute for Health Research Health Protection Research Unit in Healthcare-Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK; School of Health and Psychological Sciences, University of London, London, UK; Institute of Business and Health Management, Do
  • Mpundu M; Action on Antibiotic Resistance (ReAct) Africa, Lusaka, Zambia.
  • Mbamalu O; Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
  • Bonaconsa C; Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
  • Nampoothiri V; Department of Health Sciences Research, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
  • Singh S; Department of Health Sciences Research, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
  • Peiffer-Smadja N; Bichat Hospital, Paris, France.
  • Anton-Vazquez V; Infection and Immunity Clinical Academic Group, St George's University Hospitals NHS Foundation Trust, London, UK.
  • Moore LSP; National Institute for Health Research Health Protection Research Unit in Healthcare-Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK; Chelsea and Westminster NHS Foundation Trust, London, UK.
  • Schouten J; ESCMID Study Group for Antimicrobial Stewardship, European Society of Clinical Microbiology and Infectious Diseases, Basel, Switzerland; Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, Netherlands.
  • Kostyanev T; ESCMID Study Group for Antimicrobial Stewardship, European Society of Clinical Microbiology and Infectious Diseases, Basel, Switzerland; Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium; Laboratoire National de Santé, Dudelange, Lu
  • Vlahovic-Palcevski V; ESCMID Study Group for Antimicrobial Stewardship, European Society of Clinical Microbiology and Infectious Diseases, Basel, Switzerland; Department of Clinical Pharmacology, Medical Faculty and Faculty of Health Studies, University Hospital Rijeka, University of Rijeka, Rijeka, Croatia.
  • Kofteridis D; ESCMID Study Group for Antimicrobial Stewardship, European Society of Clinical Microbiology and Infectious Diseases, Basel, Switzerland; Department of Internal Medicine and Infectious Diseases, University Hospital of Heraklion, Heraklion, Crete, Greece.
  • Corrêa JS; School of Nursing, University of São Paulo, São Paulo, Brazil.
  • Holmes AH; National Institute for Health Research Health Protection Research Unit in Healthcare-Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK; Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.
Lancet Glob Health ; 11(3): e466-e474, 2023 03.
Article en En | MEDLINE | ID: mdl-36739875
ABSTRACT
At the 2015 World Health Assembly, UN member states adopted a resolution that committed to the development of national action plans (NAPs) for antimicrobial resistance (AMR). The political determination to commit to NAPs and the availability of robust governance structures to assure sustainable translation of the identified NAP objectives from policy to practice remain major barriers to progress. Inter-country variability in economic and political resilience and resource constraints could be fundamental barriers to progressing AMR NAPs. Although there have been regional and global analyses of NAPs from a One Health and policy perspective, a global assessment of the NAP objectives targeting antimicrobial use in human populations is needed. In this Health Policy, we report a systematic evidence synthesis of existing NAPs that are aimed at tackling AMR in human populations. We find marked gaps and variability in maturity of NAP development and operationalisation across the domains of (1) policy and strategic planning; (2) medicines management and prescribing systems; (3) technology for optimised antimicrobial prescribing; (4) context, culture, and behaviours; (5) operational delivery and monitoring; and (6) patient and public engagement and involvement. The gaps identified in these domains highlight opportunities to facilitate sustainable delivery and operationalisation of NAPs. The findings from this analysis can be used at country, regional, and global levels to identify AMR-related priorities that are relevant to infrastructure needs and contexts.
Asunto(s)

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Antiinfecciosos / Antibacterianos Tipo de estudio: Policy_brief / Prognostic_studies Límite: Humans Idioma: En Revista: Lancet Glob Health Año: 2023 Tipo del documento: Article

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Antiinfecciosos / Antibacterianos Tipo de estudio: Policy_brief / Prognostic_studies Límite: Humans Idioma: En Revista: Lancet Glob Health Año: 2023 Tipo del documento: Article