[Antimicrobial resistance in developing countries].

BACKGROUND

While bacterial infections are one of the most important causes of disease and death in developing countries, the prevalence and consequences of antimicrobial resistance are not well known.

MATERIAL AND METHODS

This is a review article based on literature retrieved from a non-systematic review and own experience from research on the topic.

RESULTS

Research on antimicrobial resistance is increasing in developing countries, but most of the data are obtained from referral hospitals in capitals and major cities. Multiresistant Gram-negative bacteria, including ESBL-(extended-spectrum beta-lactamase) producing bacteria have been documented in several countries and are associated with increased lethality. The most serious resistance problems in developing countries are associated with Gram-negative bacteria and tuberculosis and may result in increased risk of death.

INTERPRETATION

Developing countries have a much higher overall burden of infectious diseases than the rich western countries and also poor access to newer antibiotics, which can be lifesaving when treating infections caused by resistant bacteria. To combat overuse and misuse of antibiotics, the diagnosis of infectious diseases must be strengthened and antimicrobial resistance must be emphasized in education of health professionals and the general public. There is a need for improved surveillance of antimicrobial resistance and strengthened quality control of antimicrobial drugs. In the long-term perspective, poverty reduction, improved living conditions and hygiene, safe water supplies and access to quality health care (including vaccination and HIV care), may contribute to prevent emerging antimicrobial resistance.