Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, South Africa; National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa; Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, South Africa.
S Afr Med J. 2024 Sep 2;114(9):e2111. doi: 10.7196/SAMJ.2024.v114i9.2111.
Antimicrobial resistance (AMR), in which microbes adapt to and resist current therapies, is a well-recognised global problem that threatens to reverse gains made by modern medicine in the last decades. AMR is a complex issue; however, at its core, it is driven by the overuse and inappropriate use of antimicrobials. Socioeconomic factors have been identified as significant contributors to the emergence and exacerbation of AMR, especially in populations facing inadequate access to healthcare, poor sanitation services and high morbidity and mortality rates. Weak healthcare systems and water, sanitation and hygiene have been highlighted as fundamental risk factors for AMR emergence and transmission. Behavioural factors, such as purchasing antibiotics without a prescription from a registered healthcare professional, not completing the prescribed course or overly prolonged courses of antibiotics, using antibiotics to treat viral infections, lack of access to quality antibiotics, and the proliferation of substandard or falsified (SF) drugs, have also been identified as significant contributors to AMR. Low- and middle-income countries have a higher incidence of antibiotics being dispensed without a prescription than higher-income countries.
抗菌药物耐药性(AMR)是指微生物对现有治疗方法产生适应和耐药性,这是一个全球公认的问题,有可能使现代医学在过去几十年中取得的成果付诸东流。AMR 是一个复杂的问题;然而,其核心是由抗菌药物的过度和不当使用驱动的。社会经济因素已被确定为 AMR 出现和加剧的重要因素,特别是在那些难以获得医疗保健、卫生服务差以及发病率和死亡率高的人群中。薄弱的医疗保健系统以及水、环境卫生和个人卫生已被确定为 AMR 出现和传播的基本风险因素。行为因素,如从注册医疗保健专业人员处购买未经处方的抗生素、不完成规定疗程或过度延长抗生素疗程、用抗生素治疗病毒感染、无法获得质量好的抗生素以及劣药和假药的泛滥,也被确定为 AMR 的重要因素。与高收入国家相比,中低收入国家的抗生素未经处方就被配给的情况更为普遍。