Ehsan Hedayatullah, Wardak Fazel Rahim, Karimi Hasiba, Kamal Fariha, Aminpoor Hasibullah, Salam Abdul, Tariq Hira, Damani Rameen, Elshabrawi Mohamed Nasser, Faisal Mehak, Iloanusi Chukwuagoziem Augustine, Roy Ayushmaan, Shakeel Izza, Joshi Sharvari, Abubakar Md, Yosufi Abubakr, Mehrpoor Ahmad Jamshid
Faculty of Medicine and Dentistry, Medical Sciences Research Center, Ghalib University, Kabul, Afghanistan.
Department of Internal Medicine, Kabul University of Medical Sciences "Abu Ali Ibn Sina", Kabul, Afghanistan.
J Health Popul Nutr. 2025 Jul 23;44(1):265. doi: 10.1186/s41043-025-00909-z.
Antimicrobial resistance (AMR) presents a global health crisis, and Afghanistan, with its limited healthcare infrastructure, faces an acute AMR challenge. Factors such as overuse of antibiotics, unregulated drug sales, and low public awareness contribute to an accelerated spread of resistant pathogens. This study offers a comprehensive narrative analysis of the drivers of AMR in Afghanistan and proposes strategic, context-specific interventions.
A narrative review was conducted using available literature and national reports to assess AMR prevalence in Afghanistan, identify contributing socio-political and healthcare challenges, and evaluate the impact of these challenges on AMR surveillance and control.
High resistance rates are prevalent among key pathogens, including Escherichia coli, Staphylococcus aureus, and Klebsiella pneumoniae, with resistance to first-line antibiotics exceeding 80% for many infections. Afghanistan's fragile healthcare infrastructure, compounded by unregulated antibiotic sales and self-medication practices, exacerbates AMR rates. Limited AMR surveillance and inadequate infection control practices further intensify the crisis.
Addressing AMR in Afghanistan requires urgent, coordinated action. Recommendations include strengthening healthcare infrastructure, enforcing antibiotic regulations, enhancing surveillance, and implementing public education campaigns. Worldwide teamwork is vital to building a resilient healthcare system to address Afghanistan's unique AMR challenges effectively. These interventions are crucial to controlling the spread of AMR and preventing a healthcare crisis.
抗菌药物耐药性（AMR）构成了一场全球健康危机，而医疗基础设施有限的阿富汗面临着严峻的AMR挑战。抗生素的过度使用、药品销售监管不力以及公众意识淡薄等因素导致耐药病原体加速传播。本研究对阿富汗AMR的驱动因素进行了全面的叙述性分析，并提出了针对具体情况的战略干预措施。
采用现有文献和国家报告进行叙述性综述，以评估阿富汗的AMR流行情况，确定造成影响的社会政治和医疗挑战，并评估这些挑战对AMR监测和控制的影响。
关键病原体（包括大肠杆菌、金黄色葡萄球菌和肺炎克雷伯菌）的耐药率普遍较高，许多感染对一线抗生素的耐药率超过80%。阿富汗脆弱的医疗基础设施，再加上抗生素销售监管不力和自我用药行为，加剧了AMR发生率。AMR监测有限以及感染控制措施不足进一步加剧了这场危机。
应对阿富汗的AMR需要紧急、协调一致的行动。建议包括加强医疗基础设施、执行抗生素法规、加强监测以及开展公众教育活动。全球范围内的团队合作对于建立一个有韧性的医疗系统以有效应对阿富汗独特的AMR挑战至关重要。这些干预措施对于控制AMR的传播和预防医疗危机至关重要。
