Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future
Creators: name: Godman, Brian
name: Haque, Mainul
name: McKimm, Judy
name: Abu Bakar, Muhamad
name: Sneddon, Jacqueline
name: Wale, Janney
name: Campbell, Stephen
name: Martin, Antony P.
name: Hoxha, Iris
name: Abilova, Vafa
name: Paramadhas, Bene D. Anand
name: Mpinda-Joseph, Pinkie
name: Matome, Matshediso
name: de Lemos, Livia Lovato Pires
name: Sefah, Israel
name: Kurdi, Amanj
name: Opanga, Sylvia
name: Jakupi, Arianit
name: Saleem, Zikria
name: Hassali, Mohamed Azmi
name: Kibuule, Dan
name: Fadare, Joseph
name: Bochenek, Tomasz
name: Rothe, Celia
name: Furst, Jurij
name: Markovic-Pekovic, Vanda
name: Bojanić, Ljubica
name: Schellack, Natalie
name: Meyer, Johanna C.
name: Matsebula, Zinhle
name: Phuong, Thuy Nguyen Thi
name: Thanh, Binh Nguyen
name: Jan, Saira
name: Kalungia, Aubrey
name: Mtapuri-Zinyowera, Sekesai
name: Sartelli, Massimo
name: Hill, Ruaraidh
Publisher: name: Taylor & Francis
Year: 2019
Subjects: subject: Space Science
subject: Medicine
subject: Environmental Sciences not elsewhere classified
subject: Sociology
subject: FOS: Sociology
subject: Science Policy
subject: Infectious Diseases
subject: FOS: Health sciences

description: <b>Introduction:</b> Antibiotics are indispensable to maintaining human health; however, their overuse has resulted in resistant organisms, increasing morbidity, mortality and costs. Increasing antimicrobial resistance (AMR) is a major public health threat, resulting in multiple campaigns across countries to improve appropriate antimicrobial use. This includes addressing the overuse of antimicrobials for self-limiting infections, such as upper respiratory tract infections (URTIs), particularly in lower- and middle-income countries (LMICs) where there is the greatest inappropriate use and where antibiotic utilization has increased the most in recent years. Consequently, there is a need to document current practices and successful initiatives in LMICs to improve future antimicrobial use. <b>Methodology:</b> Documentation of current epidemiology and management of URTIs, particularly in LMICs, as well as campaigns to improve future antimicrobial use and their influence where known. <b>Results:</b> Much concern remains regarding the prescribing and dispensing of antibiotics for URTIs among LMICs. This includes considerable self-purchasing, up to 100% of pharmacies in some LMICs. However, multiple activities are now ongoing to improve future use. These incorporate educational initiatives among all key stakeholder groups, as well as legislation and other activities to reduce self-purchasing as part of National Action Plans (NAPs). Further activities are still needed however. These include increased physician and pharmacist education, starting in medical and pharmacy schools; greater monitoring of prescribing and dispensing practices, including the development of pertinent quality indicators; and targeted patient information and health education campaigns. It is recognized that such activities are more challenging in LMICs given more limited resources and a lack of healthcare professionals. <b>Conclusion:</b> Initiatives will grow across LMICs to reduce inappropriate prescribing and dispensing of antimicrobials for URTIs as part of NAPs and other activities, and these will be monitored.