Alam, M;
Saleem, Z;
Haseeb, A;
Qamar, MU;
Sheikh, A;
Almarzoky Abuhussain, SS;
Iqbal, MS;
Raees, F;
Chigome, A;
Cook, A;
et al.
Alam, M; Saleem, Z; Haseeb, A; Qamar, MU; Sheikh, A; Almarzoky Abuhussain, SS; Iqbal, MS; Raees, F; Chigome, A; Cook, A; Moore, CE; Mustafa, Z-U; Salman, M; Saleh, U; Shabbir, S; Godman, B
(2023)
Tackling antimicrobial resistance in primary care facilities across Pakistan: Current challenges and implications for the future.
J Infect Public Health, 16 (Supplement 1).
pp. 97-110.
ISSN 1876-035X
https://doi.org/10.1016/j.jiph.2023.10.046
SGUL Authors: Moore, Catrin Elisabeth
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Abstract
Antibiotics are gradually becoming less effective against bacteria worldwide, and this issue is of particular concern in economically-developing nations like Pakistan. We undertook a scoping review in order to review the literature on antimicrobial use, prescribing, dispensing and the challenges associated with antimicrobial resistance in primary care (PC) settings in Pakistan. Furthermore, this review aims to identify potential solutions to promote appropriate use of antimicrobials in Pakistan. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) checklist, a comprehensive scoping review was conducted to review the literature of antimicrobials used, prescribed and dispensed in PC settings in Pakistan. Google Scholar and Pub-Med were searched for the period 2000-2023. Papers were analyzed on the basis of eligibility i.e., included antimicrobial use, prescribing and dispensing practices by general population at homes, by prescribers in outpatient departments of hospitals and by pharmacists/dispensers in community pharmacies, respectively. Two researchers analyzed the articles thoroughly and disagreements were resolved through discussion with a third reviewer. Both quantitative and qualitative research studies were eligible for inclusion. Additionally, the selected papers were grouped into different themes. We identified 4070 papers out of which 46 studies satisfied our eligibility criteria. The findings revealed limited understanding of antimicrobial resistance (AMR) by physicians and community pharmacists along with inappropriate practices in prescribing and dispensing antibiotics. Moreover, a notable prevalence of self-medication with antibiotics was observed among the general population, underscoring a lack of awareness and knowledge concerning proper antibiotic usage. Given the clinical and public health implications of AMR, Pakistan must prioritize its policies in PC settings. Healthcare professionals (HCPs) need to reduce inappropriate antibiotic prescribing and dispensing, improve their understanding of the AWaRe (access, watch and reserve antibiotics) classification and guidance, monitor current usage and resistance trends, as well as implement antimicrobial stewardship (ASP) activities starting in targeted locations.
Item Type: | Article | ||||||||
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Additional Information: | © 2023 The Authors. Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). | ||||||||
Keywords: | Ambulatory care, Antibiotic dispensing, Antibiotic prescribing, Dentist prescribing antibiotics, Hand hygiene, Outpatient departments, Pakistan, Primary healthcare center, Retail pharmacy dispensing, 1117 Public Health and Health Services, 1199 Other Medical and Health Sciences | ||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Infection and Immunity Research Institute (INII) | ||||||||
Journal or Publication Title: | J Infect Public Health | ||||||||
ISSN: | 1876-035X | ||||||||
Language: | eng | ||||||||
Dates: |
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Publisher License: | Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0 | ||||||||
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PubMed ID: | 37973496 | ||||||||
Go to PubMed abstract | |||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/115876 | ||||||||
Publisher's version: | https://doi.org/10.1016/j.jiph.2023.10.046 |
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