Aníbal de J. Sosa & Denis K. Byarugaba 
Antimicrobial Resistance in Developing Countries 

Avoiding infection has always been expensive. Some human populations escaped tropical infections by migrating into cold climates but then had to procure fuel, warm clothing, durable housing, and crops from a short growing season. Waterborne infections were averted by owning your own well or supporting a community reservoir. Everyone got vaccines in rich countries, while people in others got them later if at all. Antimicrobial agents seemed at first to be an exception. They did not need to be delivered through a cold chain and to everyone, as vaccines did. They had to be given only to infected patients and often then as relatively cheap injectables or pills off a shelf for only a few days to get astonishing cures. Antimicrobials not only were better than most other innovations but also reached more of the world’s people sooner. The problem appeared later. After each new antimicrobial became widely used, genes expressing resistance to it began to emerge and spread through bacterial populations. Patients infected with bacteria expressing such resistance genes then failed treatment and remained infected or died. Growing resistance to antimicrobial agents began to take away more and more of the cures that the agents had brought.

Mục lục

Section I: General Issues in Antimicrobial Resistance. Global perspectives of the Resistance Problem.- Mechanisms of Resistance.- Poverty and Root Causes of Resistance in Developing Countries.- What the Future Holds for Resistance in Developing Countries.- The Introduction of Antimicrobial Agents in Poor-resource Countries: Impact on the Emergence of Resistance.- Section II: The Human Impact of Resistance. HIV Resistance in Developing Countries.- Drug Resistance in Malaria in Developing Countries.- Drug Resistance in Tuberculosis in Developing Countries.- Antifungal Drug Resistance in Developing Countries.- Antimicrobial Resistance in African Trypanosomiasis.- Resistance in Enteric Pathogens in Developing Countries.-Bacterial Resistant Infections in Resource-Limited Countries.- Prevalence of Resistant Enterococci in Developing Countries.- Antimicrobial Resistance in Gram-negative Bacteria from Developing Countries.- Resistance in Reservoirs and Human Commensals.- Section III: Antimicrobial Use and Misuse. Determinants of Antimicrobial Use: Poorly Understood – Poorly Researched.- Antimicrobial Use and Antimicrobial Resistance in African Countries.- Antimicrobial Use and Antimicrobial Resistance in Asian Countries.- Antimicrobial Use and Antimicrobial Resistance in Latin America and the Caribbean Countries.- Hospital Infections by Antimicrobial Resistant Organisms in Developing Countries.- Section IV: Cost, Policy and Regulation of Antimicrobials. Economic Burden of Antimicrobial Resistance.- Health Systems Strengthening to Improve Access to Antimicrobials and the Containment of Resistance.- The Role of Unregulated Sale and Dispensing of Antimicrobial Agents on the Development of Antimicrobial Resistance in Developing Countries.- Counterfeit and Substandard Anti-Infectives in Developing Countries.- Section V: Strategies to contain AMR. Containment of Antimicrobial Resistance in Developing Countries & Lessons Learned.- Surveillance of Antimicrobial Resistance.- Vaccines: A Cost-effective Strategy to Contain Antimicrobial Resistance.- Teaching Antibiotic Prescription Practices in Medical Schools in Developing Countries.- Containing Global Antibiotic Resistance: Ethical Drug Promotion in the Developing World.- News Media Reporting of Antimicrobial Resistance in Latin America and India.