Next Article in Journal / Special Issue
Something Borrowed, Something New: A Governance and Social Construction Framework to Investigate Power Relations and Responses of Diverse Stakeholders to Policies Addressing Antimicrobial Resistance
Previous Article in Journal
A Case of Ertapenem Neurotoxicity Resulting in Vocal Tremor and Altered Mentation in a Dialysis Dependent Liver Transplant Patient
Previous Article in Special Issue
Combatting Antibiotic Resistance Together: How Can We Enlist the Help of Industry?
Open AccessReview

Interventions to Reduce Antibiotic Prescribing in LMICs: A Scoping Review of Evidence from Human and Animal Health Systems

Institute of Development Studies, University of Sussex, Brighton BN1 NRE, UK
*
Author to whom correspondence should be addressed.
Received: 1 November 2018 / Revised: 17 December 2018 / Accepted: 18 December 2018 / Published: 22 December 2018
This review identifies evidence on supply-side interventions to change the practices of antibiotic prescribers and gatekeepers in low- and middle-income countries (LMICs). A total of 102 studies met the inclusion criteria, of which 70 studies evaluated interventions and 32 provided insight into prescribing contexts. All intervention studies were from human healthcare settings, none were from animal health. Only one context study examined antibiotic use in animal health. The evidence base is uneven, with the strongest evidence on knowledge and stewardship interventions. The review found that multiplex interventions that combine different strategies to influence behaviour tend to have a higher success rate than interventions based on single strategies. Evidence on prescribing contexts highlights interacting influences including health system quality, education, perceptions of patient demand, bureaucratic processes, profit, competition, and cultures of care. Most interventions took place within one health setting. Very few studies targeted interventions across different kinds of providers and settings. Interventions in hospitals were the most commonly evaluated. There is much less evidence on private and informal private providers who play a major role in drug distribution in LMICs. There were no interventions involving drug detailers or the pharmaceutical companies despite their prominent role in the contextual studies. View Full-Text
Keywords: antibiotic resistance; antibiotic prescribing; antibiotic use; antibiotic stewardship antibiotic resistance; antibiotic prescribing; antibiotic use; antibiotic stewardship
Show Figures

Figure 1

MDPI and ACS Style

Wilkinson, A.; Ebata, A.; MacGregor, H. Interventions to Reduce Antibiotic Prescribing in LMICs: A Scoping Review of Evidence from Human and Animal Health Systems. Antibiotics 2019, 8, 2.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Search more from Scilit
 
Search
Back to TopTop