Global Antibiotic Resistance

Antibiotic misuse in lower- and middle-income countries (LMICs) contributes to the development of antibiotic resistance that can disseminate globally. Strategies specific to LMICs that seek to reduce antibiotic misuse by humans, but simultaneously improve antibiotic access, have been proposed.

However, most approaches to date have not considered the growing impact of animal and environmental reservoirs of antibiotic resistance, which threaten to exacerbate the antibiotic resistance crisis in LMICs. In particular, current strategies do not prioritize the impacts of increased antibiotic use for terrestrial food-animal and aquaculture production, inadequate food safety, and widespread environmental pollution.

Here, we propose new approaches that address emerging, One Health challenges.

Antibiotic resistance is a global public health issue. The need for higher-income countries to support lower- and middle-income countries (LMICs) in identifying actionable strategies has been recognized by major global public health institutions, including the US Centers for Disease Control and Prevention (CDC) and the World Health Organization.

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