Abstract
Ten years ago, a review on the status of resistance in Mexico was bleak: with antibiotics freely sold over the counter and poor regulation of generic drugs, among other conditions, resistance among relevant pathogens often ranked top, either among Latin American countries, or even worldwide. Since then, there have been some regulatory changes, along a decline in antibiotics usage: antibiotics are (supposedly) no longer sold without prescription, generic drugs (supposedly) have to demonstrate bioequivalence, and antibiotic usage has drop, from about 13 defined daily doses per 1,000 inhabitants per day, to 7. While these changes may sound encouraging, an analysis show that regulatory changes are incomplete at best, and usage decline may be the consequence of factors such as growing poverty. The assessment of resistance continues to be haphazard, without an organized network of laboratories providing a coherent picture. However, judging from a few nationwide reports, it appears that resistance among some nosocomial pathogens (MRSA, enterococci, Pseudomonas aeruginosa) is declining, as it is among pneumococci and enteropathogens; but it is rising among community-acquired, uropathogenic Escherichia coli. Resistance to colistin is slowly increasing; and worrisome resistance determinants, such as blaNDM-1 and mcr-1, appeared in Mexico shortly after their first report elsewhere. After four years from the United Nations General Assembly high-level meeting on antibiotic resistance, Mexico is yet to deploy the basic measures to assess and control antibiotic resistance. As such, and despite the regulatory changes, the 2010-2020 period looks like a "lost decade".
Highlights
Ten years ago, I wrote a brief review on the status of antibiotic resistance in Mexico [1], including some actual data on the prevalence of resistance among relevant pathogens, and an overview of the underlying causes of the problem
Many of the issues stated before have changed along these decade, making it interesting to review again how things are and what impact, if any, such changes have had in terms of antibiotic resistance prevalence
Further papers documented the trend towards reduction of antibiotic usage: in 2010, antibiotic usage "expressed in standard units per person", was in the 8-13 range, with a 6.25 to - 4.00 compound annual growth rate [5]; by 2015, antibiotic consumption, in DDD/TID, was around 7, well below most other Latin American countries reported [6]
Summary
I wrote a brief review on the status of antibiotic resistance in Mexico [1], including some actual data on the prevalence of resistance among relevant pathogens, and an overview of the underlying causes of the problem. Introduction Ten years ago, I wrote a brief review on the status of antibiotic resistance in Mexico [1], including some actual data on the prevalence of resistance among relevant pathogens, and an overview of the underlying causes of the problem.
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