Abstract
BackgroundAntimicrobial resistance (AMR) has become an emerging issue in the developing countries as well as in Bangladesh. AMR is aggravated by irrational use of antimicrobials in a largely unregulated pluralistic health system. This review presents a ‘snap shot’ of the current situation including existing policies and practices to address AMR, and the challenges and barriers associated with their implementation.MethodsA systematic approach was adopted for identifying, screening, and selecting relevant literature on AMR situation in Bangladesh. We used Google Scholar, Pubmed, and Biomed Central databases for searching peer-reviewed literature in human, animal and environment sectors during January 2010-August 2019, and Google for grey materials from the institutional and journal websites. Two members of the study team independently reviewed these documents for inclusion in the analysis. We used a ‘mixed studies review’ method for synthesizing evidences from different studies.ResultOf the final 47 articles, 35 were primary research, nine laboratory-based research, two review papers and one situation analysis report. Nineteen articles on human health dealt with prescribing and/or use of antimicrobials, five on self-medication, two on non-compliance of dosage, and 10 on the sensitivity and resistance patterns of antibiotics. Four papers focused on the use of antimicrobials in food animals and seven on environmental contamination. Findings reveal widespread availability of antimicrobials without prescription in the country including rise in its irrational use across sectors and consequent contamination of environment and spread of resistance. The development and transmission of AMR is deep-rooted in various supply and demand side factors. Implementation of existing policies and strategies remains a challenge due to poor awareness, inadequate resources and absence of national surveillance.ConclusionAMR is a multi-dimensional problem involving different sectors, disciplines and stakeholders requiring a One Health comprehensive approach for containment.
Highlights
The world is on the verge of sliding back to ‘pre-antibiotic era’ due to evolving resistance against life-saving antimicrobial drugs, with fundamental effect on individual and public health [1]
What is the current scenario regarding use of antimicrobials among different population groups that predisposes to the emergence of Antimicrobial resistance (AMR) in Bangladesh? In the food animals and fishes? Contamination of environment and the food cycle?
19 of the articles on human health dealt with antimicrobial prescribing and/or use, five with self-medication, two on non-compliance of dosage, and 10 were on antibiotics sensitivity and resistance patterns
Summary
The world is on the verge of sliding back to ‘pre-antibiotic era’ due to evolving resistance against life-saving antimicrobial drugs, with fundamental effect on individual and public health [1]. To combat this emerging global threat in a comprehensive manner, the World Health Organization (WHO) launched a Global Action Plan (GAP) in 2015 based on a ‘One Health’ approach—emphasizing the interdependence of human health, animal health, and the environment [2]. The use of antimicrobials is banned as a food additive in some of these countries for rearing food animals, but implementation remains a problem due to the weak regulatory regime [5].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
