Issue Of Antimicrobial Resistance Research Articles

Antibiotic use and resistance: knowledge, attitudes and practices in Italian healthcare workers

Abstract Background Antimicrobial resistance (AMR) is one of the most significant public health challenges globally. The misuse or incorrect use of antibiotics has led to the emergence of resistant bacteria, making it increasingly difficult to treat infections. This study aims to identify knowledge, attitudes, and practices among Italian healthcare workers (HWs) - medical doctors (MDs) and nurses - regarding antibiotics, antibiotic use, and antibiotic resistance. Methods Cross-sectional study; a validated questionnaire from the European Centre for Disease Prevention and Control was distributed via web survey starting from April 2024 to a voluntary sample of healthcare workers employed in Italy. Descriptive analysis and multivariable logistic regression were performed to investigate predictors of knowledge regarding antibiotic use and AMR. Ethical approval was obtained from the local ethics committee. Results So far, 154 HWs were enrolled, of which 132 were nurses (85.7%). The average level of knowledge regarding AMR and antibiotic use was 6.8/7 (± 0.2) for MDs and 6.1/7 (± 0.2) for nurses, with an overall score, among HWs of 6.19 (± 0.99), compared to a European average of 6.35. The multivariable analysis highlighted that the medical profession reported higher knowledge regarding prudent antibiotic use and AMR (aOR 6.90; 95% CI 1.83-26.01, p-value = 0.004), while concerning professional practice, the unavailability and difficulty of access to guidelines seemed to increase the risk of reporting inadequate knowledge (aOR 2.04; 95% CI 1.01-4.13, p-value = 0.046). Conclusions Our preliminary results provide an insight into the importance of structuring and actively disseminating procedures/protocols and guidelines to deepen the issues of AMR and prudent antibiotic use. Also, there appears to be a need to enhance the delivery of refresher courses targeting HWs, with particular attention to settings at high infection transmission risk. EU funding: Project no. PE00000007, INF-ACT. Key messages • Although a higher knowledge about prudent antibiotic use and AMR, more efforts are needed to increase access to guidelines. • Constant updating of knowledge and practices is necessary to face the challenges of antibiotic resistance in public health.

Therapy of Aspiration: Out-of-Hospital and In-Hospital-Acquired.

Therapeutic considerations for aspiration pneumonia prioritize the risk of multidrug-resistant organisms. This involves integrating microbiological insights with each patient's unique risk profile, including the location at the time of aspiration, and whether it occurred in or out of the hospital. Our understanding of the microbiology of aspiration pneumonia has also evolved, leading to a reassessment of anaerobic bacteria as the primary pathogens. Emerging research shows a predominance of aerobic pathogens, in both community and hospital-acquired cases. This shift challenges the routine use of broad-spectrum antibiotics targeting anaerobes, which can contribute to antibiotic resistance and complications such as Clostridium difficile infections-concerns that are especially relevant given the growing issue of antimicrobial resistance. Adopting a comprehensive, patient-specific approach that incorporates these insights can optimize antibiotic selection, improve treatment outcomes, and reduce the risk of resistance and adverse effects.

Photoinactivation of Multidrug-Resistant mcr-1-Positive E. coli Using PCPDTBT Conjugated Polymer Nanoparticles under White Light.

The issue of antimicrobial resistance is an escalating concern within the scope of global health. It is predicted that the existence of antibiotic-resistant bacteria might result in an estimated annual death of up to 10 million by 2050, along with possible economic losses ranging from 100 to 210 trillion. This study reports the production of poly[2,6-(4,4-bis(2-ethylhexyl)-4H-cyclopenta[2,1-b;3,4-b']dithiophene)-alt-4,7(2,1,3-benzothiadiazole)] nanoparticles (PCPDTBT-NPs) by nanoprecipitation as an alternative to tackle this problem. The size, shape, and optical features of these conjugated polymer NPs were analyzed. Their efficacy as photosensitizers against nonresistant (ATCC) and multidrug-resistant mcr-1-positive Escherichia coli was assessed under white light doses of 250 and 375 J·cm-2. PCPDTBT-NPs inactivated both E. coli strains exposed to white light at an intensity of 375 J·cm-2, while no antimicrobial effect was observed in the group not exposed to white light. Reactive oxygen species and singlet oxygen were detected using DCFH-DA and DPBF probes, allowing the investigation of the photoinactivation pathways. This work showcases PCPDTBT-NPs as photosensitizers to eliminate multidrug-resistant bacteria through photodynamic inactivation employing visible light.

Colostrum-derived extracellular vesicles: potential multifunctional nanomedicine for alleviating mastitis

Bovine mastitis is an infectious disease that causes substantial economic losses to the dairy industry worldwide. Current antibiotic therapy faces issues of antibiotic misuse and antimicrobial resistance, which has aroused concerns for both veterinary and human medicine. Thus, this study explored the potential of Colo EVs (bovine colostrum-derived extracellular vesicles) to address mastitis. Using LPS-induced murine mammary epithelial cells (HC11), mouse monocyte macrophages (RAW 264.7), and a murine mastitis model with BALB/C mice, we evaluated the safety and efficacy of Colo EVs, in vivo and in vitro. Colo EVs had favorable biosafety profiles, promoting cell proliferation and migration without inducing pathological changes after injection into murine mammary glands. In LPS-induced murine mastitis, Colo EVs significantly reduced inflammation, improved inflammatory scores, and preserved tight junction proteins while protecting milk production. Additionally, in vitro experiments demonstrated that Colo EVs downregulated inflammatory cytokine expression, reduced inflammatory markers, and attenuated NF-κB pathway activation. In summary, we inferred that Colo EVs have promise as a therapeutic approach for mastitis treatment, owing to their anti-inflammatory properties, potentially mediated through the NF-κB signaling pathway modulation.Graphical

Bacterial Persister Cells and Development of Antibiotic Resistance in Chronic Infections: An Update.

The global issue of antimicrobial resistance poses significant challenges to public health. The World Health Organization (WHO) has highlighted it as a major global health threat, causing an estimated 700,000 deaths worldwide. Understanding the multifaceted nature of antibiotic resistance is crucial for developing effective strategies. Several physiological and biochemical mechanisms are involved in the development of antibiotic resistance. Bacterial cells may escape the bactericidal actions of the drugs by entering a physiologically dormant state known as bacterial persistence. Recent findings in this field suggest that bacterial persistence can be one of the main sources of chronic infections. The antibiotic tolerance developed by the persister cells could tolerate high levels of antibiotics and may give rise to persister offspring. These persister offspring could be attributed to antibiotic resistance mechanisms, especially in chronic infections. This review attempts to shed light on persister-induced antibiotic resistance and the current therapeutic strategies.

Bacterial Diversity and Antimicrobial Resistance of Microorganisms Isolated from Teat Cup Liners in Dairy Farms in Shandong Province, China.

Global milk consumption exceeds 800 million tons a year and is still growing. Milk quality and its products are critical to human health. A teat cup makes direct contact with the cow's teats during milking and its cleanliness is very important for the quality of raw milk. In this study, the microorganism from post-milking teat cup liners were collected from six dairy farms in Shandong Province of China, the bacterial species were identified using microbial mass spectrometry, the minimum inhibitory concentrations of the isolated strains against ten antimicrobial agents were determined using the broth microdilution method, and the antimicrobial resistance genes were detected by PCR. The results indicated that the most frequently isolated bacteria in this study were Bacillus licheniformis (39/276, 14.13%), followed by Bacillus pumilus (20/276, 7.25%), Bacillus cereus (17/276, 6.16%), and Bacillus subtili (16/276, 5.80%). The isolates exhibited the highest average resistance to lincomycin (87.37%), followed by sulfadiazine (61.05%) and streptomycin (42.63%); the highest detection rate of resistance genes was Sul1 (55.43%), followed by ant(4') (51.09%), tet(M) (25.36%), blaKPC (3.62%) and qnrS (3.62%). These findings imply the necessity for enhanced measures in disinfecting cow udders and milking equipment, highlighting the persistently challenging issue of antimicrobial resistance in Shandong Province.

Antibacterial activities, PASS prediction and ADME analysis of phytochemicals from Curcubita moschata, Curcubita maxima, and Irvingia gabonensis: insights from in silico studies.

Microbial infection management and treatment are crucial as a result of the prevalent antimicrobial resistance issue. Progressive studies are being carried out on how to develop drugs that can mitigate the resistance trends of these microorganisms. Secondary metabolites of plants can also be employed and accessed for this role, as the current study examines the antibacterial activities of phytochemicals from three (3) plants (Cucubita moschata, Cucubita maxima, and Irvingia gabonesis) through computational approaches. Molecular docking studies were carried out to show the binding affinities of the phytochemicals against two target receptors (DNA gyrase and Penicillin Binding Protein 3). In addition, drug likeness analysis, bioactivity and oral-bioavailability properties, absorption, distribution, metabolism, and excretion (ADME) profiling, as well as prediction of activity spectra for substances (PASS) using online tools like SwissADME, PASS online, AdmetSAR2, and Discovery Studio, were also performed. The results obtained identified isochlorogenic acid and apigenin-7-O-glucoside for DNA gyrase (1KZN) and apigenin-7-O-glucoside for Penicillin Binding Protein 3 (4BJP), which were further subjected to molecular dynamics simulation (MDS) and therefore recommended as the lead compounds.

Applying Giloy Stems Dye to Silk and Lyocell Fabrics to Improve Their Antimicrobial and Fastness Properties Using Bio-Mordant

The investigation of novel strategies to combat harmful bacteria is warranted given the serious threat that antimicrobial resistance poses to world health. Out of all of these, treating textile materials with antimicrobial compounds has attracted a lot of attention due to its potential to stop the spread of infectious diseases. The goal of this study was to evaluate how silk and lyocell materials' inherent antibacterial qualities might be improved by giloy dyeing and lemon mordanting. The goal of mordanting was to improve dye adhesion by using only natural ingredients such as citrus lemon extract. Using dye from Azadirachta indica, which was made by aqueous boiling, Lyocell and Silk materials were dyed under various circumstances. Following Giloy dyeing and Lemon mordanting, the antibacterial efficiency significantly improved, notably against common infections like Klebsiella pneumoniae and Staphylococcus aureus, according to the results. Furthermore, the study assessed washing and perspiration fastness capabilities, which yielded positive results and confirmed the method's feasibility. This method has the potential to considerably improve infection control measures in textiles, particularly in fields focused on public health and cleanliness. Given the serious issue of antimicrobial resistance, adopting new textile treatments like this can help to build effective and sustainable solutions. Future studies can investigate further uses and adjustments, assuring its adaptability and wider adoption across many environments.

Implementation of the pharmacovigilance database in the usage of antibiotics in a tertiary care hospital: A pilot study.

Antimicrobial resistance (AMR) has evolved into a severe public health issue that defies all current control strategies and needs multidisciplinary, creative solutions. Antimicrobial stewardship (AMS) activities demand a set of tools and abilities that can be used by health systems. In view of the growing AMR and the difficulty for the surveillance of it in the developing country, this study was conducted to incorporate pharmacovigilance (PV) in the AMS program. A cross-sectional pilot study was conducted to collect the PV database of antimicrobials induced adverse drug reactions (ADR) from the Adverse Drug Reactions Monitoring Center (AMC) of the institute for a period of 2 months from August 2022 to September 2022. The information from the database was analyzed to estimate the usage of antibiotics from the PV database from AMC and classified it under the Anatomical Therapeutic Chemical, to assess the rationality of the antimicrobial's usage based on "Access," "Watch," and "Reserve" (AWaRe) classification, and to assess the ADR of the antibiotics. The analysis was done by using the SPSS version 20.0 for Windows. The results showed that the prevalence of ADRs were more in adults' population with preponderance in female. The antibiotics usage was as per with World Health Organization standard and most of the antibiotics used were from the Access group of AWaRe classifications. Tetracyclines and penicillins were the most used antibiotic group of drugs. The number of patients included in the study was 70. Most of the causality assessment was "possible" (62.85%). In the study, almost 90% of the drug was withdrawn and 70% of the patients were in the recovering stage. Using existing PV approaches to address usage of antibiotics and AMR issues would allow PV to progress as a field, and governments will get a stronger return on their PV investments.

Investigating the Bactericidal Activity of an Ocular Solution Containing EDTA, Tris, and Polysorbate 80 and Its Impact on the In Vitro Efficacy of Neomycin Sulfate against Staphylococcus aureus: A Preliminary Study.

In the current context of emerging and spreading antimicrobial resistance in human and animal infections, new strategies need to be developed to improve the efficacy of commonly prescribed antibiotics and preserve more critical compounds for multi-drug-resistant infections. This preliminary study aimed at evaluating the benefits of an eye cleaning solution containing 0.1% EDTA, 0.02% Tris, and 0.1% Polysorbate 80 in veterinary ophthalmology. A first in vitro study was performed to assess the bactericidal activity of the test solution against Staphylococcus aureus and Pseudomonas aeruginosa strains. A second in vitro study evaluated the impact of the test solution on the antimicrobial activity of neomycin against Staphylococcus aureus. The test solution alone did not show bactericidal activity against Staphylococcus aureus and Pseudomonas aeruginosa. The test solution seemed to increase the activity of Neomycin Sulfate against Staphylococcus aureus. These findings warrant further research to better characterize the impact on the bactericidal activity of antimicrobials used in veterinary ocular surface infections of the solution containing 0.1% EDTA, 0.02% Tris, and 0.1% Polysorbate 80 as well as of each individual ingredient for a thorough understanding of how this test solution could provide a new strategy to address the growing antimicrobial resistance issue worldwide.

Impacts of ethnoveterinary medicine integrated with livestock farm technologies on the performance and antimicrobial resistance of indigenous goats in South Africa –A review

Ethnoveterinary medicine and livestock farm technologies represent a junction of innovation and tradition with the aim to accomplish livestock systems that are resilient, productive, and sustainable to meet 21st century challenges, especially the antimicrobial resistance issue. This article aims to emphasise the impacts of integrating ethnoveterinary medicine with livestock farm technologies on the performance of indigenous goats in South Africa. With the growing concern over antimicrobial resistance in livestock, there is a pressing need for complementary approaches to the health of animals and their productivity. In this review, the aim evaluated whether an integrative approach could offer a sustainable alternative that benefits animal health and productivity while addressing the concerns of antimicrobial resistance. Comparative study designs across multiple indigenous goat farms were used to integrate specific medicinal plants in ethnoveterinary medicine with present-day livestock technologies that are used to monitor the effects on livestock performance indicators and antimicrobial resistance patterns. In the treated populations, the outcomes were indicative of substantial improvements in reproduction and growth rates, and alongside, there has been a notable decrease in the markers of antimicrobial resistance. Therefore, it is proposed that through these discoveries, the integration of these traditional and modern approaches not only improve the performance of indigenous goats but also contribute immensely to the mitigation of risks associated with antimicrobial resistance.

Assessing Pharmacy Students' Knowledge and Awareness Regarding the Rational Utilization of Antibiotics and the Issue of Antimicrobial Resistance in Iraq

Assessing Pharmacy Students' Knowledge and Awareness Regarding the Rational Utilization of Antibiotics and the Issue of Antimicrobial Resistance in Iraq

Characterization of two novel Salmonella phages having biocontrol potential against Salmonella spp. in gastrointestinal conditions

Salmonella is a primary enteric pathogen related to the contamination of poultry and other food products in numerous foodborne outbreaks. The continuous emergence of multidrug-resistant bacteria has become a serious issue due to the overuse of antibiotics. Hence, lytic phages are considered alternative biocontrol agents against these bacterial superbugs. Here, two Salmonella phages—S4lw and D5lw—were subjected to genomic and biological characterization and further encapsulated to improve the stability under acidic conditions mimicking gastrointestinal conditions. The two lytic phages, S4lw and D5lw, taxonomically belong to new species under the Guernseyvirinae and Ackermannviridae families, respectively. Each phage showed antimicrobial activities against diverse Salmonella spp., such as S. Enteritidis and S. Typhimurium, achieving 1.7–3.4 log reduction after 2–6 h of treatment. The phage cocktail at a multiplicity of infection (MOI) of 100 or 1000 completely inhibited these Salmonella strains for at least 14 h at 25 °C. Additionally, the bead-encapsulated phage cocktail could withstand low pH and different simulated gut environments for at least 1 h. Overall, the newly isolated phages can potentially mitigate Salmonella spp. under the gastrointestinal environments through encapsulation and may be further applied via oral administration to resolve common antimicrobial resistance issues in the poultry production chain.

The invisible pandemic of antimicrobial resistance and its possible endings.

Antimicrobial resistance (AMR) is often framed as a 'silent pandemic,' an invisible crisis unfolding beyond the public gaze. This unseen emergency narrative fuels policy responses aimed at re-establishing human control over antimicrobial use and benefits. In this commentary, we critique the reduction of AMR to a homogenising framework - a product of long-standing paradigms for disease control and elimination. We argue that AMR stems not merely from microbial exposure to drugs, but also involves broader anthropocentric practices. We assert that merely extending AMR concerns to encompass environmental factors is insufficient. Instead, we advocate for a paradigm shift towards a holistic understanding that respects the evolutionary adaptability and survival strategies of microbial life itself. Consequently, a fundamental re-evaluation of large-scale antibiotic use and production is necessary. Rather than seeking to control AMR as a pandemic, we propose exploring the inherent complexity and interdependence of AMR issues. Our proposition advocates for alternative futures that foster collaborations between human and non-human actors, ultimately envisioning a shift in human-microbial relationships towards more integrative health strategies.

Evaluation of fortimicin antibiotic combinations against MDR Pseudomonas aeruginosa and resistome analysis of a whole genome sequenced pan-drug resistant isolate

BackgroundMultidrug-resistant (MDR) P. aeruginosa is a rising public health concern, challenging the treatment of such a ubiquitous pathogen with monotherapeutic anti-pseudomonal agents. Worryingly, its genome plasticity contributes to the emergence of P. aeruginosa expressing different resistant phenotypes and is now responsible for notable epidemics within hospital settings. Considering this, we aimed to evaluate the synergistic combination of fortimicin with other traditional anti-pseudomonal agents and to analyze the resistome of pan-drug resistant (PDR) isolate.MethodsStandard methods were used for analyzing the antimicrobial susceptibility tests. The checkerboard technique was used for the in vitro assessment of fortimicin antibiotic combinations against 51 MDR P. aeruginosa and whole genome sequencing was used to determine the resistome of PDR isolate.ResultsOut of 51 MDR P. aeruginosa, the highest synergistic effect was recorded for a combination of fortimicin with β-lactam group as meropenem, ceftazidime, and aztreonam at 71%, 59% and 43%, respectively. Of note, 56.8%, 39.2%, and 37.2% of the tested MDR isolates that had synergistic effects were also resistant to meropenem, ceftazidime, and aztreonam, respectively. The highest additive effects were recorded for combining fortimicin with amikacin (69%) and cefepime (44%) against MDR P. aeruginosa. Resistome analysis of the PDR isolate reflected its association with the antibiotic resistance phenotype. It ensured the presence of a wide variety of antibiotic-resistant genes (β-lactamases, aminoglycosides modifying enzymes, and efflux pump), rendering the isolate resistant to all clinically relevant anti-pseudomonal agents.ConclusionFortimicin in combination with classical anti-pseudomonal agents had shown promising synergistic activity against MDR P. aeruginosa. Resistome profiling of PDR P. aeruginosa enhanced the rapid identification of antibiotic resistance genes that are likely linked to the appearance of this resistant phenotype and may pave the way to tackle antimicrobial resistance issues shortly.

Exploring the dynamics of mixed-species biofilms involving Candida spp. and bacteria in cystic fibrosis.

Cystic fibrosis (CF) is an inherited disease that results from mutations in the gene responsible for the cystic fibrosis transmembrane conductance regulator (CFTR). The airways become clogged with thick, viscous mucus that traps microbes in respiratory tracts, facilitating colonization, inflammation and infection. CF is recognized as a biofilm-associated disease, it is commonly polymicrobial and can develop in biofilms. This review discusses Candida spp. and both Gram-positive and Gram-negative bacterial biofilms that affect the airways and cause pulmonary infections in the CF context, with a particular focus on mixed-species biofilms. In addition, the review explores the intricate interactions between fungal and bacterial species within these biofilms and elucidates the underlying molecular mechanisms that govern their dynamics. Moreover, the review addresses the multifaceted issue of antimicrobial resistance in the context of CF-associated biofilms. By synthesizing current knowledge and research findings, this review aims to provide insights into the pathogenesis of CF-related infections and identify potential therapeutic approaches to manage and combat these complex biofilm-mediated infections.

Attitudes of South Korean consumers toward the prudent use of antimicrobials in livestock animals

Antimicrobial resistance (AMR) in livestock is a complicated and multi-sectoral risk that threatens public health in the interactions between humans, animals, and environment. Through their increased awareness of AMR issues, consumers can make a significant impact on regulations and strategies to reduce or eliminate the use of antimicrobials use. This study aims to provide evidence-based data for promoting the prudent use of antimicrobials (PUA) in the livestock industry to reduce the risk of AMR and increase animal welfare by identifying consumers' intentions to support PUA practices in livestock farming. An online survey was conducted on 1000 respondents in South Korea to examine their intention to pay more for PUA practices in livestock farming at state and individual levels against their pro-animal attitude, risk perception of antimicrobial overuse, trust in antimicrobial overuse control, and perceived value of PUA practices. The survey data was analyzed using multiple linear regression to identify the determinants of Korean consumers' support for PUA practices. Approximately 86.3% of the respondents supported government-level spending for PUA in livestock farming, and the same portion of respondents intended to pay more for livestock products that complied with the PUA principle. The four attitudinal variables—pro-animal attitude, consumers' risk perception, trust in antimicrobial resistance control, and perceived value of PUA—positively affected both state- and individual-level support. Overall, our findings highlight the Korean consumers' demand for reducing the risk of AMR and their perceived universal value of PUA for humans and animals.

Antimicrobial Susceptibility Profiles of Pasteurella multocida Isolates from Clinical Cases of Waterfowl in Hungary between 2022 and 2023.

The waterfowl industry represents a narrow, yet economically significant, sector within the poultry industry. Although less prominent, the waterfowl sector is nonetheless of equal importance to any other livestock sector in terms of antimicrobial resistance and animal health issues. This study assesses the antimicrobial resistance profile of Pasteurella multocida bacterial strains isolated from clinical cases in Hungary's duck and goose populations, determining the minimal inhibitory concentration (MIC) of 27 samples collected from 15 different locations. The results indicate that the isolated strains were susceptible to most antibiotics, except for notable resistance to enrofloxacin. These findings support that Pasteurella multocida largely retained its susceptibility. However, the observed resistance to enrofloxacin suggests overuse of fluoroquinolones, which indicates the potential need for stricter regulation of their use in the poultry industry.

In situ captured antibacterial action of membrane-incising peptide lamellae

Developing unique mechanisms of action are essential to combat the growing issue of antimicrobial resistance. Supramolecular assemblies combining the improved biostability of non-natural compounds with the complex membrane-attacking mechanisms of natural peptides are promising alternatives to conventional antibiotics. However, for such compounds the direct visual insight on antibacterial action is still lacking. Here we employ a design strategy focusing on an inducible assembly mechanism and utilized electron microscopy (EM) to follow the formation of supramolecular structures of lysine-rich heterochiral β3-peptides, termed lamellin-2K and lamellin-3K, triggered by bacterial cell surface lipopolysaccharides. Combined molecular dynamics simulations, EM and bacterial assays confirmed that the phosphate-induced conformational change on these lamellins led to the formation of striped lamellae capable of incising the cell envelope of Gram-negative bacteria thereby exerting antibacterial activity. Our findings also provide a mechanistic link for membrane-targeting agents depicting the antibiotic mechanism derived from the in-situ formation of active supramolecules.

Drivers of antimicrobial resistance within the communities of Nepal from One Health perspective: a scoping review.

A major driver of antimicrobial resistance (AMR) is the inappropriate use of antimicrobials. At the community level, people are often engaged in behaviors that drive AMR within human, animal, and environmental (One Health) impacts. This scoping review consolidates research to determine (a) the community's knowledge, attitudes, and practices around AMR; (b) existing community-based interventions; and (c) barriers and enablers to addressing AMR in Nepal. This scoping review follows the Joanna Briggs Institute scoping review methodology. Literature indexed in PubMed, Scopus, CINAHL, Global Index Medicus, HINARI-SUMMON, Embase (Ovid), Global Health (Ovid), CAB Abstracts (Ovid), Web of Science, and Google Scholar between January 2000 and January 2023 were reviewed for inclusion. Articles were included in the review if they considered the issues of AMR at the community level in Nepal; this excluded clinical and laboratory-based studies. A total of 47 studies met these criteria, were extracted, and analyzed to consolidate the key themes. A total of 31 (66%) articles exclusively included human health; five (11%) concentrated only on animal health; no studies solely focused on environmental aspects of AMR; and the remaining studies jointly presented human, animal, and environmental aspects. Findings revealed inadequate knowledge accompanied by inappropriate practice in both the human and animal health sectors. Four community interventions improved knowledge and practices on the appropriate use of antimicrobials among community people. However, various social and economic factors were found as barriers to the appropriate use of antimicrobials in the community. Community engagement and One Health approaches could be key tools to improve awareness of AMR and promote behavioral change related to AM use in communities, as current studies have revealed inadequate knowledge alongside inappropriate practices shared in both human and animal health sectors. DOI: 10.17605/OSF.IO/FV326.