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Drivers of AMR – an Overview

A brief overview of contemporary drivers of antimicrobial resistance.

There are many drivers for AMR. However, the most significant drivers are human and animal antimicrobial misuse and overuse, as shown in the image below.

Graph showing the factors contributing to antimicrobial resistance. The most prominent factors are human antimicrobial misuse or overuse and animal antimicrobial misuse or overuse.

Click here to see a larger version of this image.

In 2016, Holmes et al. produced an excellent paper highlighting the mechanisms and drivers of antimicrobial resistance. The article reviewed numerous factors contributing to the current global status of AMR and discussed the need for a comprehensive, integrated approach to tackling AMR.

The paper noted key global factors driving AMR:

  • Lack of access to clean water.
  • Open rather than closed sewage systems.
  • Variation in healthcare infection control practices.
  • Inadequate provision of antimicrobials and diagnostics.
  • Farming systems with sub-optimal regulation of antimicrobials and high population densities.

This highlights the diverse range of actions needed to combat AMR in addition to the main focus of this course, tackling misuse and overuse of antimicrobials in human healthcare. This analysis by Collignon et al. provides a useful overview of the link between AMR and antibiotic consumption compared to other drivers.

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How to set up an Antimicrobial Stewardship Programme

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