Antimicrobial stewardship programmes in health-care facilities in low- and middle-income countries. A practical toolkit. Geneva: World Health Organization; 2019
(2019; 88 pages)

Resumen

Like access to clean water and air, we have taken antibiotics for granted for too long. Since the discovery of penicillin in 1928, antibiotics have significantly improved global health. Indeed, they have been a cornerstone of modern medicine, including cancer chemotherapy and advanced surgical procedures. And while decades of overuse and misuse of antibiotics have accelerated the emergence and spread of resistant bacteria, access to antibiotics remains a major issue in many parts of the world.

At the same time, not enough new antibiotics are being developed to fight resistant bacteria. Therefore, existing antibiotics must be used more responsibly and managed carefully to extend their lifespan while being made available to the patients who truly need them. They should be prescribed only when indicated, also because they may cause serious side effects.

This practical toolkit for implementing antimicrobial stewardship (AMS) in healthcare facilities is meant to help low- and middle-income countries achieve this goal. It provides practical guidance to support the implementation of Objective 4 of the Global Action Plan on AMR: optimizing the use of antimicrobial medicines. The toolkit provides guidance on where to get started, including the structures and resources that should be put in place at the national and health-care facility level, through a stepwise approach in low-resource settings. As the goal of an AMS programme is sustainable behaviour change in physicians’ antibiotic prescribing practices, the toolkit also provides detailed guidance on how to plan, perform and assess AMS interventions – including feedback on antibiotic use over time. Finally, the toolkit provides an overview of the competencies an AMS team needs to guide health-care professionals in changing their antibiotic prescribing behaviours.

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