Chapters authored
Treatment of Bacterial Sexually Transmitted Infections in Resource-Limited Settings
Globally, bacterial sexually transmitted infections (STIs) are a major health challenge. It is more challenging in resource-limited settings, where diagnostic capabilities are limited, health insurance is almost nonexistent and medical bills are settled out-of-pocket. In resource-limited settings, most clinicians adopt the syndromic case management approach for effective treatment due to the paucity of resources. The highest levels of multidrug resistant bacterial STIs have been found in resource-limited countries. The reasons are complex and include poor quality of health services, high burden of disease, lack of accessible, accurate, and confirmed diagnostic assays, ineffective regulations, overuse of antibiotics, inappropriate dosing, and lack of knowledge about the risks of microbial resistance. This chapter thus brings to the fore the challenges of treating bacterial sexually transmitted infections in resource-poor settings and the current evidence on the topic for scholars, researchers, and practitioners.
Part of the book: Bacterial Sexually Transmitted Infections
Antimicrobial Stewardship in Resource-Limited Settings
Antimicrobials are very important for the treatment of patients. With decades of haphazard prescription and inappropriate use, antimicrobial resistance (AMR) has emerged as a global public health threat. In resource-limited settings, besides AMR, there is also the issue of access to antibiotics and increased healthcare costs. In the past, the discovery of new drugs and the modification of older ones helped to counter antimicrobial resistance. Since the 1970s, only a handful of new agents (a few of which are novel) have been introduced into clinical practice periodically. This makes the existing antibiotics to be a limited resource. Antibiotics must, therefore, be used more responsibly and managed carefully to extend their usefulness while being made available to the patients who truly need them. Antimicrobial stewardship (AMS) refers to systematic actions or interventions that inculcate sustainable, rational, and evidence-based antibiotic prescription and use patterns in healthcare institutions. Implementation of AMS programmes would be an appropriate step towards improving patient outcomes, reducing AMR and its adverse economic impact, and building the best-practices capacity of healthcare professionals, among others. Despite these seemingly beneficial benefits, the implementation of antimicrobial stewardship programmes (ASPs) remains relatively limited and faces complex challenges in resource-poor healthcare settings.
Part of the book: Antimicrobial Stewardship