Abstract:
Critical aspects of the broader global response to AMR are efforts to minimize the emergence and
transmission of resistance to drugs used to treat tuberculosis (TB), HIV, and malaria.
The use and misuse of antimicrobials have led to the persistent expansion of AMR, thereby
lowering the effectiveness of some of these drugs (e.g., chloroquine and penicillin). Resistance to
the most commonly available antimicrobials requires the use of more expensive alternative
regimens. Unfortunately, although resistance has created a demand for new treatment options,
there has been a significant drop in the development of new antimicrobial agents in recent decades.
This has compromised the ability of healthcare workers (HCWs) to treat infectious diseases and
has increased healthcare costs. It is critical that necessary measures to respond to the resistance
crisis be taken at all levels (by institutions and by local and national governments). Measures
should include the rational use of antimicrobials through the incorporation of careful antimicrobial
stewardship (AMS) activities and programs. Ultimately, improving antimicrobial use involves
actions at the national level to guide treatment decisions made by informed HCWs and by the
awareness and cooperation of patients. Although this chapter focuses on antibiotics, its
recommendations can be applied to all antimicrobials (World Health Organization [WHO] 2015;
WHO 2021).
