Global Antimicrobial Resistance

2019
Hoffman, S.J., Bakshi, R. & Rogers Van Katwyk, S., 2019. How law can help solve the collective action problem of antimicrobial resistance. Bioethics , pp. 1-7. Article
Rogers Van Katwyk, S., et al., 2019. Government policy interventions to reduce human antimicrobial use: A systematic review and evidence map. PLOS Medicine , 16 (6) , pp. 1-17. Article
Yu, A.Y., Rogers Van Katwyk, S. & Hoffman, S.J., 2019. Probing popular and political discourse on antimicrobial resistance in China. Global Health Research and Policy , 4 (6). Article
2018
Hoffman, S.J., Rogers Van Katwyk, S. & Baral, P., 2018. Monitoring Global Progress on Addressing Antimicrobial Resistance: Analysis report of the second round of results of AMR country self-assessment survey 2018, Geneva, Switzerland: World Health Organization (Food and Agriculture Organization of the United Nations, World Organization for Animal Health, World Health Organization). PDF
Rogers Van Katwyk, S., Jones, S.L. & Hoffman, S.J., 2018. Mapping Educational Opportunities for Healthcare Workers on Antimicrobial Resistance and Stewardship Around the World. Human Resources for Health , 16 (9) , pp. 1-18. Article PDF
2017
Rogers Van Katwyk, S., et al., 2017. Government policy interventions to reduce human antimicrobial use: protocol for a systematic review and meta-analysis. Systematic Reviews , 6 (256) , pp. 1-10. PDFAbstract

Background

Antimicrobial resistance (AMR) is a recognized threat to global public health. Increasing AMR and a dry pipeline of novel antimicrobial drugs have put AMR in the international spotlight. One strategy to combat AMR is to reduce antimicrobial drug consumption. Governments around the world have been experimenting with different policy interventions, such as regulating where antimicrobials can be sold, restricting the use of last-resort antimicrobials, funding AMR stewardship programs, and launching public awareness campaigns. To inform future action, governments should have access to synthesized data on the effectiveness of large-scale AMR interventions. This planned systematic review will (1) identify and describe previously evaluated government policy interventions to reduce human antimicrobial use and (2) estimate the effectiveness of these different strategies.

Methods

An electronic search strategy has been developed in consultation with two research librarians. Seven databases (MEDLINE, CINAHL, EMBASE, CENTRAL, PAIS Index, Web of Science, and PubMed excluding MEDLINE) will be searched, and additional studies will be identified using several gray literature search strategies. To be included, a study must (1) clearly describe the government policy and (2) use a rigorous design to quantitatively measure the impact of the policy on human antibiotic use. The intervention of interest is any policy intervention enacted by a government or government agency in any country to change human antimicrobial use. Two independent reviewers will screen for eligibility using criteria defined a priori.

Data will be extracted with Covidence software using a customized extraction form. If sufficient data exists, a meta-analysis by intervention type will be conducted as part of the effectiveness review. However, if there are too few studies or if the interventions are too heterogeneous, data will be tabulated and a narrative synthesis strategy will be used.

Discussion

This evidence synthesis is intended for use by policymakers, public health practitioners, and researchers to inform future government policies aiming to address antimicrobial resistance. This review will also identify gaps in the evidence about the effectiveness of different policy interventions to inform future research priorities.

Rogers Van Katwyk, S., Jones, S. & Hoffman, S.J., 2017. Mapping educational opportunities and resources for health-care workers to learn about antimicrobial resistance and stewardship, World Health Organization. PDF