Access to effective antimicrobials: a worldwide challenge
Access to effective antimicrobials: a worldwide challenge
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DOI：
10.1016/s0140-6736(15)00474-2
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发表时间：
2016-01-09
期刊：
影响因子：
168.9
通讯作者：
Davies, Sally
中科院分区：
文献类型：
--
作者：
Laxminarayan, Ramanan;Matsoso, Precious;Davies, Sally
近年来，预期寿命和获得抗微生物剂的机会有了很大改善，特别是在低收入和中低收入国家，但病原体对抗微生物剂的耐药性不断增加，有可能使这一进展倒退。卫生保健和社区环境中的耐药微生物对严重感染（包括新生儿败血症和卫生保健相关感染）的存活率构成威胁，并限制了手术、移植和癌症治疗的潜在健康益处。同时扩大抗菌药物的适当获取，同时限制不当获取，特别是昂贵的新一代抗菌药物，这在全球卫生领域是独一无二的挑战，需要新的融资和提供医疗保健方法，以及对动物和人类病原体传播之间联系的单一健康视角。在这里，我们描述了有效抗菌剂的重要性。我们评估了由于抗菌药物耐药性导致的抗菌药物获取有限所造成的疾病负担，以及疫苗在限制抗生素需求方面的潜在影响。
Recent years have seen substantial improvements in life expectancy and access to antimicrobials, especially in low-income and lower-middle-income countries, but increasing pathogen resistance to antimicrobials threatens to roll back this progress. Resistant organisms in health-care and community settings pose a threat to survival rates from serious infections, including neonatal sepsis and health-care-associated infections, and limit the potential health benefits from surgeries, transplants, and cancer treatment. The challenge of simultaneously expanding appropriate access to antimicrobials, while restricting inappropriate access, particularly to expensive, newer generation antimicrobials, is unique in global health and requires new approaches to financing and delivering health care and a one-health perspective on the connections between pathogen transmission in animals and humans. Here, we describe the importance of effective antimicrobials. We assess the disease burden caused by limited access to antimicrobials, attributable to resistance to antimicrobials, and the potential effect of vaccines in restricting the need for antibiotics.