The Role of Unregulated Sale and Dispensing of Antimicrobial Agents on the Development of Antimicrobial Resistance in Developing Countries
Antimicrobial resistance has become a major medical and public health problem worldwide. This has been brought about by overuse and/or misuse of these drugs especially in developing countries. The role of unregulated sale and dispensing of antimicrobial agents on the development of resistance is presented in this chapter. Developing countries use both branded and generic antimicrobial agents which include major classes like beta-lactams, tetracyclines, aminoglycosides, fluoroquinolones, sulfonamides, chloramphenicol, macrolides, lincosamides, polymixins, bacitracin, vancomycin, vovobiocin, and rifamycins among others. Despite existing legislative framework to control antibiotics in most developing countries, enforcement of these regulatory processes is still a problem. Some of the factors that have led to unregulated sale and dispensing of antibiotics in developing countries include inadequate legislative framework, lack of financial resources for implementation, inadequate education on the awareness of public health risks of antimicrobial resistance, social–cultural attitudes on antimicrobial agents, easy access to antimicrobial agents due to high prevalence of HIV/AIDS, and lack of surveillance and monitoring programs on antibiotic usage in medical and veterinary use among others. Intervention measures required to contain the upsurge of antimicrobial resistance in developing countries should include the following among others: increased public education and creation of awareness to the public and pharmacists, enactment of laws where none exists and their proper enforcement and regular surveillance, and monitoring of antimicrobial usage and emergence of resistance. Mitigation measures mentioned above will go along way in the containment of antimicrobial resistance and hence protection of public health from emerging antimicrobial resistance.