infographic of how antibiotic resistance is spread

Review highlights how antibiotic resistance is spread in low-middle income countries

Colin Garner ANTRUK announcements, Learn more

A review of nearly 200 studies into the spread of antibiotic-resistant infections has highlighted individual accountability and global action as vital for preventing a global increase in deaths from such infections.

In July this year, researchers from France, Lebanon, Italy and South Africa published ‘Drivers of Antibiotic Resistance Transmission in Low- and Middle-Income Countries from a “One Health” Perspective—A Review’ in a special issue of Antibiotics journal that focussed on antibiotics in remote areas. As the world’s first charity focussing on the fight against antibiotic-resistant infections, Antibiotic Research UK fully supports the findings. Both individual and global action are needed to overcome this threat to the future of modern medicine.

What spreads antibiotic resistance?

The review lists a variety of different ways antibiotic resistance is spread. These include:

  • inappropriate socio-ecological behaviours;
  • poverty;
  • overcrowding;
  • lack of surveillance systems;
  • food supply chain safety issues;
  • highly contaminated waste effluents;
  • loose rules and regulations.

Inappropriate socio-ecological behaviours include sharing habitats and water sources with livestock, poor sanitation during butchery/preparation of meat, release of effluence from slaughter into the environment, using untreated animal waste as fertiliser for food crops. Increasing demand for dietary protein to feed growing populations in Africa, Asia and even South America has led to an increase in the administration of antibiotics to livestock, and even to some animal products as highlighted by one of the studies described in the review. These are poorly regulated practices.

Human medicine is another area where overuse and misuse of antibiotics is prevalent – even in high-income countries. The World Bank has estimated that only 50% of global antibiotic consumption is appropriately justified. Many of these ‘inappropriate’ prescriptions occur in hospitals, for example due urgent decision-making in emergency rooms. The review also explains how antibiotics prescribed by doctors, plus the improper disposal/stockpiling of unused antibiotics, are also rife.

Other issues raised in this review include the global problem caused by counterfeit antibiotics and the use of non-prescription antibiotics. It also considers environmental contamination with heavy metals and disinfectants which can drive the spread of antibiotic resistance. It is clear that tighter monitoring, regulation and enforcement of best practice needs to be implemented on a global scale.

So how are we helping?

Antibiotic Research UK believes that this review underscores the need for better education on the proper use of antibiotics, both for individuals and on a much larger – international – scale.  In a project led by Roger Harrison (a member of our Education Committee), Antibiotic Research UK co-created an online course called ‘Antibiotics and you’ with Manchester University. So far, it has been completed by people in 85 different countries and has achieved a 4.5-star rating. We also recently ran the Great University Science Quiz to help teach tomorrow’s healthcare professionals the importance of antibiotics in modern medicine and how antibiotic resistance might take us back to a pre-antibiotic age.

There is so much more that needs to be done; for that, we need your support.

Find out more about antibiotic resistance

Antibiotic-resistant bacteria cause infections that are very difficult to treat, and can even lead to sepsis and death. While the human body has an incredible immune system that can fight off many infections, we still rely heavily on antibiotics. They’re necessary for many medical procedures, such as dental work, chemotherapy, surgery and assisted childbirth. As bacteria develop resistance to these fantastic medicines, the risk posed by these procedures increases drastically.

Unfortunately, resistance to antibiotics can transmit from one bacterium to another. As resistant strains arise, they then spread into the environment. This then allows the spread of these genes for resistance to other bacteria – even other species of bacteria. Resistant bacteria are often found in healthcare settings, agricultural environments and, increasingly, the natural environment and waterways.

If you would like to help us save modern medicine so that future generations can enjoy the benefits we have grown accustomed to, please make a donation today, or consider leaving us a life-saving legacy.

* the graphic on this page is from