Substandard/counterfeit antimicrobial drugs

Abstract

Substandard/counterfeit antimicrobial drugs are a growing global problem. The most common substandard/counterfeit antimicrobials include beta-lactams (among antibiotics) and chloroquine and artemisin derivatives (among antimalarials). The most common type of substandard/counterfeit antimicrobial drugs have a reduced amount of the active drug, and the majority of them are manufactured in Southeast Asia and Africa. Counterfeit antimicrobial drugs may cause increased mortality and morbidity and pose a danger to patients. Here we review the literature with regard to the issue of substandard/counterfeit antimicrobials and describe the prevalence of this problem, the different types of substandard/counterfeit antimicrobial drugs, and the consequences for the individuals and global public health. Local, national, and international initiatives are required to combat this very important public health issue.

FIG 1

Number of countries, per category of antimicrobials, where poor-quality antimicrobials have been reported. (A) Antibiotics. (B) Antiparasitic agents.

FIG 2

Relative geographic distribution of substandard/counterfeit antimicrobials. Darker colors indicate substandard/counterfeit antibiotics. Lighter colors indicate substandard/counterfeit antiparasitic agents.