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Review
. 2021 Mar 3:14:849-858.
doi: 10.2147/IDR.S289741. eCollection 2021.

Evidence of Antibiotic Resistance from Population-Based Studies: A Narrative Review

Elisa Giacomini  1 , Valentina Perrone  1 , Davide Alessandrini  1 , Daniela Paoli  1 , Carmela Nappi  1 , Luca Degli Esposti  1
Affiliations
Review

Evidence of Antibiotic Resistance from Population-Based Studies: A Narrative Review

Elisa Giacomini et al. Infect Drug Resist. .

Abstract

The 20th century witnessed the dawn of the antibiotic revolution and is now facing the rising phenomenon of antibiotic resistance. In this narrative review, we aim to describe antibiotic resistance in clinical practice settings through population-based studies from different countries reporting the role of misuse of antibiotics in the development of resistance and the clinical and economic burden associated. The misuse of antibiotics was documented in the wide population as well as in hospitals and care facilities. It was mainly reported as over-use and inappropriate prescribing. Improper dosage regimens and longer treatment duration were regarded as pivotal factors related to antibiotic resistance; the emerging strategy of "antibiotic-de-escalation" could be the key to overcome these issues. The investigation of the self-medication attitude revealed widespread antibiotic use without following medical instructions or medical consultation. Moreover, several studies established the association of antibiotic resistance with increased risk of longer hospitalizations and mortality, highlighting the heavy clinical and economic burden of this phenomenon. In this narrative review, the widespread inappropriate use of antibiotics emerged as one of the main causes of antibiotic resistance, which negative outcomes call for the development of antibiotic stewardship programs and global surveillance networks.

Keywords: antibiotic utilization; antimicrobial resistance; real-world.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Timeline of publications indexed on PubMed related to ABR.
Figure 2
Figure 2
Main factors leading to antibiotic resistance.
Figure 3
Figure 3
Concept scheme: causes and consequences of antibiotic resistance in clinical practice.
See this image and copyright information in PMC

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