C4 - One approach doesn’t fit all: Need for country specific interventions to promote appropriate use of antibiotics

Conference Hall A - Section B & C

Organised by FIP’s Health and Medicines Information Section


Parisa Aslani (The University of Sydney, Australia) and Mohammed Azmi Hassali (Universiti Sains Malaysia, Malaysia)


Antibiotic resistance (ABR) is an important global health problem, especially in low and middle-income countries. It has been estimated that the economic burden of antimicrobial resistance has led to additional treatment costs that range from US $7 to more than US $28,500 per episode of care in hospitals in the UK.1 Furthermore, the yearly additional cost of antimicrobial resistance to the US health system alone has been estimated at US $21-34 billion, accompanied by more than 8 million additional days in hospital.2 It is possible that the situation in developing nations could be far worse. However, limited studies have been conducted to evaluate the clinical and economic impacts of ABR in those regions. Appropriate antibiotic use in humans and animals is one of the cornerstones of the World Health Organization’s Global Action Plan on Antimicrobial Resistance. Many developing countries are in the process of working on stewardship programmes in order to improve the appropriate use of antibiotics and combat ABR. Many factors, however, including but not limited to poverty, availability of resources, lack of health professionals, social and cultural influences, literacy rates and degree of acceptance, challenge the development and implementation of such programmes. Hence, stewardship programmes may not work in a similar manner in all countries.

The focus of this session will be to review the different interventions implemented globally, highlighting what has been successful, and what has been challenging in different developing countries, with a view to determine intervention components that can be transferred to different settings.

  1. Smith R, Coast J. The economic burden of antimicrobial resistance: why is it more serious than current studies suggest. Technical report. London: London School of Hygiene and Tropical Medicine; 2012.
  2. World Health Organization. Antimicrobial Resistance Global Report on Surveillance: WHO; 2014.


12:30 – 12:35 Introduction by the chairs

  1. 12:35 – 12:50 Clinical and economic impact of antibiotic resistance in developing countries
    Sabiha Essack (University of KwaZulu-Natal, South Africa)
  2. 12:50 – 13:05 Evidence-based interventions to improve appropriate use of antibiotics: The Sri Lankan experience
    Shukry Zawahir (The University of Ruhuna, Sri Lanka)
  3. 13:05 – 13:20 How to educate the general public on rational use of antibiotics: The Malaysian experience
    Azmi Hassali (Universiti Sains Malaysia, Malaysia)
  4. 13:20 – 13:35 Intervention to improve appropriate prescribing: The Philippine experience
    Yolanda Robles (The Philippines Pharmaceutical Association, Philippines)
  5. 13:35 – 13:50 Interventions used to improve appropriate dispensing of antibiotics among the general public: The Middle East experience
    Reem Al-Essa (Ministry of Health, Kuwait)

13:50 – 13:55 Conclusion by the chairs

13:55 – 14:00 Room refresh

Learning Objectives

At the end of this session, participants will be able to:

  1. Describe the current ABR-related burden in developing countries
  2. Identify the types of interventions aimed at improving appropriate use of antibiotics that have been effective and those that have been challenging
  3. Describe country or region-specific intervention(s) to promote appropriate use of antibiotics.

Type of session: Knowledge-based