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Title
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Antimicrobial resistance following Azithromycin mass drug administration : potential surveillance strategies to assess public health impact
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Author
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Abstract
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| The reduction in childhood mortality noted in trials investigating azithromycin mass drug administration (MDA) for trachoma control has been confirmed by a recent large randomized controlled trial. Population-level implementation of azithromycin MDA may lead to selection of multiresistant pathogens. Evidence suggests that repeated azithromycin MDA may result in a sustained increase in macrolide and other antibiotic resistance in gut and respiratory bacteria. Current evidence comes from standard microbiological techniques in studies focused on a time-limited intervention, while MDA implemented for mortality benefits would likely repeatedly expose the population over a prolonged period and may require a different surveillance approach. Targeted short-term and long-term surveillance of resistance emergence to key antibiotics, especially those from the World Health Organization Access group, is needed throughout any implementation of azithromycin MDA, focusing on a genotypic approach to overcome the limitations of resistance surveillance in indicator bacteria. |
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Language
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English
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Source (journal)
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Clinical infectious diseases. - Chicago, Ill.
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Publication
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Chicago, Ill.
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2020
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ISSN
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1058-4838
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DOI
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10.1093/CID/CIZ893
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Volume/pages
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70
:7
(2020)
, p. 1501-1508
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ISI
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000532686300040
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Pubmed ID
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31633161
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Full text (Publisher's DOI)
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Full text (open access)
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