Antimicrobial resistance (AMR) is a high priority across countries as it increases morbidity,
mortality and costs. Concerns with AMR have resulted in multiple initiatives internationally, nationally
and regionally to enhance appropriate antibiotic utilization across sectors to reduce AMR,
with the overuse of antibiotics exacerbated by the COVID-19 pandemic. Effectively tackling AMR
is crucial for all countries. Principally a narrative review of ongoing activities across sectors was
undertaken to improve antimicrobial use and address issues with vaccines including COVID-19.
Point prevalence surveys have been successful in hospitals to identify areas for quality improvement
programs, principally centering on antimicrobial stewardship programs. These include reducing
prolonged antibiotic use to prevent surgical site infections. Multiple activities centering on education
have been successful in reducing inappropriate prescribing and dispensing of antimicrobials in
ambulatory care for essentially viral infections such as acute respiratory infections. It is imperative to
develop new quality indicators for ambulatory care given current concerns, and instigate programs
with clear public health messaging to reduce misinformation, essential for pandemics. Regular
access to effective treatments is needed to reduce resistance to treatments for HIV, malaria and
tuberculosis. Key stakeholder groups can instigate multiple initiatives to reduce AMR. These need to
be followed up.
