Antimicrobial resistance in low- and middle-income countries: current status and future directions

Expert Rev Anti Infect Ther. 2022 Feb;20(2):147-160. doi: 10.1080/14787210.2021.1951705. Epub 2021 Jul 19.


Introduction: Rising rates of antimicrobial resistance (AMR) globally continue to pose agrave threat to human health. Low- and middle-income countries (LMICs) are disproportionately affected, partly due to the high burden of communicable diseases.

Areas covered: We reviewed current trends in AMR in LMICs and examined the forces driving AMR in those regions. The state of interventions being undertaken to curb AMR across the developing world are discussed, and the impact of the current COVID-19 pandemic on those efforts is explored.

Expert opinion: The dynamics that drive AMR in LMICs are inseparable from the political, economic, socio-cultural, and environmental forces that shape these nations. The COVID-19 pandemic has further exacerbated underlying factors that increase AMR. Some progress is being made in implementing surveillance measures in LMICs, but implementation of concrete measures to meaningfully impact AMR rates must address the underlying structural issues that generate and promote AMR. This, in turn, will require large infrastructural investments and significant political will.

Keywords: Antibiotic use; Antimicrobial resistance (AMR); Antimicrobial stewardship; Low- and middle-income countries (LMICs); Review.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • COVID-19
  • Developing Countries
  • Drug Resistance, Bacterial*
  • Humans
  • Pandemics


  • Anti-Bacterial Agents