title: Using antibiotics responsibly: are we there yet?
abstract: Problems of antibiotic access and excess coexist in the world today and are compounded by rising rates of antibiotic resistance. We introduce two dimensions of responsibility to this context: responsible individual practices and a broad societal obligation centered on sustainability. Acting on these responsibilities requires recognizing the potential tensions between an individual optimum for antibiotic use and the societal optimum. We relate the tragedy of the commons metaphor to this situation to illustrate the complexity involved, and we draw on real-world experiences in Uganda, India, China and France. We conclude that we must form a global stewardship of antibiotics that can link access, innovation and conservation efforts across countries to ensure sustainable access to effective antibiotics for all who need them.
authors: Global Health - Health Systems & Policy (HSP): Improving the Use of Medicines, Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden.|Mbarara University of Science & Technology, PO Box 1410, Mbarara, Uganda.|Department of Pharmacology, Pushpagiri Institute of Medical Sciences & Research Centre, Tiruvalla, Kerala, India.|State Key Laboratory for Diagnosis & Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.|Service de maladies infectieuses et tropicales, Université de Lorraine, EA 4360 APEMAC & CHU de Nancy, Nancy, France.
authors: Oliver James
authors: OJ
authors: Dyar
authors: Global Health - Health Systems & Policy (HSP): Improving the Use of Medicines, Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden.|Mbarara University of Science & Technology, PO Box 1410, Mbarara, Uganda.|Department of Pharmacology, Pushpagiri Institute of Medical Sciences & Research Centre, Tiruvalla, Kerala, India.|State Key Laboratory for Diagnosis & Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.|Service de maladies infectieuses et tropicales, Université de Lorraine, EA 4360 APEMAC & CHU de Nancy, Nancy, France.
authors: Celestino
authors: C
authors: Obua
authors: Global Health - Health Systems & Policy (HSP): Improving the Use of Medicines, Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden.|Mbarara University of Science & Technology, PO Box 1410, Mbarara, Uganda.|Department of Pharmacology, Pushpagiri Institute of Medical Sciences & Research Centre, Tiruvalla, Kerala, India.|State Key Laboratory for Diagnosis & Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.|Service de maladies infectieuses et tropicales, Université de Lorraine, EA 4360 APEMAC & CHU de Nancy, Nancy, France.
authors: Sujith
authors: S
authors: Chandy
authors: Global Health - Health Systems & Policy (HSP): Improving the Use of Medicines, Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden.|Mbarara University of Science & Technology, PO Box 1410, Mbarara, Uganda.|Department of Pharmacology, Pushpagiri Institute of Medical Sciences & Research Centre, Tiruvalla, Kerala, India.|State Key Laboratory for Diagnosis & Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.|Service de maladies infectieuses et tropicales, Université de Lorraine, EA 4360 APEMAC & CHU de Nancy, Nancy, France.
authors: Yonghong
authors: Y
authors: Xiao
authors: Global Health - Health Systems & Policy (HSP): Improving the Use of Medicines, Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden.|Mbarara University of Science & Technology, PO Box 1410, Mbarara, Uganda.|Department of Pharmacology, Pushpagiri Institute of Medical Sciences & Research Centre, Tiruvalla, Kerala, India.|State Key Laboratory for Diagnosis & Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.|Service de maladies infectieuses et tropicales, Université de Lorraine, EA 4360 APEMAC & CHU de Nancy, Nancy, France.
authors: Cecilia
authors: C
authors: Stålsby Lundborg
authors: Global Health - Health Systems & Policy (HSP): Improving the Use of Medicines, Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77 Stockholm, Sweden.|Mbarara University of Science & Technology, PO Box 1410, Mbarara, Uganda.|Department of Pharmacology, Pushpagiri Institute of Medical Sciences & Research Centre, Tiruvalla, Kerala, India.|State Key Laboratory for Diagnosis & Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.|Service de maladies infectieuses et tropicales, Université de Lorraine, EA 4360 APEMAC & CHU de Nancy, Nancy, France.
authors: Céline
authors: C
authors: Pulcini
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects* / Q000235:genetics / Q000378:metabolism; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology / Q000523:psychology; D024881:Drug Resistance, Bacterial; D006801:Humans; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D012941:Social Responsibility
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotic stewardship; antimicrobial resistance; complexity