TY - JOUR

T1 - Mitigating antimicrobial resistance (AMR) using implementation research

T2 - a development funder's approach

AU - Khurana, Mark P.

AU - Essack, Sabiha

AU - Zoubiane, Ghada

AU - Sreenivasan, Nandini

AU - Cordoba, Gloria Cristina

AU - Westwood, Erica

AU - Dalsgaard, Anders

AU - Mdegela, Robinson H.

AU - Mpundu, Mirfin

AU - Scotini, Rodrigo

AU - Matondo, Augustine B.

AU - Mzula, Alexanda

AU - Chanishvili, Nina

AU - Gogebashvili, Dimitri

AU - Beruashvili, Maia

AU - Tsereteli, Marika

AU - Sooronbaev, Talant

AU - Kjærgaard, Jesper

AU - Bloch, Joakim

AU - Isaeva, Elvira

AU - Mainda, Geoffrey

AU - Muuka, Geoffrey

AU - Mudenda, Ntombi B.

AU - Goma, Fusya Y.

AU - Chu, Duc-Huy

AU - Chanda, Duncan

AU - Chirwa, Uchizi

AU - Yamba, Kaunda

AU - Kapolowe, Kenneth

AU - Fwoloshi, Sombo

AU - Mwenge, Lawrence

AU - Skov, Robert

PY - 2023

Y1 - 2023

N2 - Despite the escalating burden of antimicrobial resistance (AMR), the global response has not sufficiently matched the scale and scope of the issue, especially in low- and middle-income countries (LMICs). While many countries have adopted national action plans to combat AMR, their implementation has lagged due to resource constraints, dysfunctional multisectoral coordination mechanisms and, importantly, an under-recognized lack of technical capacity to adapt evidence-based AMR mitigation interventions to local contexts. AMR interventions should be tailored, context-specific, cost-effective and sustainable. The implementation and subsequent scale-up of these interventions require multidisciplinary intervention-implementation research (IIR). IIR involves both quantitative and qualitative approaches, occurs across a three-phase continuum (proof of concept, proof of implementation and informing scale-up), and across four context domains (inner setting, outer setting, stakeholders and the implementation process). We describe the theoretical underpinnings of implementation research (IR), its various components, and how to construct different IR strategies to facilitate sustainable uptake of AMR interventions. Additionally, we provide real-world examples of AMR strategies and interventions to demonstrate these principles in practice. IR provides a practical framework to implement evidence-based and sustainable AMR mitigation interventions.

AB - Despite the escalating burden of antimicrobial resistance (AMR), the global response has not sufficiently matched the scale and scope of the issue, especially in low- and middle-income countries (LMICs). While many countries have adopted national action plans to combat AMR, their implementation has lagged due to resource constraints, dysfunctional multisectoral coordination mechanisms and, importantly, an under-recognized lack of technical capacity to adapt evidence-based AMR mitigation interventions to local contexts. AMR interventions should be tailored, context-specific, cost-effective and sustainable. The implementation and subsequent scale-up of these interventions require multidisciplinary intervention-implementation research (IIR). IIR involves both quantitative and qualitative approaches, occurs across a three-phase continuum (proof of concept, proof of implementation and informing scale-up), and across four context domains (inner setting, outer setting, stakeholders and the implementation process). We describe the theoretical underpinnings of implementation research (IR), its various components, and how to construct different IR strategies to facilitate sustainable uptake of AMR interventions. Additionally, we provide real-world examples of AMR strategies and interventions to demonstrate these principles in practice. IR provides a practical framework to implement evidence-based and sustainable AMR mitigation interventions.

KW - ANTIBIOTIC-RESISTANCE

KW - PENICILLIN

U2 - 10.1093/jacamr/dlad031

DO - 10.1093/jacamr/dlad031

M3 - Journal article

C2 - 36994233

VL - 5

JO - JAC-Antimicrobial Resistance

JF - JAC-Antimicrobial Resistance

SN - 2632-1823

IS - 2

M1 - 031

ER -