What question did this study set out to answer?

To synthesize health system and socioeconomic determinants of antimicrobial misuse in low- and middle-income countries and propose a systems-level framework for stewardship.

August 16, 2026Discover Public HealthOpen Access

Access and excess as interacting drivers of antimicrobial resistance in low and middle income countries

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Authors

QOQudus Olayiwola NGNurudeen Ajadi Gbamigbola GAGbamigbola Nurudeen Ajadi

Discussion

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Overview

Narrative review reveals that antimicrobial resistance in low- and middle-income countries is driven by both drug shortages and overuse, highlighting the need for supportive stewardship.

Key Points

To synthesize health system and socioeconomic determinants of antimicrobial misuse in low- and middle-income countries and propose a systems-level framework for stewardship.
Conducted a narrative review with structured search elements across literature from 2010 to 2026 indexed in PubMed, Scopus, and WHO IRIS.
Applied thematic synthesis and conceptual mapping across relevant health system domains and socioeconomic determinants.
Identified two interacting pathways: an access-deficit pathway causing delayed care and subtherapeutic exposure, and an excess-use pathway resulting in inappropriate antimicrobial exposure.
Developed a conceptual U-shaped model illustrating that both inadequate and excessive drug exposure increase resistance risk through selection pressure and horizontal gene transfer.
Introduced the Access–Excess–Resistance Pathway Model to guide transitions from restrictive policies toward supportive, equity-focused stewardship within a One Health approach.

Cite This Study

Olayiwola et al. (2026) studied this question.

synapsesocial.com/papers/6a81796af2fb91fc834ac84d https://doi.org/10.1186/s12982-026-02626-2

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August 16, 2026Discover Public HealthOpen Access

Access and excess as interacting drivers of antimicrobial resistance in low and middle income countries

View Full Paper

Ask AI

Bookmark

Authors

QOQudus Olayiwola NGNurudeen Ajadi Gbamigbola GAGbamigbola Nurudeen Ajadi

Discussion

Member takes

Overview

Narrative review reveals that antimicrobial resistance in low- and middle-income countries is driven by both drug shortages and overuse, highlighting the need for supportive stewardship.

Key Points

To synthesize health system and socioeconomic determinants of antimicrobial misuse in low- and middle-income countries and propose a systems-level framework for stewardship.
Conducted a narrative review with structured search elements across literature from 2010 to 2026 indexed in PubMed, Scopus, and WHO IRIS.
Applied thematic synthesis and conceptual mapping across relevant health system domains and socioeconomic determinants.
Identified two interacting pathways: an access-deficit pathway causing delayed care and subtherapeutic exposure, and an excess-use pathway resulting in inappropriate antimicrobial exposure.
Developed a conceptual U-shaped model illustrating that both inadequate and excessive drug exposure increase resistance risk through selection pressure and horizontal gene transfer.
Introduced the Access–Excess–Resistance Pathway Model to guide transitions from restrictive policies toward supportive, equity-focused stewardship within a One Health approach.

Cite This Study

Olayiwola et al. (2026) studied this question.

synapsesocial.com/papers/6a81796af2fb91fc834ac84d https://doi.org/10.1186/s12982-026-02626-2

View Full Paper

Ask AI

Bookmark