Dampak Resistensi Antibiotik terhadap Kesehatan Masyarakat di Negara Berkembang dan Upaya Pencegahannya untuk Meningkatkan Kualitas Kesehatan Global

Kadek Risa Apriani; Ketut Widyani Astuti

doi:10.62027/praba.v3i3.492

Authors

Kadek Risa Apriani Universitas Udayana
Ketut Widyani Astuti Universitas Udayana

DOI:

https://doi.org/10.62027/praba.v3i3.492

Keywords:

Antibiotic resistance, Developing countries, productivity

Abstract

Antimicrobial resistance (AMR) poses a major global health threat, with severe impacts in developing countries due to weak health systems, poor regulation, and low sanitation standards. This review summarizes 12 studies from Asia and Africa on AMR’s clinical, social, economic, and environmental effects. AMR leads to first-line treatment failure, prolonged hospital stays, increased morbidity and mortality, and necessitates costly, toxic last-line antibiotics. Economic consequences include higher treatment costs, productivity loss, and poverty risk from high medical expenses. Environmental contributors such as contamination from medical waste, livestock, and the food industry accelerate resistant bacteria spread. Effective control requires integrated strategies, including Antimicrobial Stewardship Programs (ASP) based on AWaRe classification, laboratory strengthening, One Health approaches, public education, strict antibiotic distribution regulations, and cross-sector monitoring. These measures aim to curb AMR progression and reduce health burdens in developing nations. The rise of AMR further complicates healthcare delivery in countries already struggling with limited resources and underfunded healthcare systems. The growing prevalence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) organisms threatens the effectiveness of current medical treatments, including those for common infections such as tuberculosis and pneumonia. Infections that were once easily treatable with antibiotics are now leading to longer and more complicated hospitalizations, greater healthcare costs, and higher death rates. Additionally, the lack of access to newer, more effective antibiotics and diagnostic tools makes managing resistant infections in these regions even more challenging. Environmental factors, particularly contamination from healthcare facilities and agricultural practices, play a key role in the proliferation of resistant pathogens.

References

Adiwinoto, S. (2018). Pola resistensi antibiotik pada pasien sepsis di RSUP Dr. Kariadi Semarang. Jurnal Kedokteran Diponegoro, 7(4), 1797-1809.

Aiesh, S. M., Shbair, W. M., & Abu-Elamreen, F. H. (2024). Fluoroquinolone resistance pattern of Enterobacteriaceae isolated from hospitalized patients in Gaza Strip, Palestine. Medical Journal of Indonesia, 33(1), 45-51.

Aiesh, S. M., Shbair, W. M., Al-Haddad, M. S., & Abu-Elamreen, F. H. (2023). Antimicrobial resistance pattern of carbapenem-resistant Enterobacteriaceae isolated from patients in Gaza Strip, Palestine. Journal of Infection and Public Health, 16(4), 499-505.

Ayukekbong, J. A., Ntemgwa, M., & Atabe, A. N. (2017). The threat of antimicrobial resistance in developing countries: Causes and control strategies. Antimicrobial Resistance & Infection Control, 6, 47. https://doi.org/10.1186/s13756-017-0208-x

Bullens, D., Khan, N. Z., Adeel, M. Y., & Firdous, R. (2022). High antimicrobial resistance among Escherichia coli isolates from urinary tract infections in Pakistan. BMC Infectious Diseases, 22, Article 389.

Cathartica, A., Junando, M., Sayoeti, M. F. W., & Suri, N. (2025). Narrative review: Penggunaan antibiotik reserve dalam era resistensi antimikroba. Sains Medisina, 3(4), 131-138.

Founou, R. C., Founou, L. L., & Essack, S. Y. (2017). Clinical and economic impact of antibiotic resistance in developing countries: A systematic review and meta-analysis. BMC Infectious Diseases, 17, 1-18. https://doi.org/10.1371/journal.pone.0189621

Ingle, D. J., Levine, M. M., Kotloff, K. L., Holt, K. E., & Robins-Browne, R. M. (2018). Dynamics of antimicrobial resistance in intestinal Escherichia coli from children in community settings in South Asia and Sub-Saharan Africa. Nature Microbiology, 3(9), 1063-1073. https://doi.org/10.1038/s41564-018-0217-4

Islam, T., Kubra, K., & Hassan Chowdhury, M. M. (2018). Prevalence of methicillin-resistant Staphylococcus aureus in hospitals in Chittagong, Bangladesh: A threat of nosocomial infection. Journal of Microscopy and Ultrastructure, 6(4), 188-191. https://doi.org/10.4103/JMAU.JMAU_30_18

Januari, C., Sudarwanto, M. B., & Purnawarman, T. (2019). Resistensi antibiotik pada Escherichia coli yang diisolasi dari daging ayam pada pasar tradisional di Kota Bogor. Jurnal Veteriner, 20(1), 125-131. https://doi.org/10.19087/jveteriner.2019.20.1.125

Krushna, R., Meena, S., & Mishra, P. (2024). Adverse drug reactions associated with antibiotic use in a tertiary care hospital in India. International Journal of Basic & Clinical Pharmacology, 13(2), 180-184.

Laxminarayan, R., Duse, A., Wattal, C., Zaidi, A. K. M., Wertheim, H. F. L., Sumpradit, N., & Cars, O. (2013). Antibiotic resistance: The need for global solutions. The Lancet Infectious Diseases, 13(12), 1057-1098. https://doi.org/10.1016/S1473-3099(13)70318-9

Lestari, E. S., & Marchaban. (2023). Evaluasi penggunaan antibiotik pada pasien sepsis dengan metode Gyssens di RSUP Dr. Sardjito. Majalah Farmaseutik, 19(2), 235-243. https://doi.org/10.31941/benzena.v2i01.3114

Murray, C. J. L., Ikuta, K. S., Sharara, F., Swetschinski, L., Robles Aguilar, G., Gray, A., & Lopez, A. D. (2022). Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. The Lancet, 399, 629-655. https://doi.org/10.1016/S0140-6736(21)02724-0

Naylor, N. R., Atun, R., Zhu, N., Kulasabanathan, K., Silva, S., Chatterjee, A., & Robotham, J. V. (2018). Estimating the burden of antimicrobial resistance: A systematic literature review. Antimicrobial Resistance & Infection Control, 7, 58. https://doi.org/10.1186/s13756-018-0336-y

Normaliska, R., Mirnawati, B. S., & Hadri, L. (2019). Pola resistensi antibiotik pada Escherichia coli penghasil ESBL dari sampel lingkungan di RPH-R Kota Bogor. Jurnal Vokasi Kesehatan, 5(1), 9-17. https://doi.org/10.29244/avi.7.2.42-48

Organisation for Economic Co-operation and Development. (2018). Stemming the superbug tide: Just a few dollars more. OECD Publishing.

Sahu, C., Singh, S., Pathak, A., Patel, S. S., Ghoshal, U., Singh, U. S., & Hashim, Z. (2022). Trends of drug resistance to the commonly used antibiotics to combat the COVID-19 pandemic: Experience from a super-speciality institute of northern India. Journal of Family Medicine and Primary Care, 11, 6255-6259. https://doi.org/10.4103/jfmpc.jfmpc_548_22

Shah, D. A., Wasim, S., & Abdullah, F. E. (2015). Antibiotic resistance pattern of Pseudomonas aeruginosa isolated from urine samples of urinary tract infections patients in Karachi, Pakistan. Pakistan Journal of Medical Sciences, 31(2), 341-345.

Shbaita, A. A., Abu-Elamreen, F. H., & Aiesh, S. M. (2023). Multidrug resistance of Pseudomonas aeruginosa isolated from clinical samples in Gaza Strip. The Egyptian Journal of Medical Human Genetics, 24(1), Article 32.

Singh, N., & Keugtae, K. (2025). Factors influencing antibiotic resistance in developing countries: A narrative review. Asian Journal of Medicine and Health Sciences, 8(1), 15-27.

Sirag, A., & Mohamed Nor, N. (2021). Out-of-pocket health expenditure and poverty: Evidence from a dynamic panel threshold analysis. Healthcare, 9(5), 536. https://doi.org/10.3390/healthcare9050536

World Health Organization. (2020). Antimicrobial resistance. https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance.

Zhang, T., Lin, X., Zhang, Y., Wang, S., Mao, L., Mao, P., & Yang, J. (2021). Economic burden of antibiotic resistance in China: A national level estimate for inpatients. Antimicrobial Resistance & Infection Control, 10, 5. https://doi.org/10.1186/s13756-020-00872-w