The uncertain role of substandard and falsified medicines in the emergence and spread of antimicrobial resistance

Sean Cavany (), Stella Nanyonga, Cathrin Hauk, Cherry Lim, Joel Tarning, Benn Sartorius, Christiane Dolecek, Céline Caillet, Paul N. Newton and Ben S. Cooper ()
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Sean Cavany: University of Oxford
Stella Nanyonga: University of Oxford
Cathrin Hauk: University of Oxford
Cherry Lim: University of Oxford
Joel Tarning: University of Oxford
Benn Sartorius: University of Oxford
Christiane Dolecek: University of Oxford
Céline Caillet: University of Oxford
Paul N. Newton: University of Oxford
Ben S. Cooper: University of Oxford

Nature Communications, 2023, vol. 14, issue 1, 1-9

Abstract: Abstract Approximately 10% of antimicrobials used by humans in low- and middle-income countries are estimated to be substandard or falsified. In addition to their negative impact on morbidity and mortality, they may also be important drivers of antimicrobial resistance. Despite such concerns, our understanding of this relationship remains rudimentary. Substandard and falsified medicines have the potential to either increase or decrease levels of resistance, and here we discuss a range of mechanisms that could drive these changes. Understanding these effects and their relative importance will require an improved understanding of how different drug exposures affect the emergence and spread of resistance and of how the percentage of active pharmaceutical ingredients in substandard and falsified medicines is temporally and spatially distributed.

Date: 2023
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Persistent link: https://EconPapers.repec.org/RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-023-41542-w

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DOI: 10.1038/s41467-023-41542-w

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