National data on Antimicrobial Resistance (AMR) in Chile in the context of community-acquired respiratory tract infections: links between antimicrobial susceptibility, local and international antimicrobial prescribing guidelines, access to medicines and clinical results.

Abstract

Background: Antimicrobial resistance (AMR) is one of the greatest threats to global public health. Contributing to this process, among other factors, is the indiscriminate use of antimicrobials in community-acquired respiratory infections. Each country has implemented strategies to confront this growing phenomenon.The objective of this review was to determine Chilean initiatives to deal with Antimicrobial Resistance (AMR), antibiotic use and prescribing, and availability of susceptibility data, for the critical community-acquired respiratory tract infection (CA-RTI) pathogens Streptococcus pneumoniae and Haemophilus influenzae and to spot areas where more information is needed and suggest a call to action to enhance patient clinical outcomes, through a narrative review of the literature.  In Chile, antibiotics sales only occur under medical prescription; however, in later years, a new consumption associated with physician drug prescription has emerged in the community, especially for penicillin derivatives, quinolones, and macrolides. Data have shown a susceptibility reduction to amoxicillin and clavulanate combination and other antibiotics against S. pneumoniae. As a consequence, the local government proposed the National Plan on Antimicrobial Resistance 2017-2020. The new version from 2021 to 2025 led to a decreasing trend in Chile's S. pneumoniae and H. influenzae isolates. Such results highlight the importance of the development of local guidelines.