Journal of Vaccine Research 2024, Vol.14, No.2, 54-64 http://medscipublisher.com/index.php/jvr 55 This study explores the role of vaccination strategies in mitigating antimicrobial resistance (AMR) from a global perspective. By reviewing existing literature and case studies, it highlights the effectiveness of vaccines in reducing antibiotic use and preventing the spread of resistant infections. The study examines the current state of vaccine development against resistant pathogens and identifies challenges and opportunities for future research and policy implementation. This research underscores the critical importance of incorporating vaccination into global AMR action plans and provides actionable insights for stakeholders in public health, research, and policy-making. 2 Background on Antimicrobial Resistance 2.1 Mechanisms of AMR development Antimicrobial resistance (AMR) is a significant global health threat that has been exacerbated by the misuse and overuse of antibiotics in humans, livestock, and agriculture. The development of AMR is primarily driven by the selective pressure exerted by the widespread use of antibiotics. When antibiotics are used, they kill susceptible bacteria, but resistant strains can survive and proliferate (Morrison and Zembower, 2020). This process is accelerated by inappropriate antibiotic use, such as under-dosing, over-prescribing, and using antibiotics for viral infections where they are ineffective (Jansen and Anderson, 2018; Buchy et al., 2019). Additionally, the exchange of genetic elements responsible for resistance between bacteria further propagates AMR (Kumar, 2018). The mechanisms of resistance include the production of enzymes that degrade antibiotics, alterations in bacterial cell targets, and changes in membrane permeability that prevent antibiotic entry (Buchy et al., 2019). 2.2 Current global impact of AMR AMR poses a severe threat to global health, leading to increased mortality, prolonged hospital stays, and higher healthcare costs. It is estimated that AMR caused approximately 1.95 million deaths in 2019, with projections suggesting it could cause up to 10 million deaths annually by 2050 if not addressed (Mullins et al., 2023). The economic burden of AMR is also substantial, with increased medical expenditures and reduced productivity due to prolonged illness (Saeed et al., 2023). AMR also undermines efforts to control infectious diseases, making it a significant threat to global health security. It complicates the management of diseases like tuberculosis, malaria, and HIV/AIDS, and contributes to the resurgence of previously controlled infections. Low- and middle-income countries are disproportionately affected by AMR due to limited access to healthcare, inadequate infection control, and the unregulated sale and misuse of antibiotics, exacerbating health disparities and hampering progress towards universal health coverage. The World Health Organization (WHO) has declared AMR a global emergency, emphasizing the need for coordinated international efforts to combat this crisis (Jansen et al., 2021; Costanzo and Roviello, 2023). 2.3 Traditional methods to combat AMR Traditional methods to combat AMR have focused on several key strategies. Antibiotic stewardship programs aim to optimize the use of antibiotics to minimize the development of resistance by selecting the appropriate drug, dose, duration, and route of administration, while effectively treating infections (Jansen and Anderson, 2018; Buchy et al., 2019). Improving hygiene and infection control measures in healthcare settings, such as hand hygiene, disinfection and sterilization protocols, vaccination, and the use of personal protective equipment (PPE), is crucial for preventing the spread of infections in healthcare institutions and the community (Buchy et al., 2019). Additionally, there has been a push for the development of new antibiotics, although progress has been slow due to the scientific and economic challenges associated with antibiotic research and development (Costanzo and Roviello, 2023; Mullins et al., 2023). Restricting the use of antibiotics in agriculture and livestock rearing is another important measure to reduce the overall burden of AMR (Jansen et al., 2018). While traditional methods have made some progress in addressing AMR, the rise of resistant bacterial strains continues to outpace these efforts. Novel strategies, including the use of vaccines, are urgently needed to mitigate the global impact of AMR.
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