BACKGROUND Antimicrobial stewardship has not always prevailed in a wide variety of medical institutions in Japan. METHODS The infection control team was involved in the review of individual use of antibiotics in all inpatients (6348 and 6507 patients/year during the first and second annual interventions, respectively) receiving intravenous antibiotics, according to the published guidelines, c...

In India, over the last decade, a series of stewardship failures in the health system, particularly in the medical profession, have led to a massive erosion of trust in these institutions. In many low- and middle-income countries (LMICs), the situation is similar and has reached crisis proportions; this crisis requires urgent attention. This paper draws on the insights from the recent developme...

BACKGROUND Antibiotic resistance (ABR) is a quickly worsening problem worldwide, also in low- and middle-income countries (LMICs). Appropriate antibiotic use in humans and animals, i.e. antibiotic stewardship (ABS), is one of the cornerstones of the World Health Organization's global action plan for ABR. Many LMICs are in the process of developing stewardship programs. AIMS We highlight chall...

Cities are rapidly increasing in importance as a major factor shaping the Earth system, and therefore, must take corresponding responsibility. With currently over half the world's population, cities are supported by resources originating from primarily rural regions often located around the world far distant from the urban loci of use. The sustainability of a city can no longer be considered in...

www.frontiersinecology.org © The Ecological Society of America R – including grasslands, shrublands, savannas, deserts, prairies, steppe, and tundra – comprise 30–40% of Earth’s ice-free terrestrial surface (depending on one’s definition and data sources; Asner et al. 2004) and account for 91% of the world’s grazing lands (Reid et al. 2008). Encompassing watersheds for vast downstream populatio...

OBJECTIVES To describe the methodology in developing an antimicrobial self-assessment toolkit (ASAT). METHODS The ASAT was developed through a National Pharmacy Reference Group using an evidence-based approach of published information and national reports to identify criteria for inclusion. These were subdivided into domains that addressed: 1) Antimicrobial management within the Trust-structu...