ReviewBMJ global health2021
Shortage of essential antimicrobials: a major challenge to global health security.
Review in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
55 citing papers in PubMed, 1 synthesis or guideline pooled it, 104 citations in OpenAlex.
- Progress, impacts and lessons from market shaping in the past decade: a systematic review.Frontiers in public health · 2025Pooled it
- Market landscape of penicillin for syphilis and rheumatic heart disease, WHO South-East Asia Region.Bulletin of the World Health Organization · 2026Article
- Article
- Structural drivers of drug shortages and market withdrawal: a longitudinal analysis of the Romanian pharmaceutical market.BMC health services research · 2026Article
- Structural Patterns of Antibiotic Shortages: A Cross-National Analysis of Systemic Antibacterials.Antibiotics (Basel, Switzerland) · 2026Article
- Modelling impacts of paediatric amoxicillin shortage management on pneumococcal resistance and invasive disease in Europe.Nature communications · 2026Article
- Supply Chain Vulnerabilities in First-Line Treatments for Sexually Transmitted Infections: Implications for U.S. Public Health Preparedness.medRxiv : the preprint server for health sciences · 2026Article
- Metal Oxide Nanocomposites as Next-Generation Antimicrobial Agents Against Oral Cariogenic Pathogens: Mechanistic Actions of Ag-ZnO and Cu-ZnO onMaterials (Basel, Switzerland) · 2026Article
- Association between antimicrobial use and the detection rates of carbapenem-resistant Enterobacterales: long-term surveillance results from a single centre.Infection prevention in practice · 2026Article
- Impact of shortages of amoxicillin and amoxicillin/clavulanate on the outcome of bacterial sinusitis in adults: a French retrospective, single-centre study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Antimicrobial stewardship from a One Health perspective.Nature reviews. Microbiology · 2026Review
- The "Cairo Accord"- towards the eradication of RHD: revisited (2026).Frontiers in cardiovascular medicine · 2026Review
- Rapid and high-sensitivity quantitative fluorescent immunoassay for detection ofFrontiers in microbiology · 2026Article
- Osteomyelitis in HIV pathogenesis, challenges, and therapeutic strategies.Annals of medicine and surgery (2012) · 2026Review
- The colistin resistance pandemic: A dual threat from plasmid-encoded mobilised colistin resistance genes and chromosomal mutations.African journal of laboratory medicine · 2026Review
- From 60 Causes to 10 Solutions Against Antibiotics Shortages in Sweden: Platinea's Approach to Developing Policy Interventions.Antibiotics (Basel, Switzerland) · 2025Article
- Factors contributing to human and veterinary medicine shortages in developing countries: perspectives of suppliers and regulators in Namibia.Tropical medicine and health · 2025Article
- US Antibiotic Importation and Supply Chain Vulnerabilities.JAMA health forum · 2025Article
- Strategies and Recent Advances in Tackling Antibacterial Resistance in India: A Comprehensive Narrative Review.Cureus · 2025Review
- Mapping socioeconomic factors driving antimicrobial resistance in humans: An umbrella review.One health (Amsterdam, Netherlands) · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The lack of access to safe and effective antimicrobials for human populations is a threat to global health security and a contributor to the emergence and spread of antimicrobial resistance (AMR). The increasingly common shortages of antimicrobials are an additional threat to the emergence of AMR. While the threat of such drug shortages is most acutely experienced in low-income and middle-income settings, their consequences impact the quality and effectiveness of antimicrobials worldwide. Furthermore, there is a need for robustly conducted studies examining the impact of these increasingly prevalent shortages on patient outcomes and on the emergence and spread of AMR. In this review, we have mapped common drivers for antimicrobial shortages and propose strategies for rethinking the regulation, supply and pricing of antimicrobials to secure their sustainable access across diverse healthcare systems and to help minimise the unintended consequences of weak and ineffective supply chains. Greater government involvement in antimicrobial manufacture and supply is essential to ensure no one is left behind. Dedicated demand systems need to be developed for antimicrobials which take into consideration evolving AMR patterns, burden of diseases, pandemic events and supply and demand issues and facilitate implementation of strategies to address them. Interventions, ranging from advocacy and forecasting to public-private collaborations, new economic models and international consortia working across countries and supply chains, will help assure access to safe and effective antimicrobials to all populations around the globe and ensure that shortages no longer contribute to AMR.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.