ReviewInfection and drug resistance2026
Economic Barriers to Antimicrobial Susceptibility Testing as a Structural Contributor to Antimicrobial Resistance in Low- and Middle-Income Countries: A Narrative Review.
Review in Infection and drug resistance, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Bacterial antimicrobial resistance (AMR) was directly responsible for an estimated 1.27 million deaths in 2019, with the burden. Antimicrobial susceptibility testing (AST) is essential for guiding targeted therapy and stewardship, yet the specific economic mechanisms that prevent its scale-up in low-resource settings remain poorly understood and inadequately addressed in policy. Methods: A narrative review was conducted following SANRA guidelines and PRISMA transparency principles. PubMed/MEDLINE, Scopus, and Google Scholar were searched (01 January 2026-30 April 2026) using Boolean combinations of terms across three domains: AST and diagnostics; economic and health-system barriers; and AMR and stewardship. Studies published 2019-2026 addressing economic barriers to AST, prescribing behaviour, resistance patterns, or financing strategies in LMICs were eligible. Evidence was synthesized thematically. Findings: Economic barriers to AST operate at three levels: patient-level out-of-pocket costs and transport; laboratory-level infrastructure deficits, reagent shortages, and workforce gaps; and health-system-level underinvestment and donor dependency. These barriers sustain broad-spectrum empirical prescribing, amplify selection pressure, and drive the emergence of methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum β-lactamase (ESBL)-producing Enterobacterales, and carbapenem-resistant organisms. Consequences include treatment failure, catastrophic household expenditure, and threats to universal health coverage. Effective responses require subsidized diagnostics, insurance coverage for microbiology services, tiered laboratory strengthening, and integration of diagnostic stewardship with antimicrobial stewardship. Conclusion: Economic barriers to AST are a structural, multi-level contributor to AMR in LMICs. Sustainable AMR control requires financed national action plans that explicitly fund accessible, quality-assured AST alongside prescribing reform.
Indexed as
Identifiers
What OpenQuestion holds
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.