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Center For Disease Dynamics, Economics & Policy

Global geographic trends in antimicrobial resistance: the role of international travel

The Question: Antimicrobial resistance (AMR) is a rapidly emerging global public health threat with various clinical, biological, economic, and sociocultural drivers. The increasing ease of international travel and trade facilitates the spread of drug-resistant pathogens but remains an understudied topic. Therefore, CDDEP researchers reviewed the role of travel in the global rise and spread of AMR and consider actions at the levels of travelers, travel medicine practitioners and policymakers that would mitigate this threat.

What We Found: The travel medicine community has a key role to play in advocating for the recognition of AMR as a priority on the international health agenda. Key policy and practice recommendations include ensuring travelers are current with vaccines, aware of ways of treating and preventing travelers’ diarrhea (other than antibiotic use), and are informed on safe sexual practices. Healthcare providers need to be aware of patients’ travel histories to provide appropriate treatment to those who are at high risk of exposure and to prevent further spread. At the global scale, there is an urgent need to ensure reliable and universal access to clean water, sanitation and hygiene infrastructure; vaccines, and high quality antimicrobials. High-income countries must ensure their use of antimicrobials is appropriate to reduce selection for AMR. Finally, robust and consistent AMR surveillance across all countries is needed to monitor and respond to this emerging threat.

The review article titled, “Global geographic trends in antimicrobial resistance: the role of international travel” was published on May 22, 2019 in the Journal of Travel Medicine, available online here, and was included in the 2021 Oxford University Press cross-journal collection of highly cited articles.