A review of antibiotic misuse and bacterial resistance in Iraq.

Background: Antimicrobial resistance poses a serious threat to healthcare globally. Reviewing current practice regarding antibiotic prescription and use is crucial to understanding antimicrobial resistance issues in Iraq and how to tackle them.

Aim: To review and analyse studies addressing antimicrobial resistance as well as antibiotic prescription, dispensing and use in Iraq.

Methods: In June 2023, we searched Google Scholar for, and reviewed, empirical studies related to antibiotic use and antimicrobial resistance in Iraq.

Results: Thirty-seven eligible studies published between 2012 and 2023 were included in the review. Multi-drug-resistant bacteria, such as E. coli and P. aeruginosa, were commonly reported by the studies. Most physicians in public hospitals prescribed antibiotics frequently and empirically without relying on culture and sensitivity tests, and community pharmacists often dispensed antibiotics to patients without prescriptions, indicating self-medication and misuse of antibiotics in Iraq. Antibiotic residuals were found in raw meat and drinking water. Although there were antimicrobial resistance control regulations and plans, they were not fully implemented.

Conclusion: This review shows that antimicrobial resistance and antibiotic misuse are serious problems in Iraq. The responsible authorities should work together to implement and enforce compliance to the antimicrobial resistance control plans using the One Health approach.