Objectives: To analyze challenges and opportunities in the implementation of the Colombian National Plan for responding Antimicrobial Resistance AMR, with particular focus on Neisseria Gonorrhoeae.
Methods: Qualitative study based on grounded theory, orientated by semi-structured interviews with users of clinics, and key informants responsible of the AMR and Sexually Transmitted Infections (STIs). Interviews were orientated toward knowledge about AMR, antibiotics rational use, and the interconnection between Neisseria Gonorrhoeae and AMR. In total 23 interviews were conducted in four Colombian cities selected due to the higher incidences of resistance to gonorrhea. Interviews were recorded, transcript, coded and analyzed with N-Vivo 11.
Results: The main facilitators process of the implementation plan are laboratory-based surveillance, governance addressing antimicrobial resistance, and inter-institutional coordination. Among challenges or implementation difficulties arose the lack of shared objectives among responsible actors, particularly the lack of and inter institutional agenda tackling antimicrobial resistance and sexually transmitted infections; absence of protocols addressing irrational use of antibiotics and insufficient coping of technical guidelines. Overall, general public is not familiar with antimicrobial resistance nor with its individual and collective effects, and that patients are not receiving enough information about rational use of antibiotics.
Conclusions: More research is needed to understand the impacts of governance addressing antimicrobial resistance. Strategies on this subject should promote sex education and information about the importance of rational usage of antibiotics and prevention of sexually transmitted infections. Furthermore, gonorrhea should be enforced as a strategic infection of antimicrobial resistance improving responses to these phenomena.