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Antibiotics
Special Issues
Global Inequities and Supply Challenges in Access to Antibiotics
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Global Inequities and Supply Challenges in Access to Antibiotics

A Special Issue of Antibiotics (ISSN 2079-6382) belonging to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: 30 April 2027 | Viewed by 1999

Editors

Dr. Márió Gajdács

E-Mail Website
Guest Editor
Department of Public Health, Albert Szent-Györgyi Faculty of Medicine, University of Szeged, 6720 Szeged, Hungary
Interests: antimicrobial resistance; antimicrobial stewardship; knowledge-attitude-practice (KAP); qualitative methods; quantitative methods; epidemiology; public health; novel antimicrobials
Special Issues, Collections and Topics in MDPI journals
Dr. Maarten Lambert

E-Mail Website
Guest Editor Assistant
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
Interests: antibiotics; antimicrobial resistance; drug shortages; community pharmacy practice

Special Issue Information

Dear Colleagues,

Antibiotics remain among the most essential medical interventions of the modern era, yet their global availability is increasingly uncertain. In recent years, alarming shortages of commonly used antibiotics have been reported across both high- and low-income countries, reflecting vulnerabilities in global manufacturing, supply chains, and market incentives. Crucially, antibiotics are the drug class most affected by shortages. At the same time, profound inequities in access persist; while some regions struggle with the overuse and misuse of antibiotics, others face dangerous scarcity, leaving even treatable infections without effective therapy. These disparities not only jeopardize patient outcomes but also contribute to the broader antimicrobial resistance crisis through the use of substandard or inappropriate alternatives.

This Special Issue aims to explore the multifaceted challenge of ensuring equitable and sustainable access to essential antibiotics. We welcome manuscripts addressing the causes and consequences of and potential solutions to antibiotic shortages, including analyses of economic drivers, policy frameworks, global supply networks, and health system responses. Contributions highlighting regional experiences, strategies to strengthen antibiotic availability, and exploring the relationship between antibiotic shortages and antibiotic resistance are particularly encouraged.

Dr. Márió Gajdács
Guest Editor

Dr. Maarten Lambert
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • antibiotic access
  • drug shortages
  • health equity
  • antimicrobial resistance
  • access to medicines
  • pharmaceutical supply chain
  • essential medicines
  • pharmacoepidemiology
  • guideline adherence

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Published Papers (2 papers)

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Research

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18 pages, 616 KB  
Article
How Health Policies Shape Antibiotic Use: A Nationwide Study of “Access”-Group Antibiotics Availability and Consumption in a Middle-Income Country: The Case of Kazakhstan
by Antonio Sarria-Santamera, Márió Gajdács, Aliya Raimbayeva, Tatyana Belikhina, Lyudmila Pivina, Nurlan Aukenov, Larissa Makalkina, Nurgul Aldiyarova and Yuliya Semenova
Antibiotics 2026, 15(6), 585; https://doi.org/10.3390/antibiotics15060585 - 8 Jun 2026
Viewed by 546
Abstract
Background/Objectives: Few studies have examined how health policies may influence antibiotic consumption at a global level, particularly with respect to the World Health Organization (WHO) “Access” group antibiotics. Our present study aims to address this gap by investigating how health policies affect [...] Read more.
Background/Objectives: Few studies have examined how health policies may influence antibiotic consumption at a global level, particularly with respect to the World Health Organization (WHO) “Access” group antibiotics. Our present study aims to address this gap by investigating how health policies affect the availability of “Access” antibiotics in a middle-income country of Kazakhstan. Methods: This study employed a mixed-methods approach: the quantitative component consisted of a time series analysis of “Access” antibiotic consumption within the period 2017–2024; the qualitative component involved an analysis of health policies centered on regulating the availability of “Access” antibiotics and their prescription at the primary care level. Results: A declining trend in the consumption of “Access” antibiotics was observed during the period from 2017 to 2023; however, in 2024 there was a rebound in consumption. The consumption of “Access” antibiotics did not reach the 60% threshold recommended by the WHO. A total of 50 “Access” antibiotics were found to be unavailable in the country, of which 9 are included in the WHO Essential Medicines List. Analysis of health policies highlighted that the registration of medicines may only be initiated by the manufacturer or its representative. Furthermore, analysis of national standards of care for common infections in primary care indicated a preference for prescribing “Watch” antibiotics, or prescribing antibiotics where their use would not be indicated. Conclusions: A coordinated policy response is needed in Kazakhstan to strengthen antimicrobial stewardship, including improving the availability of “Access” antibiotics, decentralization, revising national standards of care, and addressing regulatory barriers to medicine registration. Full article
(This article belongs to the Special Issue Global Inequities and Supply Challenges in Access to Antibiotics)
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Review

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25 pages, 410 KB  
Review
Some Newer Antibiotics Active Against Helicobacter pylori and Anaerobic Bacteria and the Potential Benefits of Their Wider Availability in More Countries: A Narrative Review
by Lyudmila Boyanova, Liliya Yordanova Boyanova, José Medeiros, Georgi Dimitrov, Petyo Hadzhiyski, Raina Gergova and Rumyana Markovska
Antibiotics 2026, 15(6), 581; https://doi.org/10.3390/antibiotics15060581 - 7 Jun 2026
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Abstract
It is crucial to consider newer antibiotics with activity against anaerobes and Helicobacter pylori, given their healthcare importance, and the constantly growing antibiotic resistance/multidrug resistance, which complicates the therapy. The aim of this review was to emphasize certain recently approved or still-under-investigation [...] Read more.
It is crucial to consider newer antibiotics with activity against anaerobes and Helicobacter pylori, given their healthcare importance, and the constantly growing antibiotic resistance/multidrug resistance, which complicates the therapy. The aim of this review was to emphasize certain recently approved or still-under-investigation antibiotics with potential benefits for treating Clostridioides difficile infections (CDIs), other anaerobic infections, and those caused by H. pylori, covering recent data from articles published primarily in 2020–2026. Given the limited number of antibiotics for treating CDI and fidaxomicin nonavailability in many countries, it is necessary to conduct more extensive laboratory and clinical studies of promising antibiotics such as ibezapolstat, delafloxacin, lascufloxacin, omadacycline, eravacycline, ridinilazole, and CRS3123. Against Bacteroides fragilis group species, delafloxacin and eravacycline showed good activity. Research on rifasutenizol for bacterial vaginosis, sarecycline and nadifloxacin for acne vulgaris and amixicile for periodontal diseases needs to be expanded. For H. pylori infection, delafloxacin, sitafloxacin, nemonoxacin, zoliflodacin, and rifasutenizol may improve the suboptimal success of most eradication regimens. However, more efforts, in coordination between medical, scientific, manufacturing, and government representatives, should ensure wider access to and research on the newer antibacterials. Establishing more research groups, careful examination of market issues, and additional approaches, such as nanomaterials, efflux pump inhibitors, phage therapy, and CRISPR-Cas systems, should be beneficial. Notwithstanding the difficulties, there are many opportunities to promote research on and potential use of newer antibiotics which show advantages over the older antibacterials, and to make them available to numerous countries and patients worldwide. Full article
(This article belongs to the Special Issue Global Inequities and Supply Challenges in Access to Antibiotics)
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