01979nas a2200217   4500000000100000008004100001260001600042653002700058653002700085653002400112653002100136100001600157700001600173700002700189700001200216245015400228856015300382300001100535520120100546022001401747       2021                            d  bElsevier BV10aMicrobiology (medical)10aPharmacology (medical)10aInfectious Diseases10aGeneral Medicine1 aRambliere L1 aGuillemot D1 aDelarocque-Astagneau E1 aHuynh B00aWhat is the impact of mass and systematic antibiotic administration on antibiotic resistance in low- and middle-income countries? A systematic review  uhttps://www.sciencedirect.com/science/article/pii/S0924857921001138/pdfft?md5=d4492a504e8f71550f5fce50fc0e7359&pid=1-s2.0-S0924857921001138-main.pdf  a1063643 aAntibiotic consumption is a key driver of antibiotic resistance (AR), particularly in low- and middle-income countries, where risk factors for AR emergence and spread are rife. However, the potential contribution of mass and systematic antibiotic administration (MDA/SDA) to AR spread is unknown. We conducted a systematic review to provide an overview of MDA/SDA in low- and middle-income countries, including indications, antibiotics used and, if investigated, levels of AR over time. This systematic review is reported in accordance with the PRISMA statement. Of 2438 identified articles, 63 were reviewed: indications for MDA/SDA were various, and targeted populations were particularly vulnerable, including pregnant women, children, HIV-infected populations and communities in outbreak settings. Available data suggest MDA/SDA may lead to significant AR increase, especially after azithromycin administration. However, only 40% of studies evaluated AR. Integrative approaches that evaluate AR in addition to clinical outcomes are needed to understand consequences of MDA/SDA implementation, combined with standardized AR surveillance for timely detection of antibiotic resistance emergence.  a0924-8579