Impacto de la resistencia antimicrobiana en el primer nivel de atención

Resumen

Antimicrobial resistance (AMR) represents one of the main threats to global public health, especially at the primary care level, where most common infections are managed. This study analyzes the clinical and epidemiological impact of AMR in primary care centers in Panama, evaluating prescribing patterns, prevalence of resistant strains, and clinical outcomes in a cohort of 300 patients treated for respiratory, urinary, and skin infections. It was found that 38% of urinary tract infections and 27% of respiratory infections showed resistance to first-line antibiotics. Empirical prescribing without microbiological confirmation occurred in 62% of cases and was associated with a higher rate of clinical complications (OR: 2.3; 95% CI: 1.5–3.6; p<0.001).

Multivariable analysis showed that advanced age, the presence of comorbidities, and bacterial resistance were factors associated with adverse outcomes. The results suggest that family medicine can play a key role in containing antimicrobial resistance (AMR) through rational prescribing strategies, community education, and clinical surveillance. Strengthening continuing medical education, implementing updated clinical guidelines, and improving access to microbiological testing at the primary care level are recommended. This study provides relevant evidence for the design of public policies aimed at reducing AMR from a comprehensive perspective, centered on primary care and a family health approach.