"We found poor governance and higher levels of corruption are associated with higher levels of antibiotic resistance," lead researcher Peter Collignon from The Australian National University (ANU) School of Medicine said.
"It is a finding that will be surprising to most people in the field of Medicine," said Collignon.
Antimicrobial resistance is an urgent global health priority. The World Health Organisation describes it as a looming crisis in which common and treatable infections are becoming life threatening.
Collignon said the research suggests that addressing corruption and control of antibiotics could help lower antibiotic resistance and save lives.
The research, published in the journal PLOS ONE, found that a country's level of antibiotic resistance is not related to its wealth.
Co-author Sanjaya Senanayake said countries with higher levels of corruption often had less rigorous and less transparent processes, with less effective controls over areas pertinent to antibiotic resistance.
"These include factors that affect antibiotic usage and the ways antibiotic-resistant bacteria spread via water, foods and poor infection control," Senanayake said.
"In countries with greater corruption, antibiotic usage may also be much higher than what is recorded. If governance and control of corruption can be improved, this can be an important factor in reversing high levels of antibiotic resistance," said Senanayake.
"This may be because clinicians in the private health system are subject to fewer controls when it comes to both the volumes and types of antibiotics used," Senanayake said.
"If more appropriate prescribing and better antimicrobial stewardship were to take place, that will likely result in lower levels of antibiotic resistance," said Senanayake.
Poorer countries should not regard antibiotic resistance as an inevitable consequence of their financial situation, said co-researcher Professor Premachandra Athukorala, from ANU Arndt-Corden Department of Economics.
"If governance and corruption issues can be better addressed, it is very likely that major reductions in levels of antibiotic resistance will result - this will also lead to many other benefits worldwide," he said.
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