ReviewJAC-antimicrobial resistance2025
Increasing the use of the WHO AWaRe system in antibiotic surveillance and stewardship programmes in low- and middle-income countries.
Review in JAC-antimicrobial resistance, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed.
- From Access to Watch: An AWaRe-Oriented Evaluation of Antibiotic Prescribing in ASL Salerno.Antibiotics (Basel, Switzerland) · 2026Article
- Antibiotic Consumption and Healthcare-Associated Infection Surveillance in a Multi-Unit Emergency Hospital in Romania: A Retrospective Observational Study.Medicina (Kaunas, Lithuania) · 2026Observational
- National and Hospital Level Antimicrobial Consumption Patterns in Kenya.Antibiotics (Basel, Switzerland) · 2026Article
- Current State of the Fight Against Antimicrobial Resistance: What Are the Different Strategies for Tomorrow?Antibiotics (Basel, Switzerland) · 2026Review
- Using oral and parenteral formulation of AWaRe antibiotics as a proxy estimate of community and hospital healthcare sector use.JAC-antimicrobial resistance · 2026Article
- Antibiotic utilization in outpatient and inpatient hospitals in Zambia: a systematic review, key findings and public health implications.Infection prevention in practice · 2026Review
- The Role of Pharmacovigilance Database in Identifying Antibiotic Resistance and Inappropriate Use: An Analysis of VigiBase Reports From Lower-Middle-Income Countries.Pharmacoepidemiology and drug safety · 2026Article
- Antibiotic prescribing patterns and consumption at a comprehensive specialized hospital in northern Ethiopia: a prospective cross-sectional study underscoring the need for antimicrobial stewardship.BMC infectious diseases · 2026Article
- Strengthening healthcare systems to prevent antimicrobial resistance in LMICs: it is time to act.Journal of global health · 2026Article
- Analysis of Antibiotic Consumption Trends and Pathogens' Epidemiological Profile Within a Multidisciplinary Clinical Hospital from Romania.Antibiotics (Basel, Switzerland) · 2026Article
- Development of AWaRe-Based Quality Indicators to Assess the Appropriateness of Antibiotic Prescribing in Primary Healthcare in South Africa.Antibiotics (Basel, Switzerland) · 2026Article
- Country governance of antimicrobial resistance (AMR) surveillance: observations on global progress and aid programme effectiveness using data from the Tracking AMR Country Self-Assessment Survey (TrACSS).Globalization and health · 2026Article
- Landscape of national antibiotic utilisation in Malaysia: an analysis of national pharmaceutical sales data from 2019 to 2023.Journal of pharmaceutical policy and practice · 2026Article
- A comparison of antibiotic resistance reports in pharmacovigilance databases and conventional surveillance across "One Health".Frontiers in public health · 2026Article
- Comparison between model global AWaRe-based quality indicators and quality indicators developed to assess the appropriateness of antibiotic prescribing in primary healthcare in South Africa.Frontiers in public health · 2026Article
- Antimicrobial resistance of bacteria isolated in a resource-limited region: the experience of the North Kivu Provincial Reference Laboratory in the Democratic Republic of the Congo.Frontiers in medicine · 2026Article
- Prescription precision: Evaluating antimicrobial prescription practices in paediatric and neonatal inpatients.Southern African journal of infectious diseases · 2026Article
- Antibiotic Prescription Patterns in Poland in the Years 2019-2024 Based on Reimbursement Data from the National Healthcare Fund.Antibiotics (Basel, Switzerland) · 2025Article
- Prevalence and Associated Factors for Purchasing Antibiotics Without a Prescription Among Patients in Rural South Africa: Implications for Addressing Antimicrobial Resistance.Antibiotics (Basel, Switzerland) · 2025Article
- Diagnostic Stewardship Trends and Antimicrobial Resistance Profiles of Bacteria Isolated in Zambia: A Five-Year Retrospective Study (2020-2024).Antibiotics (Basel, Switzerland) · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Antimicrobial resistance (AMR) presents a major global health threat, driven in part by the inappropriate use of antibiotics including in low- and middle-income countries (LMICs). Improving the quality of antibiotic use is a key rationale for the development of the WHO's AWaRe (Access, Watch and Reserve) system. There is a need to review the uptake of the AWaRe system since its launch to guide future practice. Methods: A literature search was conducted between 2017, the launch of AWaRe, and 2024. Inclusion criteria were studies that reported on antibiotic use in LMICs using the AWaRe system. Results: Eighty-five studies were included in the review, of which 56.4% focused on antibiotic use trends, with 28.2% reporting on prescribing patterns; 51.7% of the studies included inpatients. Only 14.1% of studies reported meeting the 2024 United Nations General Assembly (UNGA) AMR recommended target of at least 70% of human antibiotic use being Access antibiotics, with a concerning trend of overuse of Watch antibiotics (68.2% of studies). Dispensing practices revealed significant dispensing of antibiotics without prescriptions especially in Pakistan and Bangladesh. Watch antibiotics were more available but also more expensive than Access antibiotics. Conclusions: Encouragingly, many LMICs are now reporting antibiotic use via the AWaRe system, including in antimicrobial stewardship programmes (ASPs). Wide variation exists in the proportion of AWaRe antibiotics used across LMICs, with overuse of Watch antibiotics. There is an urgent need for targeted AWaRe-based ASPs in LMICs to meet recent UNGA recommendations. Improving the use, availability and affordability of Access antibiotics is essential to combat AMR.
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.