ArticleInfection and drug resistance2026
Addressing Antimicrobial Resistance: A Point Prevalence Survey Using AWaRe Indicators from Outpatient Settings of Multan, Pakistan.
Article in Infection and drug resistance, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Background/Objective: Antimicrobial resistance (AMR) is an escalating public health concern in low- and middle-income countries (LMICs), including Pakistan, where primary care (PC) settings play a significant role in driving inappropriate antibiotic use. This study aimed to evaluate antibiotic prescribing patterns in outpatient departments (OPDs) of hospitals in Multan, Pakistan. Methodology: Data were collected from the OPDs of two hospitals in Multan during two 4-month periods: September to December 2023 and January to April 2024, using the Global Point Prevalence Survey (GPPS) methodology. The GPPS protocol was followed for data collection, and the WHO AWaRe indicators were applied to determine the appropriateness of antibiotic prescriptions in PC settings. Results: Of 1208 patients attending OPDs, 409 (33.85%) received at least one antibiotic. A total of 532 antibiotics were prescribed, of which 65.2% belonged to the Access group, with amoxicillin-clavulanic acid being the most frequently prescribed agent. However, only 41 prescriptions (7.7%) were compliant with WHO AWaRe recommendations, indicating a high level of inappropriate prescribing. Antibiotic use was particularly high for respiratory symptoms such as sore throat, cough, and nasal congestion, which are predominantly viral in origin. While Ophthalmology and Dermatology OPDs had the lowest prescribing rates, Pulmonology and Paediatrics OPDs showed the highest. Conclusion: The study concluded that antibiotic prescribing was frequent in PC OPDs in Multan, with inadequate compliance with WHO AWaRe recommendations, regardless of the excessive use of Access antibiotics. Targeted ASP efforts are necessary to minimize inappropriate antibiotic prescribing.
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