Increasing the use of the WHO AWaRe system in antibiotic surveillance and stewardship programmes in low- and middle-income countries

Antimicrobial resistance (AMR) is a global health threat, primarily due to inappropriate antibiotic use in low- and middle-income countries (LMICs). The WHO’s AWaRe system aims to improve antibiotic use quality. A literature review between 2017 and 2024 found that only 14.1% of studies met the UNGA AMR recommended target of 70% Access antibiotics. Overuse of Watch antibiotics was observed, particularly in Pakistan and Bangladesh. Targeted AWaRe-based antimicrobial stewardship programs are needed to meet UNGA recommendations and improve Access antibiotic use.