Strengthening systems to monitor antibiotics. An action oriented approach
Abstract
Background Antibiotics have become lynchpins of our modern systems of healthcare, animal health and agriculture. Monitoring the types and volumes of antibiotics distributed, used and discharged across these systems is critical to provide evidence for action. With limited resources, implementation of multiple tools and recommendations for antibiotic monitoring is challenging. This paper sets out principles and case study illustrations for establishing systems to monitor antibiotic supply and use in resource-constrained settings. Methods A technical working group and wider reference group drew together expertise and experience from 71 individuals representing different countries, continents and One Health domains, to establish the value of monitoring antibiotics, review tools and guidelines, share experiences and generate principles for prioritising action. This included a literature review, in person workshop, online meetings and collaborative writing between August 2024 and May 2025. Results The literature search identified two types of outputs: a) antibiotic monitoring and surveillance tools (covering data collection-oriented and residue control tools), and b) guidelines, standards, and mapping/assessment tools for monitoring antibiotics. The group identified multiple purposes for establishing a coordinated system for monitoring antibiotic use across human, animal, plant and environmental domains at country level, including ensuring access, and informing efforts to mitigate…
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