Associated organisationsIND Annelie a. Monnier 281599 · IND Joseph Elikem Efui Acolatse 281492 · IND Nga Do 149279 · IND Siswanto Agus Wilopo 279264 · International Centre for Diarrhoeal Disease Research, Bangladesh · ISI Foundation · King's College London · Lagos State University College of Medicine · Radboud University Medical Centre · St George's, University of London · University of Cape Town · University of East Anglia · University of OxfordEurope PMC affiliations are not treated as award recipients or mapped locations.
Funding£3.6M
PeriodApr 2024 — Apr 2028
In plain English
AI plain-English summary
More than 90% of all human antibiotic use happens in GP clinics and health centres, not hospitals, and in low- and middle-income countries that use is shifting dangerously toward broad-spectrum "Watch" antibiotics. This matters because inappropriate antibiotic use drives antimicrobial resistance—a global health threat that makes common infections harder to treat. Current efforts to improve prescribing in primary care are hampered by poor data on what is actually being prescribed and a lack of proven interventions tailored to resource-limited settings. The research will develop and test a practical solution. It will pilot new methods to measure antibiotic use patterns, then build an educational and organisational intervention based on the WHO’s AWaRe system—a simple traffic-light classification that tells prescribers which antibiotics to use (Access), which to watch carefully (Watch), and which to reserve (Reserve). The intervention will be evaluated in a large cluster randomised trial across Asia and Africa. If successful, the project will provide a blueprint for national surveillance and future trials in primary care across the global south. It could shift prescribing habits at scale, slowing the rise of resistance without requiring expensive new infrastructure.
View original technical description
The global rise in inappropriate antibiotic use is a threat to population health. Over 90% of human use is in primary care (PC), with rapidly increasing use of broad-spectrum oral Watch antibiotics seen in low- and middle-income countries (LMICs). A core component of antibiotic stewardship is improvement in clinical treatment decision-making by frontline health workers. The overall aim of this proposal is to develop and test a framework for future surveillance, benchmarking and population-based interventional trials of optimal antibiotic use in LMIC PC settings. We will pilot new methods of estimating patterns of antibiotic use (WS1), develop a new AMS intervention (WS2) and evaluate it in a paradigmatic clinical trial (WS3). Novel methods of measuring antibiotic use will be designed to facilitate national surveillance, benchmarking and improved outcome capture in LMIC PC clinical trials. The educational and organisational intervention will be based on the 2022 WHO Essential Medicines List (EML) AWaRe (Access–Watch–Reserve) Book. The pragmatic global cluster randomised trial will be performed in countries across Asia and Africa to determine the effectiveness and safety of an AWaRe system-based intervention on appropriately reducing total and oral Watch antibiotic prescribing and will be designed as a blueprint for future population-based PC trials.
Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.
Is something wrong? Let us know