Strengthening systems to monitor antibiotics. An action oriented approach

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 antimicrobial resistance (AMR). Tools to monitor use closer to end-user level were less standardised and often more complex. Proposed steps for establishing national antibiotic monitoring systems include starting where the greatest impact can be anticipated in a given context and alignment with other programmes. Conclusions The agricultural, population, epidemiological, cultural and economic contexts of different countries mean different starting points for establishing antibiotic monitoring. This project characterised an action-oriented prioritisation approach, targeting collection and collation of antibiotic data that have the highest likelihood of affecting change that can achieve impact. Such an approach is risk-based, prioritising monitoring of the antibiotic use that poses greatest risks as locally defined and is feasible to change; sustainable, aligning local expertise, infrastructure and technology with other country priorities; and transparent, ensuring evidence availability within the system alongside reporting ‘up and out.’ Effective national antibiotic monitoring systems require a collaborative and coordinated strategy focusing on data for action.

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Journal
Wellcome Open Research
Published
2026-09-24
DOI
https://doi.org/10.12688/wellcomeopenres.24568.2
Primary Topic
Pharmaceutical and Antibiotic Environmental Impacts
Type
article
Field-Weighted Citation Impact
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article

Strengthening systems to monitor antibiotics. An action oriented approach

Kaunda Yamba, Pascale Ondoa, D. G. Joakim Larsson, Alejandro García et al.
Wellcome Open Research
Pharmaceutical and Antibiotic Environmental Impacts
article

Strengthening systems to monitor antibiotics. An action oriented approach

Kaunda Yamba, Pascale Ondoa, D. G. Joakim Larsson, Alejandro García, Jennifer Bonnah, Jennifer Hegewisch-Taylor, Walter L. Fuller, Clare Chandler, Henson Kainga, Olafur Valsson, Javiera Cornejo, Collins Mitambo, Nada Hanna, Mike Sharland, Anahí Dreser, Morgan Jeannin, Nyambura Moremi, Bronwen Holloway, Marie Verhaegen, Freddy Eric Kitutu, Shaffi Fazaludeen Koya, Sharon Odeo, S. M. Sabrina Yesmin, Aitziber Echeverría, Angkana Lekagul, Joseph Nkhoma, Elizabeth Tayler, Amit Khurana, Ana L. P. Mateus, Renata Tigulini de Souza Bogo, Jane Lwoyero, Sophie Masika, David Verner-Jeffreys, Mary Nkansa, Dishon Muloi, Janet Midega, Mwapu Ndahi, Susanna Sternberg-Lewerin, Stanley Fenwick, Jyoti Joshi, Sabiha Y. Essack, J Scott Weese
article en

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 antimicrobial resistance (AMR). Tools to monitor use closer to end-user level were less standardised and often more complex. Proposed steps for establishing national antibiotic monitoring systems include starting where the greatest impact can be anticipated in a given context and alignment with other programmes. Conclusions The agricultural, population, epidemiological, cultural and economic contexts of different countries mean different starting points for establishing antibiotic monitoring. This project characterised an action-oriented prioritisation approach, targeting collection and collation of antibiotic data that have the highest likelihood of affecting change that can achieve impact. Such an approach is risk-based, prioritising monitoring of the antibiotic use that poses greatest risks as locally defined and is feasible to change; sustainable, aligning local expertise, infrastructure and technology with other country priorities; and transparent, ensuring evidence availability within the system alongside reporting ‘up and out.’ Effective national antibiotic monitoring systems require a collaborative and coordinated strategy focusing on data for action.

Wellcome Open ResearchVol. 11
Uppsala University (SE), Mott MacDonald (United Kingdom) (GB), Food and Agriculture Organization of the United Nations (IT), Global Fund to Fight AIDS, Tuberculosis and Malaria (CH), St George's, University of London (GB), United Nations Environment Programme (KE), Ministry of Livestock and Fisheries (TZ), Gulf States Marine Fisheries Commission (US), Federal Ministry of Agriculture and Rural Development (NG), Wellcome Trust Centre for the History of Medicine (GB), Swedish University of Agricultural Sciences (SE), London School of Hygiene & Tropical Medicine (GB), Lilongwe University of Agriculture and Natural Resources (MW), World Health Organization Regional Office for the Eastern Mediterranean (EG), National Institute of Public Health (SI), Ministério da Saúde (BR), National Public Health Laboratory (NP), Ministry of Health (MW), CNR de la Résistance aux Antibiotiques (FR), World Health Organization Regional Office for Africa (CG), Food and Drug Administration (TH), Directorate General of Health Services (BD), University of Africa (ZM), Interdisciplinary Center for Aquaculture Research (CL), Food and Drugs Authority (GH), International Centre for Antimicrobial Resistance Solutions (DK), Federal Ministry of Livestock Development (NG), University College London (GB), International Livestock Research Institute (KE), Makerere University (UG), WorldFish (MY), Centre for Science and Environment (IN), University of Guelph (CA), Wellcome Trust (GB), University of Gothenburg (SE), Organisation Mondiale de la Santé Animale (FR), University of KwaZulu-Natal (ZA)
Openalex Percentile: Top 23%
Pharmaceutical and Antibiotic Environmental Impacts
DOIOpen Access PDFOpenAlex
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