Global variation in Antibiotic Prescribing Guidelines and the implications for decreasing AMR in the future

This study evaluates antibiotic prescribing guidelines, particularly among low- and middle-income countries (LMICs), to improve antibiotic use quality and reduce antimicrobial resistance (AMR). 181 guidelines were included, with the majority originating from high-income countries. The GRADE methodology was used in only 20.4% of the guidelines. Patient education was often underemphasized, particularly in LMICs. The findings highlight significant disparities in guideline development, adaptation, and implementation across different WHO regions. Advancing the development and implementation of standardized, context-specific guidelines aligned with the WHO AWaRe framework and supported by equity-focused reforms can strengthen antimicrobial stewardship and address AMR’s public health challenge.