Status and implications of the knowledge, attitudes and practices towards AWaRe antibiotic use, resistance and stewardship among low- and middle-income countries

Antimicrobial resistance (AMR) is increasing globally, especially in low- and middle-income countries (LMICs). This is driven by inappropriate prescribing and dispensing of antibiotics, particularly Watch antibiotics. A review of 459 papers from 2018 to 2024 found that high rates of prescribing antibiotics for viral infections despite professed knowledge of antibiotics and AMR were prevalent. Patients’ beliefs about the effectiveness of antibiotics for self-limiting infectious diseases were a major challenge. The development of the AWaRe system presents opportunities for standardization of educational input and practical training programs.