July 26, 2026
Overview:
Antibiotics save millions of lives, but using too many or the wrong ones can drive the development of antimicrobial resistance (AMR). To promote appropriate antibiotic use, the World Health Organization groups antibiotics into three categories under its Access, Watch, and Reserve (AWaRe) classification. Access antibiotics are the preferred first choice for treating common bacterial infections; Watch antibiotics should be used more cautiously because they are more likely to drive the emergence and spread of AMR; and Reserve antibiotics are last-resort treatments for severe infections caused by drug-resistant bacteria.
While the AWaRe system guides how antibiotics should be used, countries differ in their disease burden, levels of antibiotic resistance, and healthcare systems. In this study, OHT researchers and colleagues estimated the optimal use of AWaRe antibiotics in 186 countries, territories, and areas based on the burden of bacterial infections and AMR.
The Question:
How much of each type of antibiotic does each country need to treat infections effectively while avoiding unnecessary use that can drive AMR?
The Findings:
The researchers found that about three-quarters (77 percent) of the antibiotics needed worldwide should come from the Access group, which includes antibiotics recommended as the first choice for treating many common bacterial infections.
This supports the United Nations’ goal that at least 70 percent of antibiotic use should come from this group.
The researchers also found that many countries use too many broad-spectrum antibiotics, which are more likely to contribute to drug resistance, while some do not have enough access to essential first-choice antibiotics or last-resort antibiotics needed to treat highly resistant infections.
The findings provide practical, country-specific guidance that can help governments improve antibiotic use, preserve the effectiveness of antibiotics, and ensure patients receive the treatment they need.
Read the article in the Lancet Public Health here.
