{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T18:23:25Z","timestamp":1789151005256,"version":"build-2803163510"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T00:00:00Z","timestamp":1662422400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Antimicrobial resistance (AMR) is one of the biggest threats to global public health. Selection of resistant bacteria is driven by inappropriate use of antibiotics, amongst other factors. COVID-19 may have exacerbated AMR due to unnecessary antibiotic prescribing. Country-level knowledge is needed to understand options for action.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To review the current situation with respect to AMR in Pakistan and initiatives addressing it. Identifying areas where more information is required will provide a call to action to minimize any further rises in AMR and improve patient outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>National AMR initiatives, antibiotic use and prescribing in Pakistan, and availability of susceptibility data, in particular for the key community-acquired respiratory tract infection (CA-RTI) pathogens (Streptococcus pneumoniae and Haemophilus influenzae) were identified. National and international antibiotic prescribing guidelines for specific CA-RTIs (community-acquired pneumonia, acute otitis media and acute bacterial rhinosinusitis) commonly used locally were also reviewed, plus local antibiotic availability. Insights from a local clinician and clinical microbiologist were sought to contextualize this information.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pakistan is active in developing initiatives to address AMR such as compiling a National Action Plan. However, antibiotic consumption is high and although there is legislation in place prohibiting over-the-counter purchase of antibiotics, this is still possible. Healthcare professionals use local and international antibiotic prescribing guidelines for CA-RTIs when managing patients. As highlighted by the clinical microbiologist\u2019s expert comments, surveillance of AMR in locally prevalent microorganisms is lacking. A more standardized inclusive approach in developing local guidelines, using up-to-date local surveillance data of isolates from community-acquired infections, could make management guideline use more locally relevant for clinicians. This would pave the way for a higher level of appropriate antibiotic prescribing and improved adherence. This would, in turn, potentially limit AMR development and improve clinical outcomes for patients.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jac\/dkac213","type":"journal-article","created":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T08:08:23Z","timestamp":1662451703000},"page":"i18-i25","source":"Crossref","is-referenced-by-count":20,"title":["Country data on AMR in Pakistan in the context of community-acquired respiratory tract infections: links between antibiotic susceptibility, local and international antibiotic prescribing guidelines, access to medicine and clinical outcome"],"prefix":"10.1093","volume":"77","author":[{"given":"Didem","family":"Torumkuney","sequence":"first","affiliation":[{"name":"GlaxoSmithKline , 980 Great West Road, Brentford, Middlesex TW8 9GS , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bushra","family":"Jamil","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Infectious Diseases, The Aga Khan University Hospital , Karachi , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Summiya","family":"Nizamuddin","sequence":"additional","affiliation":[{"name":"Shaukat Khanum Memorial Cancer Hospital and Research Centre, Section of Microbiology, Department of Pathology , 7A Block R3, Johar Town, Lahore , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"van Hasselt","sequence":"additional","affiliation":[{"name":"GlaxoSmithKline, The Campus, Flushing Meadows , 57 Sloane Street, Bryanston, Gauteng, 2021 , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uzma","family":"Pirzada","sequence":"additional","affiliation":[{"name":"GlaxoSmithKline , 35 Dockyard Road, West Wharf, Karachi 74000 , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rendani","family":"Manenzhe","sequence":"additional","affiliation":[{"name":"GlaxoSmithKline, The Campus, Flushing Meadows , 57 Sloane 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