{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T03:28:37Z","timestamp":1792466917127,"version":"4.5.0"},"reference-count":69,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002383","name":"King Saud University","doi-asserted-by":"crossref","award":["ORF-2025-856"],"award-info":[{"award-number":["ORF-2025-856"]}],"id":[{"id":"10.13039\/501100002383","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: The escalating burden of antimicrobial resistance (AMR) poses a critical threat to public health in Pakistan, with rates of high antibiotic consumption and limited standardized surveillance on AMR rates. Our study aimed to carry out a multicentric surveillance of AMR to generate regional antibiograms for Northern Punjab, Pakistan, to guide empirical antimicrobial therapy and stewardship efforts. Methods: A laboratory-based, retrospective cross-sectional study was conducted over a six-month period across three tertiary care hospitals. Socio-demographic, clinical, and microbiological data (including specimen type and antibiotic prescription rates) were collected from N = 485 patients with confirmed bacterial infections. Antimicrobial susceptibility testing was performed based on Clinical Laboratory Standards Institute (CLSI) recommendations. Statistical analyses were carried out using SPSS v.22.0. Results: In our study setting, Gram-positive bacteria were common causes (60.0%) of infections, with Staphylococcus aureus (12.2%) and Streptococcus pneumoniae (10.3%) being the most relevant. Among Gram-negative bacteria (40.0%), Escherichia coli (14.0%) and Pseudomonas aeruginosa (5.8%) were shown to be important pathogens. Overall, 25.0% of S. aureus isolates were methicillin-resistant (MRSA), while ~30% of E. coli showed resistance to third-generation cephalosporins (3GCs). Enterobacterales species had highly variable susceptibility rates (40\u201370%) for fluoroquinolones. Meropenem and vancomycin\/linezolid retained high efficacy (&gt;90%) against most Gram-negative and Gram-positive isolates, respectively. In all healthcare settings studied, ceftriaxone was the most frequently prescribed antibiotic. Conclusions: High levels of resistance against first-line antibiotics were noted in our setting of Northern Punjab, Pakistan, underscoring the critical need for robust antimicrobial stewardship programs, tailored to local institutional contexts, capabilities, and needs. The regional antibiogram developed based on our data may provide vital evidence for informing local empirical treatment guidelines, which need to be continuously updated.<\/jats:p>","DOI":"10.3390\/antibiotics14111154","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T10:07:03Z","timestamp":1763114823000},"page":"1154","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Multicentric Surveillance of Antimicrobial Resistance to Generate Data-Driven Regional Antibiograms: A Laboratory-Based Cross-Sectional Study in Pakistan"],"prefix":"10.3390","volume":"14","author":[{"given":"Nadia","family":"Noreen","sequence":"first","affiliation":[{"name":"Department of Pharmacy, University of Lahore, Lahore 54792, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3436-1467","authenticated-orcid":false,"given":"Adeel","family":"Aslam","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy and Biomedical Sciences, Mahsa University, Jenjarom 42610, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4605-5501","authenticated-orcid":false,"given":"Mateen","family":"Abbas","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Capital University of Science and Technology (CUST), Islamabad 44000, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6374-3506","authenticated-orcid":false,"given":"Asma","family":"Ghulam Mustafa","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Lahore, Lahore 54792, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0773-0463","authenticated-orcid":false,"given":"Shazia","family":"Jamshed","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, School of Pharmacy, IMU (International Medical University), Kuala Lumpur 57000, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1270-0365","authenticated-orcid":false,"given":"M\u00e1ri\u00f3","family":"Gajd\u00e1cs","sequence":"additional","affiliation":[{"name":"Department of Public Health, Albert Szent-Gy\u00f6rgyi Faculty of Medicine, University of Szeged, 6720 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7282-471X","authenticated-orcid":false,"given":"Ayesha","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Policy, University Park Campus, University of Nottingham, Nottingham NG72RD, UK"},{"name":"Office of Lifelong Learning and the Physician Learning Program, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G1C9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4077-4524","authenticated-orcid":false,"given":"Wajid","family":"Syed","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3825-2812","authenticated-orcid":false,"given":"Adel","family":"Bashatah","sequence":"additional","affiliation":[{"name":"Department of Nursing Administration and Education, College of Nursing, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9189-3841","authenticated-orcid":false,"given":"Naji","family":"Alqahtani","sequence":"additional","affiliation":[{"name":"Department of Nursing Administration and Education, College of Nursing, King Saud University, Riyadh 11451, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Salam, M.A., Al-Amin, M.Y., Salam, M.T., Pawar, J.S., Akhter, N., Rabaan, A.A., and Alqumber, M.A.A. 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