Rational Use of Antibiotics

Antibiotics have revolutionised medicine by enabling effective treatment of infections and supporting advanced medical interventions, yet their benefits are increasingly threatened by irrational use. Irrational antibiotic use—comprising inappropriate prescribing, self-medication, incorrect dosing, unsupervised access, and agricultural misuse—has become a primary global driver of antimicrobial resistance (AMR). There are multifaceted determinants of irrational use across patients, prescribers, health systems, pharmaceutical markets, and the veterinary and environmental sectors. There are severe consequences of misuse, including treatment failures, increased morbidity and mortality, economic burden, and erosion of public trust in health systems. The World Health Organisation (WHO) has outlined comprehensive frameworks to promote rational use, including the Global Action Plan on AMR, the AWaRe classification of antibiotics, and facility-level antimicrobial stewardship programmes. Key strategies include enhanced surveillance, strengthened diagnostics, improved regulatory enforcement, education of prescribers and patients, and multisectoral collaboration through a One Health approach. Despite progress, significant challenges persist in raising awareness, enforcing regulations, ensuring access to diagnostics, and striking a balance between stewardship and equitable access to essential antibiotics. Several context-specific, programmatic solutions integrate governance, behavioural interventions, agricultural regulation, and research to safeguard antibiotic efficacy for future generations.