Abstract

Considerable concerns with AMR across Africa, enhanced by inappropriate prescribing of antibiotics in ambulatory care. This includes prescribing for self-limiting conditions and Watch antibiotics. Inappropriate prescribing is enhanced by concerns with ambulatory care prescribers’ knowledge of antibiotics including their perceived effectiveness for self-limiting conditions, AMR and ASPs. Appropriate education of prescribers, including surrounding the AWaRe system and guidance, which recommends the prescribing of antibiotics with less resistance potential, alongside introducing ASPs in ambulatory care, can help address concerns. This will increasingly include instigating agreed quality indicators, and their monitoring, surrounding the AWaRe system and guidance. Improved surveillance of local resistance patterns can help with appropriately updating antibiotics prescribing guidance, including revising AWaRe guidance based on local patterns. Additional financing is needed to attain national goals