Metrics and Methods for Assessing Antibiotic Use – Roundtable

In late November 2017, the AMR Centre hosted 38 researchers, health and policy professionals in London for a roundtable to discuss how best antibiotic use can be measured in a way that informs strategies to address antibiotic resistance both nationally and internationally. This is a major challenge across different settings given the variety of antibiotics in use, the variety of sources and supply chains for antibiotics, the large size of informal markets and the difficulty of knowing what is prescribed and what is finally used by an individual, and for how long. Even more challenging is how we might meaningfully measure and compare antibiotic use across human and livestock – which includes not only terrestrial farming but also aquaculture (fishery) use. This was exactly the issue put to the group of experts over two days. Representatives from public health, tropical medicine, veterinary medicine, development studies, civil society, and funders came together with focal points on AMR in key multi-national agencies – the Food and Agriculture Organisation, the World Organisation for Animal Health (OIE) as well as the World Health Organisation. Participants repeatedly expressed their enthusiasm for the opportunity to discuss these methodological issues with other experts from different sectoral and disciplinary backgrounds. The methodological issues raised are challenging, and the group outlined several steps forward for addressing these in the short term such that ultimately country partners can be provided with technical support to help them to identify the extent and distribution of use of different antibiotics across the settings in their countries, with the hope of comparable data across settings and countries.

In advance of the meeting, AMR Centre researchers Kevin Queenan, Clare Chandler and Catherine Goodman prepared a  rapid review of existing methods to collect granular data on antibiotic use data in low and middle income countries. The review revealed a number of important gaps in this literature, and in particular that very few protocols have been designed to generate volume metrics. Following-on from the review, the roundtable discussed objectives for usage data and suitable collection methods, and outlined a series of next steps.