Metrics and Methods for Assessing Antibiotic Use

This project addresses how best to measure antibiotic use in humans, agriculture and aquaculture 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.

In Phase I of the work, in 2017, the AMR Centre research team 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. In November 2017 we brought 38 researchers, health and policy professionals together in London for a roundtable to discuss these issues 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. This unique opportunity for discussing these methodological issues with other experts from different sectoral and disciplinary backgrounds was productive, leading to a series of recommended next steps. Read the workshop report here.

In Phase II of the work, in 2018, the AMR Centre at LSHTM collaborated with ILRI and SLU to run a workshop in Entebbe to bring together researchers with experience on the ground of carrying out surveys of antibiotic use in animals. Read the workshop report here.

Ultimately, the ambition of this work has been to provide country partners 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 over time as well as across settings and countries.

Project Duration: 2017 – 2019
LSHTM lead investigator: Catherine Goodman
LSHTM staff: Kevin Queenan, Clare Chandler, Matthew Hennesse
Funding: Improving Human Health (IHH) flagship project of the CGIAR Research Program on Agriculture for Nutrition and Health Program
Collaborators: RVC, ILRI