Open research questions in Antibiotic Use and Resistance
246 unresolved questions extracted from the limitations and future-work sections of 913 Antibiotic Use and Resistance papers in our library. Each links back to the study that raised it.
What the literature leaves open
development of a framework to move from retrospective AMR prediction toward validated, interpretable, and actionable surveillance intelligence, - investigation of machine learning for AMR surveillance intelligence across One Health, - evaluation of the effectiveness of machine learning in real-time surveillance systems
From surveillance to intelligence: a scoping review of machine learning for antimicrobial resistance surveillance intelligence across One Health · 2026 · DOIPrior reviews have largely treated machine learning for AMR as a prediction task, - existing syntheses have summarised model families and reported performance for resistance prediction, but have not addressed actionable surveillance intelligence, - there is a need for a framework to distinguish technical prediction from actionable surveillance intelligence.
From surveillance to intelligence: a scoping review of machine learning for antimicrobial resistance surveillance intelligence across One Health · 2026 · DOIThe paper identifies the challenge of implementing antimicrobial stewardship interventions in routine clinical practice. It also mentions the challenge of addressing the human factors that influence antimicrobial use. Another challenge is the need for standardized outcome measures and stronger One Health collaboration.
Interventions to Reduce Antibiotic Prescribing in Small Animal Veterinary Practice: Evidence and Clinical Impact · 2026 · DOICurrent studies differ in methodology, - Often have short follow-up periods, - Include limited data from routine primary veterinary practices, - Rarely demonstrate a direct reduction in antimicrobial resistance
Interventions to Reduce Antibiotic Prescribing in Small Animal Veterinary Practice: Evidence and Clinical Impact · 2026 · DOIPersistent gaps in adherence to evidence-based prescribing guidelines. Reducing unnecessary antibiotic prescribing in dental emergency settings. Limited generalizability due to the study being conducted in a single academic centre.
Appropriateness of antibiotic prescribing in dental practice: results of two clinical audits conducted at a university hospital · 2026 · DOIThe need to evaluate the impact of azithromycin MDA on antibiotic resistance. The lack of understanding of the selection of macrolide resistance determinants in the gut and nasopharynx.
Mass azithromycin distribution and antibiotic resistance in the gut and nasopharynx: a cluster-randomized trial · 2026 · DOIGuidelines that lacked detailed prescribing information were excluded, - Documents not published in English were excluded, - The study only included readily available published material
Global variation in antibiotic prescribing guidelines and the implications for decreasing AMR in the future · 2025 · DOIFurther research is needed to address the challenges of AMR, - Studies should investigate the effectiveness of different implementation strategies, - Research should focus on improving patient education and counseling in LMICs
Global variation in antibiotic prescribing guidelines and the implications for decreasing AMR in the future · 2025 · DOIOur findings also highlighted gaps in knowledge regarding the appropriate mask use for tuberculosis prevention and antibiotic selection for specific pathogens, consistent with other studies.
Inappropriate antibiotic prescribing in dental emergency settings. Lack of improvement in prescribing practices despite clinical guidelines.
Appropriateness of antibiotic prescribing in dental practice: results of two clinical audits conducted at a university hospital · 2026 · DOIIt remains unclear whether antibiotic treatment reduces subsequent health care use or work absence.
Antibiotic treatment for acute sinusitis and subsequent health care use and work absence: a nationwide registry study from Norway · 2026 · DOIRecognized in some countries, this practice is poorly documented and not recommended in France.
Deferred prescribing in practice: an observational study in community pharmacies in France during 2024–5 and feedback from pharmacists · 2026 · DOIDiscussion: The inconsistent results indicate a great need for education on the use of prophylactically prescribed ABD.
A Survey of German Dentists on the Prophylactic Use of Antibacterial Drugs in Patients in Risk Groups: Diabetes, Joint Replacement, Risk of Endocarditis, and Immunosuppression or Organ Transplantation · 2026 · DOIAntimicrobial resistance (AMR) poses a major global health threat, yet the effectiveness of national action plans (NAPs) remains uncertain.
Evaluation of antimicrobial resistance governance across 193 countries to inform the 2026 Global Action Plan update · 2026 · DOIConclusion: Knowledge of antibiotic use and AMR is moderate, but there are gaps in knowledge, awareness, and understanding of AMR terminology, and antibiotic-use practices.
Health Literacy, Antibiotic Use Behaviors, and Awareness of Antimicrobial Resistance Among Patients in Karachi, Pakistan · 2026 · DOIThe extent of antibiotic overuse in hospitalized children with community-onset viral LRTIs has not been described in recent years.
Antibiotic overuse in a contemporary cohort of children hospitalized with influenza, RSV, or SARS-CoV-2: a retrospective cohort study · 2025 · DOIDespite its significance, only a few studies have delved into parental perspectives.
Parental knowledge, attitude, and practice on self-medication of antibiotics for children in bandung, indonesia: a questionnaire-based survey and module-based learning intervention · 2025 · DOIHowever, surveillance data on antimicrobial susceptibility profiles of pathogens remains scarce in Malawi.
Trends and patterns of antimicrobial resistance among common pathogens isolated from adult bloodstream and urinary tract infections in public health facilities in Malawi, 2020–2024 · 2025 · DOIDespite its significance, data on the effects of seasonal variations, demographics, and healthcare settings on AMR in Pakistan are scarce.
Seasonal and hospital settings variations in antimicrobial resistance among clinical isolates from cardiac patients: insights from a 7-Year study · 2025 · DOIFuture research should examine the implementation of Artificial Intelligence, Machine Learning, and AI-CDSS over a more extended period to understand its long-term effects on professional practices and organizational structures.
The impact of artificial intelligence on the prescribing, selection, resistance, and stewardship of antimicrobials: a scoping review · 2025 · DOIBACKGROUND: After the coronavirus disease 2019 (COVID-19) pandemic, no studies on bacterial and atypical pathogens were conducted in primary care.
A new pathogen pattern of acute respiratory tract infections in primary care after COVID-19 pandemic: a multi-center study in southern China · 2025 · DOIEthiopia is a country with a high burden of acute RTIs, and the pattern of antibiotic prescribing has not been thoroughly studied.
Antibiotic prescribing for outpatients with respiratory tract infections in public and private clinics of a resource-constrained setting, northern Ethiopia: a cross-sectional study · 2025 · DOICONCLUSION: The existing evidence based on adaptation and implementation of AMSP is sparse.
Antimicrobial stewardship programs in primary and secondary care settings in India: current challenges, facilitators, perceptions, and impact – a scoping review · 2025 · DOIBACKGROUND: Antibiotics are frequently prescribed for acute upper respiratory infections (URIs) despite limited evidence of their effectiveness, particularly in older individuals.
Association between antibiotic prescriptions for acute upper respiratory infections and pneumonia among older adults: a nationwide cohort study · 2025 · DOIThe analysis showed a lack of guidelines or toolkits for appropriate antibiotic prescribing in dentistry in India.
Dental antibiotic policies, stewardship, and implementation in India: A policy document analysis · 2024 · DOI
Most-cited papers in Antibiotic Use and Resistance
- Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis · The Lancet · 2022 · 13,367 citations
- Outpatient antibiotic use in Europe and association with resistance: a cross-national database study · The Lancet · 2005 · 5,127 citations
- Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050 · The Lancet · 2024 · 2,930 citations
- Antibiotic resistance is ancient · Nature · 2011 · 2,344 citations
- Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis · The Lancet · 2010 · 1,926 citations
- Global mortality associated with 33 bacterial pathogens in 2019: a systematic analysis for the Global Burden of Disease Study 2019 · The Lancet · 2022 · 1,853 citations
- Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011 · JAMA · 2016 · 1,552 citations
- Access to effective antimicrobials: a worldwide challenge · The Lancet · 2015 · 1,183 citations
- Antimicrobial resistance: Impacts, challenges, and future prospects · Journal of Medicine Surgery and Public Health · 2024 · 1,028 citations
- Risk factors for hospital-acquired candidemia. A matched case-control study · Archives of Internal Medicine · 1989 · 520 citations
Most recent work
- Evaluation of antimicrobial resistance governance across 193 countries to inform the 2026 Global Action Plan update · Nature Medicine · 2026
- Confronting antimicrobial resistance in Jordan: regulatory, economic, and behavioral determinants of non-prescription antibiotic dispensing in community pharmacies—a mixed-methods study · Frontiers in Medicine · 2026
- Effects of a comprehensive antibiotic stewardship program on antibiotic prescribing for acute respiratory infections in rural facilities: a cluster randomized trial · Nature Medicine · 2026
- Self-medication among older adults in rural India: structural gaps in primary care and pain management · BMC Health Services Research · 2026
- Reducing Over-the-Counter Sale of Antibiotics in Low- and Middle- Income Countries: A Randomized Controlled Trial · Economic Development and Cultural Change · 2026
- Enhancing clinical utility of AI-based antimicrobial resistance models: a perspective · mBio · 2026
- Global randomised controlled trials in infection prevention and control: a bibliographic review from the past two decades · Journal of Hospital Infection · 2026
- A point prevalence survey on antibiotic dispensing practices identifies targets for quality improvement of antimicrobial stewardship in community pharmacies in Dar es Salaam, Tanzania · Journal of Pharmaceutical Policy and Practice · 2026
- Estimating optimal levels of WHO Access, Watch, Reserve (AWaRe) antibiotic use in 186 countries, territories, and areas on the basis of clinical infection and resistance burden · The Lancet Public Health · 2026
- Antibiotic Prescribing in Dental Practice: A Cross-sectional Survey in Trinidad and Tobago · International Dental Journal · 2026
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