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Open research questions in Antibiotic Use and Resistance

1,041 gap statements mined from Antibiotic Use and Resistance papers in our 7.9M-paper local library, which holds 3,730 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • Therefore, while the impact of MeMed BV on overall antibiotic prescribing and downstream antimicrobial stewardship outcomes remains uncertain, the absence of statistical significance should not be interpreted as a lack of effect.

    Diagnostic Performance of the MeMed BV Test to Distinguish Between Bacterial and Viral or Other Non-Bacterial Causes Amongst ED and Urgent Care Patients: A Systematic Review with Meta-Analysis · 2026 · DOI

  • The findings provide preliminary insights into AMS within an under-researched setting and may help inform future research and intervention development.

    Exploring Healthcare Workers’ Knowledge, Attitudes and Behaviors to Antibiotic Use, Including in Acne, and Antibiotic Resistance in English Correctional Facilities in 2024 · 2026 · DOI

  • There was a lack of a formal sampling frame. The study had to adapt to operational challenges associated with data collection.

    Implications of self-medication among socially vulnerable older adults in the COVID-19 era (2021–2023) · 2026 · DOI

  • For CEF, paediatric evidence remains limited and is mainly based on pharmacokinetic studies and off-label case reports rather than controlled efficacy trials.

    Reserve antibiotics in paediatrics: single-centre clinical experience and antimicrobial stewardship implementation · 2026 · DOI

  • Alongside this, to date, evidence-based quality indicators have not been systematically developed and used for PHCs in LMIC settings, resulting in gaps in understanding the quality of antibiotic prescribing to facilitate tailored AMS interventions in primary care.

    Development of AWaRe-Based Quality Indicators to Assess the Appropriateness of Antibiotic Prescribing in Primary Healthcare in South Africa · 2026 · DOI

  • A major limitation across included studies is the substantial variation in surveillance quality and data availability between regions. While DDD is widely used for benchmarking antimicrobial use, it does not account for patient-level factors such as age, weight, renal function, or disease severity.

    Antimicrobial Consumption and Resistance Dynamics Across Healthcare Level: Global Evidence and Stewardship Implications · 2026 · DOI

  • Future efforts to control antimicrobial resistance (AMR) should focus on evidence-informed, precision stewardship strategies that build on the patterns of antimicrobial use and resistance identified in this review.

    Antimicrobial Consumption and Resistance Dynamics Across Healthcare Level: Global Evidence and Stewardship Implications · 2026 · DOI

  • A further limitation of this study is the absence of data regarding the specific clinical indications for the cefoperazone-sulbactam prescription, as no data is collected regarding the diagnosis, aetiology of the infection treated or the medical specialty of the prescribing physicians.

    Evolution of cefoperazone-sulbactam consumption in Romania between 2011 and 2024 · 2026 · DOI

  • Additionally, there is also substantial digital fragmentation within social care and lack of data sharing between health and social care. Without similar integrated governance approaches more widely, there is a risk that data remain siloed, not used to maximize value, duplicate efforts, and poorly understood by the public.

    Extent of Digital Health Fragmentation and Potential Implications for Antimicrobial Prescribing: Rapid Evidence Review · 2026 · DOI

  • Although this limited evidence cannot be generalized quantitatively to all AI applications in AMR, it supports the need for local external validation, continuous performance monitoring, periodic recalibration, and predefined procedures for reviewing or suspending models whose performance becomes inadequate. The clinical meaning of the reported performance measures also remains uncertain.

    Artificial Intelligence in the Fight Against Antimicrobial Resistance: Applications in Diagnosis, Susceptibility Prediction, Precision Dosing, and Antibiotic Discovery · 2026 · DOI

  • Lastly, NAP and all stakeholders should encourage further research into the economic implications of AMR to inform policy decisions with emphasis on longitudinal studies, which could provide deeper insights into the long-term impacts on health systems and economies.

    Estimating Economic Costs Associated with Treating Antimicrobial-Resistant Infections in Humans in Malawi · 2026 · DOI

  • Continued multidisciplinary stewardship interventions, prospective audit and feedback, and monitoring of meropenem use are warranted to further optimize carbapenem prescribing in the ICU.

    The Impact of an Intensive Care Unit Antimicrobial Stewardship Program on the Appropriateness of Meropenem Prescribing at a Tertiary Hospital: A Retrospective Quasi-Experimental Study · 2026 · DOI

  • Future research should examine which changes in farm practice reduce antimicrobial use without increasing mortality or compromising fish welfare. If diagnostic access improves and treatments become more targeted, even moderate antimicrobial use may represent better stewardship than lower but poorly documented or poorly justified use.

    Antimicrobial Use in European Aquaculture and the Aquatic Environment: From Regulatory Transformation to Sustainable Disease Management · 2026 · DOI

  • The lack of a universal classification system for nonantibiotic antimicrobials. The potential for selective pressure on microbial communities and promotion of cross-resistance and co-selection with antibiotics.

    Neglected but Not Harmless: Characterising Nonantibiotic Antimicrobial Use in Small Animal Practices in Colombia · 2026 · DOI

  • Unlike in inpatient settings, in pediatric outpatient settings—where most antibiotic prescriptions occur [123]—stewardship efforts face additional challenges due to limited resources, lack of structured frameworks, and insufficient organizational support. As a result, interventions are often guideline-based, while more comprehensive strategies are rarely implemented.

    State of the Art of Antimicrobial and Diagnostic Stewardship in Pediatric Setting · 2025 · DOI

  • Kyrgyzstan tracks antibiotic consumption via import and sales records, Tajikistan relies on import and certification records, Russia uses only sales records, and the data source for Kazakhstan remains unclear.

    Social Determinants of Health and Antibiotic Consumption · 2025 · DOI

  • Although data from similar studies conducted in LRS are scarce, a multicenter study from Iran, also an LRS, reported an average antibiotic consumption of 121.

    A Retrospective Study of the Impact of the COVID-19 Pandemic on the Utilization and Quality of Antibiotic Use in a Tertiary Care Teaching Hospital in Low-Resource Settings · 2025 · DOI

  • Pioneering studies in Bangladesh have already demonstrated its power, directly linking the high abundance of ARGs in urban waters to human sewage, providing unequivocal evidence for targeted public health interventions like improving WASH infrastructure.

    Operationalising Genomic Surveillance for Antimicrobial Resistance in Low- and Middle-Income Countries: A One Health Perspective from Bangladesh · 2026 · DOI

  • In LRI, this pattern was not limited to the regression estimates; the DASC-based metric more consistently tracked chart-adjudicated prescribing quality across multiple analyses.

    Novel antibiotic stewardship metrics and the quality of antibiotic prescribing for lower respiratory and urinary tract infection across 24 VA hospitals · 2026 · DOI

  • The inclusion of representatives from the productive sector, including professional associations, the pharmaceutical and pesticide industries, and academia within the committee structure has promoted an approach of shared responsibility in AMR containment.

    Agricultural governance to strengthen the multisectoral response to antimicrobial resistance: the experience of Bolivia · 2026 · DOI

  • No comprehensive bottom-up analysis has been conducted in Europe to precisely quantify the incremental economic burden of resistant infections. Prior studies have focused on top-down models, which may not capture the multifaceted consequences of antibiotic resistance.

    The inpatient economic burden of antibiotic resistance in Switzerland: a regression-based analysis · 2026 · DOI

  • The progressive improvement observed in the present study, particularly the larger increase in appropriateness during the second post-implementation year, is also consistent with the concept that stewardship effects may require sustained implementation, repeated feedback, and continued engagement with prescribers rather than being limited to the initial implementation period.

    The Impact of an Intensive Care Unit Antimicrobial Stewardship Program on the Appropriateness of Meropenem Prescribing at a Tertiary Hospital: A Retrospective Quasi-Experimental Study · 2026 · DOI

  • While there is a significant body of the literature regarding bundles and prevention of hospital-acquired infections in PICU, strategies to reduce antimicrobial consumption are widely under-reported.

    Antimicrobial Stewardship Programs in Pediatric Intensive Care Units: A Systematic Scoping Review · 2025 · DOI

  • Further studies should investigate the long-term effects of self-medication, - Research should focus on developing strategies to improve healthcare access for socially vulnerable populations, - Studies should examine the impact of misinformation on self-medication…

    Implications of self-medication among socially vulnerable older adults in the COVID-19 era (2021–2023) · 2026 · DOI

  • The study only examined data from a single university veterinary hospital, - The 'other small animal species' group was excluded from inferential tests due to its small sample size (n = 7), - The lack of a universal classification system for NAAs may limit the comparability…

    Neglected but Not Harmless: Characterising Nonantibiotic Antimicrobial Use in Small Animal Practices in Colombia · 2026 · DOI

Most-cited papers in Antibiotic Use and Resistance

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Open questions raised by papers listed on this page include: (1) While the impact of MeMed BV on overall antibiotic prescribing and downstream antimicrobial stewardship outcomes remains uncertain, the absence of statistical significance should not be interpreted as a lack of effect (“Diagnostic Performance of the MeMed BV Test to Distinguish Between Bacterial…”, 2026); (2) There is also substantial digital fragmentation within social care and lack of data sharing between health and social care (“Extent of Digital Health Fragmentation and Potential Implications for…”, 2026); (3) Continued multidisciplinary stewardship interventions, prospective audit and feedback, and monitoring of meropenem use are warranted to further optimize carbapenem prescribing in the ICU (“The Impact of an Intensive Care Unit Antimicrobial Stewardship Program on the…”, 2026); (4) Future research should examine which changes in farm practice reduce antimicrobial use without increasing mortality or compromising fish welfare (“Antimicrobial Use in European Aquaculture and the Aquatic Environment: From…”, 2026); (5) The lack of a universal classification system for nonantibiotic antimicrobials (“Neglected but Not Harmless: Characterising Nonantibiotic Antimicrobial Use in…”, 2026). 1,041 gap statements have been mined from Antibiotic Use and Resistance papers in our 7.9M-paper local library, which holds 3,730 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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