Scoping review shows WHO Access antibiotic susceptibility remains low in Pakistan clinical isolates
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Key Takeaway
Note that WHO Access antibiotic susceptibility remains low in Pakistan clinical isolates.
This scoping review synthesizes evidence from 74 studies conducted in Pakistan regarding human clinical isolates. The scope focuses on the susceptibility of WHO Access antibiotics, specifically aminoglycosides, beta lactams, and cephalosporins. The authors examine trends in antimicrobial resistance patterns within this specific setting without reporting adverse events or tolerability data.
The main synthesized finding indicates that susceptibility of WHO Access antibiotics remained low across major pathogens. However, the review notes notable declines in susceptibility for S. aureus and Pseudomonas spp. In contrast, susceptibility of E. coli showed variable results across the included studies. No specific effect sizes, absolute numbers, or p-values were reported for these outcomes.
The authors highlight that safety data, including adverse events and discontinuations, were not reported in the source materials. Funding or conflicts of interest were also not reported. The review acknowledges that strengthening surveillance programs is essential to curb antimicrobial resistance and align national efforts with global antibiotic use targets. This practice relevance underscores the need for continued monitoring rather than immediate clinical guideline changes based on this synthesis alone.
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View Original Abstract ↓
BackgroundAntimicrobial resistance (AMR) poses a major public health challenge in Pakistan due to irrational antibiotic use and weak surveillance. The WHO AWaRe framework and United Nations General Assembly (UNGA) declaration urge a 70% global use of Access antibiotics. This scoping review aims to assess whether current susceptibility patterns in Pakistan (2020–2024) support achieving or maintaining the 70% Access target.MethodsA PRISMA-ScR–based scoping review identified 2020–2024 studies reporting susceptibility of WHO Access antibiotics in Pakistan. Eligible studies included human clinical isolates tested by standardized antimicrobial susceptibility methods. Weighted pathogen-antibiotic-year-wise susceptibilities were analyzed, along with pathogen-and WHO ATC (anatomical therapeutic chemical classification) class–wise temporal trends.ResultsA total of 74 studies published between 2020 and 2024 were included. Most studies were conducted in Punjab. Overall, the susceptibility of WHO Access antibiotics remained low across major pathogens. S. aureus and Pseudomonas spp showed notable declines, while E. coli has shown variable susceptibility. Among WHO ATC classes, aminoglycosides, beta lactams, and cephalosporins demonstrated low susceptibility.ConclusionThis scoping review revealed that persistently low susceptibility to Access antibiotics in Pakistan challenges the feasibility of the WHO's 70% utilization target. Strengthening surveillance programs is essential to curb AMR and align national efforts with global antibiotic use targets.
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