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Can Pakistan achieve the UNGA 70% antibiotic access target? A scoping review of susceptibility data

Fiza Benish1, Zikria Saleem2, Shairyar Afzal3

  • 1Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Punjab, Pakistan.

Frontiers in Public Health
|May 18, 2026
PubMed
Abstract

Insights

Antimicrobial resistance in Pakistan shows low susceptibility to Access antibiotics, challenging global targets. Enhanced surveillance is crucial for effective antibiotic use and combating resistance.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Pharmacology

Background:

  • Antimicrobial resistance (AMR) is a significant public health threat in Pakistan, exacerbated by inappropriate antibiotic consumption and insufficient monitoring.
  • The World Health Organization (WHO) AWaRe framework and the United Nations General Assembly (UNGA) advocate for a 70% global utilization rate of Access antibiotics.
  • Assessing current antibiotic susceptibility patterns in Pakistan is vital to determine the feasibility of meeting the WHO's Access antibiotic target.

Purpose of the Study:

  • To evaluate if Pakistan's antibiotic susceptibility patterns between 2020 and 2024 align with the WHO's goal of 70% Access antibiotic utilization.
  • To identify trends in pathogen susceptibility to WHO Access antibiotics within Pakistan.

Main Methods:

  • A scoping review following the PRISMA-ScR guidelines was conducted, analyzing studies from 2020-2024 on Access antibiotic susceptibility in Pakistan.
  • Included studies focused on human clinical isolates tested using standardized antimicrobial susceptibility methods.
  • Data were analyzed for weighted pathogen-antibiotic-year susceptibilities and temporal trends by pathogen and WHO Anatomical Therapeutic Chemical (ATC) class.

Main Results:

  • Seventy-four studies from 2020-2024, primarily from Punjab, were included in the review.
  • Overall susceptibility to WHO Access antibiotics remained low for major pathogens, with declining susceptibility observed for *S. aureus* and *Pseudomonas* spp.
  • *E. coli* exhibited variable susceptibility, and low susceptibility rates were noted for aminoglycosides, beta-lactams, and cephalosporins (WHO ATC classes).

Conclusions:

  • Low susceptibility to Access antibiotics in Pakistan hinders the achievement of the WHO's 70% utilization target.
  • Strengthening national AMR surveillance programs is imperative to combat resistance and align with global antibiotic stewardship goals.
Keywords:
WHO AWaRe antibioticsaccess antibioticsantibiotic agentantibiotic resistanceantibioticsantimicrobial resistanceantimicrobial susceptibility

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