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In the MEASURE focus area of the Toolbox you find guidance on how to generate data on the various aspects of antibiotic resistance in humans and animals. Having accurate data is crucial to assess the antibiotic resistance situation and to determine the impact of interventions.

The MEASURE focus area covers the following categories:

  • Burden of antibiotic resistance
  • Antibiotic resistance
  • Consumption of antibiotics
  • Appropriate use of antibiotics
  • Infections
  • Quality of antibiotics
  • Knowledge, attitudes, beliefs and practices (KABP)

Examples from the field describe initiatives that have undertaken activities to measure antibiotic resistance or related aspects.

The narrative text is accompanied by “Selected resources” of hands-on materials that may be used directly or adapted to your particular setting. Browse through then pick and choose what material is most helpful for you!

Why measure?

Action and investment on the evolving problem of antibiotic resistance should be supported by evidence of benefit and cost-effectiveness. Information about resistance levels, antibiotic consumption, health care-associated infections, the quality of antibiotics, and social-behavioral factors are aspects that can be measured to provide insight to the current situation and inform stakeholders in work to develop strategies, action plans, medical and veterinary treatment decisions and interventions. Data can also be used to evaluate interventions or be fed into the development of standard treatment guidelines and essential drug lists.

How to measure antibiotic resistance

The capacity to measure factors of importance for antibiotic resistance varies between countries and regions and is dependent on available resources, the infrastructure of the health care and animal health system, coordination and trained personnel. Although there is unfortunately often limited data available, it is always good to start by checking what information currently exists. In the next step, new data can be generated, even on a small scale.

Conducting point prevalence surveys is a good way to get started and can be a useful tool to quickly assess the current situation. KABP surveys allow to get important insights into antibiotic consumption patterns and occurrence of antibiotic resistance drivers. Over time efforts can be scaled up and eventually act as inputs to monitoring and surveillance.

Using data to inform policy action: a situation analysis in Kenya:

The Global Antibiotic Resistance Partnership (GARP) working group in Kenya conducted a situation analysis on antibiotic consumption and resistance in Kenya in 2011. A desktop review was conducted on the health and economic context, burden of disease, antibiotic resistance, antibiotic consumption and supply chain, government policies and the regulatory environment.

The information was used to develop recommendations for policy action on surveillance and monitoring, training and education, vaccination, quality control, supply chain improvements and veterinary use of antibiotics. GARP has performed similar situational analyses in several countries, see Antibiotic resistance – human, for more information.

Global Antibiotic Resistance Partnership-Kenya Working Group. Situation Analysis and recommendations: Antibiotic use and Resistance in Kenya [Internet]. Washington, DC and New Delhi: Center for Disease Dynamics,  Economics & Policy; 2011 [cited 2014 Aug 21]. Available from: