{
  "abstract": "There are major concerns regarding the risk of antimicrobial resistance evoked through the inappropriate use of antibiotics. The WHO AWaRe classification has identified antibiotics that have high resistance potential. This cohort study utilized data from seven UK databases, including two community care databases and five hospital databases. The study period was from 2012 to 2025, or from the start of electronic prescription data. Longitudinal trends in Watch antibiotic use and patient demographic information were summarized. Data-driven large-scale characterization was used to identify conditions of interest, and prior use of Access and other Watch antibiotics was summarized. The study included 433 368 hospital and 11 705 843 primary care records of Watch antibiotic use. Quarterly crude incidence rates showed seasonal variation in community prescribing, with rates generally higher in the third and fourth quarters. Although use in community care increased during the COVID-19 pandemic, it remained below prepandemic levels. Most community users were female, while most hospital users were male. Hospital users had more severe conditions, including healthcare-associated infections and sepsis, while community care users were more commonly treated for skin and respiratory tract infections. Prior Access antibiotic use was generally recorded in fewer than 50% of patients. Prior Access of Watch antibiotic use was minimal in community care. Our results highlight the complexity of antibiotic use across different healthcare settings. Regional and demographic variation indicates areas where prescribing practices could be refined. Ongoing surveillance and targeted stewardship interventions are essential to promote appropriate use and prevent resistance.",
  "abstract_shown": true,
  "affiliations": [
    "Health Data Sciences (HDS), Translational Sciences, Botnar Research Centre, University of Oxford, Oxford, United Kingdom.",
    "Bone and Joint Health, Queen Mary University of London, London, United Kingdom.",
    "Barts Health NHS Trust, NHS Trust, London, United Kingdom.",
    "Barts Life Sciences, Queen Mary University of London, London, United Kingdom.",
    "NIHR University College London Hospitals Biomedical Research Centre, London, United Kingdom.",
    "Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom.",
    "Lancashire Teaching Hospitals, NHS Foundation Trust, Preston, United Kingdom.",
    "Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom.",
    "DataLoch, NHS Lothian, Edinburgh, United Kingdom.",
    "Clinical Practice Research Datalink (CPRD), Medicines and Healthcare products Regulatory Agency (MHRA), London, United Kingdom.",
    "Leeds Teaching Hospitals, NHS Trust, Leeds, United Kingdom.",
    "Leeds Institute of Medical Research, University of Leeds, Leeds, United Kingdom.",
    "Department of Medical Informatics, Erasmus MC University, Rotterdam, The Netherlands."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 31,
  "authors": [
    {
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        0
      ],
      "name": "Elin J Rowlands"
    },
    {
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        0
      ],
      "name": "Cecilia Campanile"
    },
    {
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        1,
        2,
        3
      ],
      "name": "Hiba Junaid"
    },
    {
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        1,
        2
      ],
      "name": "Jennifer C E Lane"
    },
    {
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        1,
        2
      ],
      "name": "Usama Rahman"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Ben Eaton"
    },
    {
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        1,
        2
      ],
      "name": "Xavier L Griffin"
    },
    {
      "affs": [
        4
      ],
      "name": "Andy South"
    },
    {
      "affs": [
        4
      ],
      "name": "Ana Cavalcante"
    },
    {
      "affs": [
        4
      ],
      "name": "Duncan Cartner"
    },
    {
      "affs": [
        4
      ],
      "name": "Steve Harris"
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    {
      "affs": [
        5
      ],
      "name": "Ofran Almossawi"
    },
    {
      "affs": [
        5
      ],
      "name": "Lydia Briggs"
    },
    {
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        5
      ],
      "name": "Daniel Key",
      "orcid": "0000-0002-9559-1784"
    },
    {
      "affs": [
        5
      ],
      "name": "Prasiddha Khadka"
    },
    {
      "affs": [
        6
      ],
      "name": "Timothy Howcroft"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Vishnu Vardhan Chandrabalan"
    },
    {
      "affs": [
        8
      ],
      "name": "Peter S Hall",
      "orcid": "0000-0001-6015-7841"
    },
    {
      "affs": [
        8
      ],
      "name": "Mahéva Vallet"
    },
    {
      "affs": [
        8
      ],
      "name": "Marta Pasikowska"
    },
    {
      "affs": [
        8
      ],
      "name": "Nicola Symmers"
    },
    {
      "affs": [
        8
      ],
      "name": "Colin McLean"
    },
    {
      "affs": [
        8
      ],
      "name": "Spyro Nita"
    },
    {
      "affs": [
        9
      ],
      "name": "Daniel Dedman"
    },
    {
      "affs": [
        9
      ],
      "name": "Zara Cuccu"
    },
    {
      "affs": [
        10
      ],
      "name": "Stelios Theophanous"
    },
    {
      "affs": [
        11
      ],
      "name": "Geoff Hall"
    },
    {
      "affs": [
        0
      ],
      "name": "Martí Català"
    },
    {
      "affs": [
        0,
        12
      ],
      "name": "Daniel Prieto Alhambra",
      "orcid": "0000-0002-3950-6346"
    },
    {
      "affs": [
        0
      ],
      "name": "Edward Burn",
      "orcid": "0000-0002-9286-1128"
    },
    {
      "affs": [
        0
      ],
      "name": "Danielle Newby"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5g8wvqw6zcw6z.bib",
  "cited_by": 0,
  "doi": "10.1093/eurpub/ckag198",
  "fulltext_url": "https://europepmc.org/articles/PMC13728849",
  "id": "5g8wvqw6zcw6z",
  "issns": [
    "1101-1262",
    "1464-360X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42974914",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00860"
    ],
    [
      "heading",
      "AcademicSubjects/SOC01210"
    ],
    [
      "heading",
      "AcademicSubjects/SOC02610"
    ],
    [
      "heading",
      "Evidence, Intelligence and Innovation"
    ],
    [
      "heading",
      "Original Manuscript"
    ],
    [
      "openalex",
      "2402|Antibiotic Use and Resistance"
    ]
  ],
  "openalex": "W4416868006",
  "pdf_url": "https://europepmc.org/articles/PMC13728849?pdf=render",
  "pmcid": "PMC13728849",
  "pmid": "42974914",
  "published": "2026-10-01",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/5g8wvqw6zcw6z.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:49Z",
      "native_id": "MED:42974914",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42974914"
    },
    {
      "first_seen": "2026-11-07T12:21:44Z",
      "native_id": "PMC13728849",
      "source": "pmc",
      "url": "https://doi.org/10.1093/eurpub/ckag198"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "openalex:2402|Antibiotic Use and Resistance",
      "subfield": "microbiology"
    }
  ],
  "title": "Patterns and potential indications of WHO AWaRe Watch antibiotic use across UK community and hospital care: a national observational study.",
  "title_text": "Patterns and potential indications of WHO AWaRe Watch antibiotic use across UK community and hospital care: a national observational study.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:21:44Z",
  "url": "https://research.draconitic.com/paper/5g8wvqw6zcw6z",
  "venue": "European journal of public health",
  "versions": []
}