Reducing antibiotic exposure to combat antimicrobial resistance: rethinking use, packaging, and dispensing practices

Antimicrobial resistance (AMR) is a global health threat, intensified by structural inequities, weak regulatory systems, and low access to care in low-income and middle-income countries. Reducing unnecessary antibiotic exposure is a crucial step in combating AMR. Inappropriate use, including prolonged treatment durations, non-prescription supply, and use of leftover medicines, undermines antibiotic stewardship efforts. Optimising treatment requires adherence to evidence-based shorter courses than currently used longer antibiotic courses and addressing barriers to treatment adherence. Packaging reform and exact-dose dispensing are key but overlooked interventions to reduce antibiotic misuse and waste. Although legal and logistical challenges remain, particularly in low-income and middle-income countries, these solutions should be integrated into broad strategies that address systemic barriers. Coordinated actions from prescribers, pharmacists, regulators, and patients are needed. Minimising antibiotic exposure is essential to mitigating AMR and requires context-sensitive policy, behavioural change, and structural reform to preserve antibiotic effectiveness for future generations.