AMR dimension(s) | Recommendation | Evidence illustration |
AMR population-level dimensions considered | Amoxicillin-clavulanate rather than amoxicillin alone is recommended as empiric antimicrobial therapy for Acute Bacterial Rhinosinusitis (ABRS) in adults (weak, low).13 | Local national surveillance data in the United States of America for amoxicillin and beta-lactamase-producing Haemophilus influenzae was narratively described in the evidence summary was clearly linked to the recommendation. |
AMR outcome-level dimensions considered | In neonates with gonococcal conjunctivitis, the WHO sexually transmitted infections (STIs) guideline suggests one of the following treatment options:
| The outcome of ‘AMR’ was formally considered within a PICO framework within the guideline’s online supplemental file 1. |
Population and outcome-level dimensions considered | Bedaquiline should be included in longer multidrug-resistant (MDR) TB regimens for patients aged 18 years or more (strong recommendation, moderate certainty in the estimates of effect).90 | The recommendation considers a multidrug-resistant TB patients, and the outcome ‘acquisition (amplification) of drug resistance’91 was formally considered within a PICO framework provided within the guideline’s supplemental materials. |
Alternative first choice of antibiotics for adults aged 18 years and over with pharyngitis and a penicillin allergy or intolerance: Clarithromycin 250 mg to 500 mg wo times per day a day for 5 days days.55 | Summary of committee discussions show that population-level resistance data was considered: ‘based on evidence, clinical experience and resistance data, the committee agreed to recommend the following alternative first-choice antibiotics for use in penicillin allergy or for phenoxymethylpenicillin intolerance: clarithromycin or erythromycin (which is preferred in pregnancy)’.55 Additional formal outcome considerations include ‘antibiotic resistance’ within the guideline’s supplemental materials. |
PICO, population, intervention, comparison, and outcome; TB, tuberculosis.