Topic overview

Start with the big picture

A valid prescription is a central safeguard for systemic antibacterials, but access is not controlled uniformly. Over-the-counter sales remain common in many low- and middle-income countries, while online pharmacies may provide either regulated services or routes that bypass local rules. National agencies set controls, and international frameworks such as the WHO Essential Medicines List and AWaRe categorization inform policy without replacing local prescription requirements. Stewardship also addresses practical drivers of demand, including delays in point-of-care testing, and uses pharmacy gatekeeping, patient education, and community interventions to reduce unnecessary antibiotic use. Agricultural and veterinary channels broaden the issue beyond human medicine, supporting a One Health approach to regulation.