RT Journal Article SR Electronic T1 Setting the standard: multidisciplinary hallmarks for structural, equitable and tracked antibiotic policy JF BMJ Global Health JO BMJ Global Health FD BMJ Publishing Group Ltd SP e003091 DO 10.1136/bmjgh-2020-003091 VO 5 IS 9 A1 Claas Kirchhelle A1 Paul Atkinson A1 Alex Broom A1 Komatra Chuengsatiansup A1 Jorge Pinto Ferreira A1 Nicolas Fortané A1 Isabel Frost A1 Christoph Gradmann A1 Stephen Hinchliffe A1 Steven J Hoffman A1 Javier Lezaun A1 Susan Nayiga A1 Kevin Outterson A1 Scott H Podolsky A1 Stephanie Raymond A1 Adam P Roberts A1 Andrew C Singer A1 Anthony D So A1 Luechai Sringernyuang A1 Elizabeth Tayler A1 Susan Rogers Van Katwyk A1 Clare I R Chandler YR 2020 UL http://gh.bmj.com/content/5/9/e003091.abstract AB There is increasing concern globally about the enormity of the threats posed by antimicrobial resistance (AMR) to human, animal, plant and environmental health. A proliferation of international, national and institutional reports on the problems posed by AMR and the need for antibiotic stewardship have galvanised attention on the global stage. However, the AMR community increasingly laments a lack of action, often identified as an ‘implementation gap’. At a policy level, the design of internationally salient solutions that are able to address AMR’s interconnected biological and social (historical, political, economic and cultural) dimensions is not straightforward. This multidisciplinary paper responds by asking two basic questions: (A) Is a universal approach to AMR policy and antibiotic stewardship possible? (B) If yes, what hallmarks characterise ‘good’ antibiotic policy? Our multistage analysis revealed four central challenges facing current international antibiotic policy: metrics, prioritisation, implementation and inequality. In response to this diagnosis, we propose three hallmarks that can support robust international antibiotic policy. Emerging hallmarks for good antibiotic policies are: Structural, Equitable and Tracked. We describe these hallmarks and propose their consideration should aid the design and evaluation of international antibiotic policies with maximal benefit at both local and international scales.