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 Kirchhelle, Claas A1 Atkinson, Paul A1 Broom, Alex A1 Chuengsatiansup, Komatra A1 Ferreira, Jorge Pinto A1 Fortané, Nicolas A1 Frost, Isabel A1 Gradmann, Christoph A1 Hinchliffe, Stephen A1 Hoffman, Steven J A1 Lezaun, Javier A1 Nayiga, Susan A1 Outterson, Kevin A1 Podolsky, Scott H A1 Raymond, Stephanie A1 Roberts, Adam P A1 Singer, Andrew C A1 So, Anthony D A1 Sringernyuang, Luechai A1 Tayler, Elizabeth A1 Rogers Van Katwyk, Susan A1 Chandler, Clare I R 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.