Blind antibiotic prescribingDoctors prescribe antibiotics without knowing what works locally
Resistance is as much a data problem as a drug problem. Surveillance depends on cultures, and much of the world's prescribing happens where there is no microbiology laboratory within reach, so the clinician makes a reasonable guess, and what happens next is rarely recorded anywhere that would improve the next one. The map of what still works is drawn from the minority of cases that reach a lab.
Prescribers in primary and rural care · national AMR programmes · hospital pharmacy and stewardship teams
Why now
The WHO's 2025 global surveillance report draws on more than 23 million confirmed cases reported by 104 countries across 93 combinations of infection type, pathogen and antibiotic: the most complete picture yet assembled, and still one built from where testing exists rather than where prescribing happens.
Why it matters
The feedback loop that would slow resistance is broken at its cheapest point: capture. Anything that makes empirical prescribing legible without requiring a laboratory improves the map for everyone, and most of what is sold here is tests rather than information.
From public reporting
Framed from public reporting. Here is what it was drawn from, so the framing can be checked against it:
Caring for an ageing parent means medications, appointments, home visits, bills and forms, shared between siblings in different cities and often different countries. It runs on a group chat, a shared folder and whoever remembers. Things fall through, one person quietly carries most of it, and the professionals involved each see a fragment of a picture nobody holds whole.
For whomAdult children caring for parents · home-care workers · family doctors seeing only their slice
Loss happens at the handovers: field to packer, packer to distributor, distributor to shelf. Every party measures only its own side of each one. So each set of numbers looks defensible while the total is enormous, and the interventions that would work are precisely the ones nobody can see, because they sit between two businesses rather than inside one.
For whomGrowers and packers · distributors and independent retailers · redistribution charities working the same corridors
Support has been largely automated, and for routine questions that is an improvement. The unusual case is where it breaks: a bereavement, a billing error, a locked account, a situation the script has no branch for. The customer loops, rephrases, tries again, and eventually gives up, and the company never learns it happened, because a failed escape is rarely a metric anyone collects.
For whomCustomers in genuinely unusual situations · the few remaining human agents · support leaders flying blind
