Interpreting point prevalence survey data on antibiotic use: guidance for facility antimicrobial stewardship teams and national policymakers.

Point Prevalence Surveys (PPS) are widely used to describe antibiotic use in hospitals to inform antimicrobial stewardship programmes and national policies on Antimicrobial Resistance (AMR). While PPS offer valuable insight into patterns of antibiotic exposure and prescribing practices, their metrics are often interpreted beyond their technical design. This guidance provides a practical framework for interpreting PPS data appropriately and translating them into facility-level actions and policy learning. PPS provides a cross-sectional snapshot of antibiotic exposure and prescribing practice indicators (e.g. indication, route, documentation, guideline compliance and AWaRe classification). While these parameters support quality improvement, prevalence of antibiotic use is not a proxy for antibiotic consumption or stewardship impact because it reflects both initiation and duration of therapy and is influenced by factors like case-mix. Misinterpretation can lead to policy misalignment, inappropriate benchmarking and counterproductive performance targets. We propose a structured interpretation framework to enable stewardship learning leading to corrective actions rather than performance scoring.