## 5 Conclusions  
The prevalence of antimicrobial use in the hospitals included in this study was 50% (30-57%), with most antibiotics prescribed belonging to the WHO 'Access' and 'Watch' groups. No 'Reserve' category antibiotics were prescribed across the study sites. Not Recommended antibiotics were prescribed, albeit infrequently. This aligns with previously published data in that the 'Access' and 'Watch' category antibiotics are commonly prescribed in LMICs, although to varying extents across countries. As a result of the CwPAMS health partnership programme and collaboration with other hospitals, PPS data are available for the most part for the first time, strengthening the global commitment to improved antimicrobial surveillance. AMS interventions as a result of the PPSs conducted include formation of AMS committees, preparation of new AMS guidelines and provision of training. Other common interventions included the presentation of findings to clinicians, thus supporting awareness and the multi-disciplinary approach to successful AMS programmes. In order to continue to monitor the impact of interventions, repeat PPS should be carried out and to strengthen the quality of data, widening participation is encouraged. **Supplementary Materials:** The following are available online at [[https://www.mdpi.com/article/10.3390/antibiotics10091122/s1](https://www.mdpi.com/article/10.3390/antibiotics10091122/s1)]([https://www.mdpi.com/article/10.3390/antibiotics10091122/s1](https://www.mdpi.com/article/10.3390/antibiotics10091122/s1)), Table S1: Most common reason for antimicrobial prescribing across 17 hospitals participating in the PPS, Table S2: Proportional use of ATC level 5-defined antimicrobials in each of 4 countries, Table S3: Countries and Antibiotic Prescription by AWaRe Categories, Table S4: Gender and Antibiotic Prescription by AWaRe Categories, Table S5: Age and Antibiotic Prescription by AWaRe Categories. SlInfo1: Antimicrobial Stewardship Intervention summaries. **Author Contributions:** Conceptualization, D.A.-O., A.-K.L., N.O.-N. and J.A.O. ; Data curation, D.A. ([PERSON]), Z.A., D.A. ([PERSON]), D.M.A., D.C.B., S.B., C.B., J.B., P.B., C.C.D., F.G., J.H.S., Y.J., F.E.K., I.M.K., M.M., S.M., C.M., N.W.J.O., E.P.-Q., I.S., J.S. and A.S.C.J. ; Formal analysis, N.D., D.A.-O. and O.O. ; Methodology, D.A.-O., A.-K.L., N.O.-N., J.A.O. and I.P. ; Project administration, N.D.; Supervision, D.-A.-O. ; Writing--original draft, N.D.O., O.I.P. and A.V. ; Writing--review and editing, N.D., D.A.-O., D.A. ([PERSON]), Z.A., D.A. ([PERSON]), D.M.A., D.C.B., S.B., J.B., C.C.D., F.G., J.H.S., Y.J., F.E.K., I.M.K., A.-K.L., M.M., S.M., C.M., N.O.-N., W.J.O., J.A.O., E.P.-Q., I.P., I.S., J.S., A.S.C.J. and A.V. All authors have read and agreed to the published version of the manuscript. **Funding:** This was funded by the Department of Health and Social Care using UK aid funding and is managed by the Fleming Fund. The Fleming Fund is a \(\epsilon\)265 million UK aid investment to tackle antimicrobial resistance by supporting low- and middle- income countries to generate, use, and share data on AMR. The Fleming Fund programme is managed by the UK Department of Healthand Social Care. CwPAMS programme is managed by Commonwealth Pharmacists Association and Tropical Health Education Trust (THET). The views expressed in this publication are those of the author and not necessarily those of the Department of Health and Social Care, the NHS, CPA or THET. The Global Point Prevalence Survey is coordinated at the University of Antwerp, Belgium and supported through an unrestricted grant given to them by bioRxiv and personal Methusalem grant to [PERSON] from the Flemish government; neither funder had a role with any of the CwPAMS projects. None of the funders had any role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. All sites obtained approval from their respective hospital administration.