Surveillance of antimicrobial use can provide insights on how antimicrobials are being utilised in healthcare settings. Data from antimicrobial utilisation surveillance are useful tools to inform therapy decisions, to assess the public health consequences of antimicrobial misuse, and to evaluate the impact of resistance containment interventions. Information on antimicrobial utilisation is essential in the development of strategies for a more judicious use of antimicrobials.

National-level surveillance of antibiotic utilisation was initiated in selected Malaysian hospitals in 2001. It currently encompasses designated hospitals under the Ministry of Health (MoH), Ministry of Higher Education (MoHE), Ministry of Defence (MinDef), as well as selected private hospitals. The scope of surveillance was expanded in July 2015 to include primary care facilities, specifically MoH health clinics. In 2020, the surveillance further broadened to incorporate antifungal utilisation data from several MoH hospitals. This programme is now collectively referred to as the National Surveillance on Antimicrobial Utilisation (NSAU).

Data were categorised into two main groups—All Wards (excluding ICU) and ICU—to enable more targeted analysis of antimicrobial utilisation patterns in critical care settings. Antimicrobial use was reported using standardised usage density rates, expressed in defined daily doses (DDDs) according to the World Health Organization’s Anatomical Therapeutic Chemical (ATC) classification system. This methodology facilitates meaningful comparisons at the state, national, and regional levels. The surveillance covered the utilisation of 14 selected antibiotics and 3 antifungals in hospitals, and 3 antibiotics in health clinics, for the period of January to December each year.

Echinocandin antifungals were incorporated into the surveillance beginning in 2023.