Antimicrobial resistance continues to spread rapidly at a global scale. Little evidence exists on the association of antimicrobial stewardship programs (ASPs) with the consumption of antibiotics across healthcare and income settings. Ya, et al. (2023) sought to synthesize current evidence regarding the association between antimicrobial stewardship programs and the consumption of antibiotics globally.

The main outcome measures were proportion of patients receiving an antibiotic prescription and defined daily doses per 100 patient-days.

Overall, 52 studies (with 1 794 889 participants) measured the association between ASPs and antimicrobial consumption and were included, with 40 studies conducted in high-income countries and 12 in low- and middle-income countries (LMICs). ASPs were associated with a 10% (95% CI, 4%-15%) reduction in antibiotic prescriptions and a 28% reduction in antibiotic consumption (rate ratio, 0.72; 95% CI, 0.56-0.92). ASPs were also associated with a 21% (95% CI, 5%-36%) reduction in antibiotic consumption in pediatric hospitals and a 28% reduction in World Health Organization watch groups antibiotics (rate ratio, 0.72; 95% CI, 0.56-0.92).

In this systematic review and meta-analysis, ASPs appeared to be effective in reducing antibiotic consumption in both hospital and non-hospital settings. Impact assessment of ASPs in resource-limited settings remains scarce; further research is needed on how to best achieve reductions in antibiotic use in LMICs.

Reference: Ya KZ, et al. Association Between Antimicrobial Stewardship Programs and Antibiotic Use Globally: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2023;6(2):e2253806. doi:10.1001/jamanetworkopen.2022.53806