Leveraging local public health to advance antimicrobial stewardship (AMS) implementation and mitigate antimicrobial resistance (AMR): a scoping review

Valerie Leung; Diane Ashiru-Oredope; Lauri Hicks; Sarah Kabbani; Mehdi Aloosh; Irene E Armstrong; Kevin A Brown; Nick Daneman; Kevin Lam; Hamidah Meghani; Mahad Nur; Kevin L Schwartz; Bradley J Langford

doi:10.1093/jacamr/dlae187

Leveraging local public health to advance antimicrobial stewardship (AMS) implementation and mitigate antimicrobial resistance (AMR): a scoping review

JAC Antimicrob Resist. 2024 Dec 18;6(6):dlae187. doi: 10.1093/jacamr/dlae187. eCollection 2024 Dec.

Authors

Valerie Leung^{1

2}, Diane Ashiru-Oredope^{3

4}, Lauri Hicks⁵, Sarah Kabbani⁵, Mehdi Aloosh^{6

7}, Irene E Armstrong^{8

9}, Kevin A Brown^{1

9}, Nick Daneman^{1

10

11}, Kevin Lam¹, Hamidah Meghani¹, Mahad Nur⁸, Kevin L Schwartz^{1

9

12}, Bradley J Langford^{1

9

13}

Affiliations

¹ Communicable Disease Control, Public Health Ontario, Toronto, ON, Canada.
² Department of Pharmacy, Michael Garron Hospital, Toronto East Health Network, Toronto, ON, Canada.
³ HCAI and AMR Division, Clinical and Public Health Group, UK Health Security Agency, London, UK.
⁴ Division of Pharmacy Practice and Policy, School of Pharmacy University of Nottingham, Nottingham, UK.
⁵ Division of Healthcare Quality Promotion, CDC, Atlanta, GA, USA.
⁶ Windsor-Essex County Health Unit, Windsor, ON, Canada.
⁷ Department of Health Research Methods, Evidence, and Impact, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
⁸ Health Protection, Toronto Public Health, Toronto, ON, Canada.
⁹ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
¹⁰ Clinical Epidemiology and Healthcare Research, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
¹¹ Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
¹² Department of Medicine, Li Ka Shing Knowledge Institute, Unity Health Toronto, ON, Canada.
¹³ Department of Pharmacy, Hotel Dieu Shaver Health and Rehabilitation Centre, St. Catharines, ON, Canada.

Abstract

Objective: To explore the role of local public health organisations in antimicrobial stewardship (AMS) and antimicrobial resistance (AMR) surveillance.

Methods: A scoping review was conducted. Peer-reviewed and grey literature from countries within the organisation for economic co-operation and development was searched between 1999 and 2023 using the concepts of local public health, AMR and AMS. Thematic analysis was performed to identify themes.

Results: There were 63 citations illustrating 122 examples of AMS and AMR surveillance activities with local public health involvement. Common AMS activities (n = 105) included healthcare worker education (n = 22), antimicrobial use (AMU) evaluation (n = 21), patient/public education (n = 17), clinical practice guidelines (n = 10), and antibiograms (n = 10). Seventeen citations described local public health activities in AMR surveillance; the majority focussed on communicable diseases (n = 11) and/or AMR organisms (n = 6).

Conclusions: Local public health capabilities should be leveraged to advance high-impact activities to mitigate AMR, particularly in the areas of knowledge translation/mobilisation, optimising surveillance and establishing strategic collaborations.

Policy implications: Future work should focus on better understanding barriers and facilitators, including funding, to local public health participation in these activities.

Publication types

Review