Implementing a multimodal antimicrobial stewardship programme in primary care in Kosova-a protocol for implementation...

Area of Science:

• Public Health
• Infectious Diseases
• Implementation Science

Background:

• Antimicrobial resistance (AMR) is a global crisis, exacerbated by inappropriate antibiotic prescribing in primary care.
• Kosova faces significant challenges with antibiotic overuse for upper respiratory tract infections due to limited diagnostics and regulatory gaps.
• This protocol outlines an antimicrobial stewardship programme to promote rational antibiotic use and combat AMR in Kosova's primary healthcare.

Purpose of the Study:

• To enhance appropriate antibiotic use for acute upper respiratory tract infections in primary healthcare facilities.
• To evaluate the implementation of an antimicrobial stewardship programme.
• To gather knowledge for scaling the programme to other primary care settings or levels of care.

Main Methods:

• A mixed-methods implementation research approach utilizing quantitative and qualitative data.
• Application of RE-AIM and Consolidated Framework for Implementation Research for theoretical grounding.
• Analysis of barriers and facilitators, prescriber preferences (conjoint analysis), and cost-effectiveness.

Main Results:

• The programme pilots interventions including training, diagnostics, and quality improvement.
• It addresses the gap between AMR policy and practical implementation in Kosova.
• Evidence on barriers, enablers, and economic impact will be generated.

Conclusions:

• The pilot programme aims to strengthen stewardship practices and improve antibiotic use in Kosova.
• Findings will inform policy updates and scale-up strategies for AMR containment.
• Lessons learned are expected to benefit other low- and middle-income countries facing similar AMR challenges.