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

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This study introduces a multimodal antimicrobial stewardship programme in Kosova to combat rising antimicrobial resistance by improving antibiotic prescribing for respiratory infections in primary care. The initiative aims to reduce resistance and inform future large-scale implementations.

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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.