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Exploring antibiotic stewardship interventions within a One Health context: a scoping review.

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Antibiotic resistance (ABR) is a global threat, driven by antibiotic overuse. A One Health approach is vital, but current interventions often prioritize human health, necessitating better evaluation of stewardship strategies across sectors.

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Area of Science:

  • Public Health
  • Veterinary Medicine
  • Environmental Science

Background:

  • Antibiotic resistance (ABR) poses a significant threat to global health, driven by antibiotic overuse in human, animal, and food production sectors.
  • The interconnectedness of human, animal, and environmental health necessitates a One Health approach to combat ABR effectively.
  • Existing antibiotic stewardship interventions lack a comprehensive overview from a One Health perspective.

Purpose of the Study:

  • To conduct a scoping review of existing policy interventions for antibiotic stewardship.
  • To provide a comprehensive overview of antibiotic stewardship interventions from a One Health perspective.
  • To assess the characteristics, implementation, and impacts of these interventions.

Main Methods:

  • Systematic literature search using PRISMA extension for Scoping Reviews guidelines across three databases.
  • Purposive sampling of interventions for detailed assessment based on 26 variables.
  • Descriptive analysis of extracted data to summarize intervention characteristics and impacts.

Main Results:

  • Twenty-nine selected interventions focused on communication, antibiotic access/usage, and disposal.
  • Interventions showed variability in One Health aspects, including cross-sectoral collaboration and equity.
  • Facilitators included livestock industry engagement and provision of antibiotic alternatives; impacts were observed in antibiotic use, resistance, awareness, and animal health.

Conclusions:

  • One Health antibiotic stewardship interventions often prioritize human health objectives.
  • There is a continuous need to strengthen the evaluation of these interventions to understand implementation facilitators, barriers, and impacts.
  • Enhanced evaluation is crucial for optimizing antibiotic stewardship strategies across human, animal, and environmental health domains.