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Journals / Ankara Üniversitesi Eczacılık Fakültesi Dergisi / 2026 / Cilt: 49 Sayı: 3

INTEGRATED TRAINING PROGRAMS FOR ANTIMICROBIAL STEWARDSHIP AND INFECTION PREVENTION AND CONTROL FOR PRIMARY CARE PHYSICIANS: A REVIEW OF THE CURRENT LITERATURE

BİRİNCİ BASAMAK HEKİMLERİ İÇİN ANTİMİKROBİYAL YÖNETİM İLE ENFEKSİYON ÖNLEME VE KONTROLÜNE YÖNELİK ENTEGRE EĞİTİM PROGRAMLARI: MEVCUT LİTERATÜRÜN BİR İNCELEMESİ

Melda Keçik(Gazi University)0000-0003-0528-1932
Muammer Çelik(DOKUZ EYLUL UNIVERSITY, SCHOOL OF MEDICINE)0000-0001-6190-5370
Can Huseyin Hekımoglu0000-0002-2156-4636
F. Nur Baran Aksakal(Gazi University)0000-0002-8624-3307
Pages
766–772
Publication Date
2025-09-19
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Developing and evaluating such programs could be a key step in combating AMR at the frontline of healthcare.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: Antimicrobial resistance (AMR) is a growing global threat, recognized by the World Health Organization (WHO) as a silent pandemic.
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Key Findings & Data:A systematic search using PubMed, Google Scholar, and Scopus identified 95 relevant articles, excluding settings outside PHC and specific AMS or IPC interventions beyond training.
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Conclusion & Impact:Developing and evaluating such programs could be a key step in combating AMR at the frontline of healthcare.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Antibiyotik direnci · antibiyotik yönetimi · birinci basamak sağlık hizmetleri

Abstract

Objective: Antimicrobial resistance (AMR) is a growing global threat, recognized by the World Health Organization (WHO) as a silent pandemic. Its impact endangers health systems worldwide, compromising progress toward Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs). Primary health care (PHC) plays a crucial role in ensuring access to high-quality, affordable healthcare, disease prevention, and community health improvement. However, the risk of infection transmission in PHC settings highlights the need for robust infection prevention and control (IPC) measures alongside antimicrobial stewardship (AMS) to ensure responsible antibiotic use and optimal patient outcomes. Material and Method: This research examines the current literature on AMS and IPC training programs for primary care physicians. A systematic search using PubMed, Google Scholar, and Scopus identified 95 relevant articles, excluding settings outside PHC and specific AMS or IPC interventions beyond training. Result and Discussion: Despite the recognized importance of AMS and IPC, no integrated training programs addressing both strategies in PHC settings were identified. The findings suggest an urgent need for structured, evidence-based training programs to enhance AMS and IPC implementation in primary care. Developing and evaluating such programs could be a key step in combating AMR at the frontline of healthcare.

Özet

Amaç: Antimikrobiyal direnç (AMD), Dünya Sağlık Örgütü (DSÖ) tarafından sessiz bir pandemi olarak tanımlanan ve giderek büyüyen küresel bir tehdittir. Bu durum, sağlık sistemlerini dünya genelinde tehlikeye atarak Evrensel Sağlık Kapsamı (UHC) ve Sürdürülebilir Kalkınma Amaçalarına (SKA'lar) yönelik ilerlemeyi sekteye uğratmaktadır. Birinci basamak sağlık hizmetleri, yüksek kaliteli, erişilebilir ve uygun maliyetli sağlık hizmetleri sunarak hastalıkların önlenmesi ve toplum sağlığının iyileştirilmesinde kritik bir rol oynamaktadır. Ancak, birinci basamak sağlık hizmeti sunulan ortamlarda enfeksiyon yayılma riski, sorumlu antibiyotik kullanımı ve en iyi hasta sonuçlarını sağlamak için güçlü enfeksiyon önleme ve kontrol (EÖK) önlemlerinin yanı sıra AMD ile mücadele uygulamalarına duyulan ihtiyacı ortaya koymaktadır. Gereç ve Yöntem: Bu araştıma, birinci basamak hekimleri için AMY ve EÖK eğitim programlarına ilişkin mevcut literatürü incelemektedir. PubMed, Google Scholar ve Scopus veritabanlarında yapılan sistematik bir arama sonucunda birinci basamak sağlık hizmeti dışındaki ortamlar ve eğitim dışındaki spesifik AMY veya EÖK müdahaleleri hariç tutularak 95 ilgili makale belirlenmiştir. Sonuç ve Tartışma: AMY ve EÖK’nın önemine dair güçlü kanıtlar bulunmasına rağmen, birinci basamak sağlık hizmeti sunulan ortamlarda her iki stratejiyi bir arada ele alan entegre eğitim programlarına rastlanmamıştır. Bulgular, birinci basamak sağlık hizmetlerinde AMY ve EÖK uygulamalarını güçlendirmek için yapılandırılmış, kanıta dayalı eğitim programlarına acil bir ihtiyaç olduğunu göstermektedir. Bu tür programların geliştirilmesi ve değerlendirilmesi, sağlık hizmetlerinde AMR ile mücadelede önemli bir adım olabilir.

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Cite This Article

Keçik, M., Çelik, M., Hekımoglu, C. H., Aksakal, F. N. B. (2025). INTEGRATED TRAINING PROGRAMS FOR ANTIMICROBIAL STEWARDSHIP AND INFECTION PREVENTION AND CONTROL FOR PRIMARY CARE PHYSICIANS: A REVIEW OF THE CURRENT LITERATURE. Ankara Üniversitesi Eczacılık Fakültesi Dergisi, Cilt: 49 Sayı: 3, 766–772. https://doi.org/10.33483/jfpau.1663313

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References (38)

  1. World Health Organization. (2024). WHO global action plan on antimicrobial resistance. Retrieved December 1, 2024, from https://www.who.int/. Accessed date: 01.12.2024.
  2. World Health Organization. (2024). UN General Assembly High Level Meeting on Antimicrobial Resistance 2024. Retrieved November 30, 2024, from https://www.who.int/. Accessed date: 30.11.2024.
  3. Avent, M.L., Hall, L., Davis, J.S. (2020). Antimicrobial stewardship in the primary care setting: From dream to reality? BMC Family Practice, 21(1), 134. [CrossRef]
  4. OECD. (2018). Stemming the superbug tide: Just a few dollars more. OECD Health Policy Studies. OECD Publishing, Paris, p.130. Retrieved November 12, 2024, from https://www.oecd.org/en/. Accessed date: 12.11.2024.
  5. World Health Organization and UNICEF. (2024). Operational framework for primary health care: Transforming vision into action. Retrieved November 10, 2024, from https://www.who.int/teams/. Accessed date: 10.11.2024.
  6. World Health Organization. (2024). IPC PHC core components. Retrieved November 10, 2024, from https://www.who.int/teams/. Accessed date: 10.11.2024.
  7. Ochie, C.N., Aniwada, E.C., Uchegbu, E.K., Asogwa, T.C., Onwasoigwe, C.N. (2022). Infection prevention and control: Knowledge, determinants, and compliance among primary healthcare workers in Enugu metropolis, South-East Nigeria. Infection Prevention in Practice, 4(2), 100214. [CrossRef]
  8. Gozdzielewska, L., Deepti, K.C., Butcher, J., Molesworth, M., Davis, K., Barr, L., DiBari, C., Mortgat, L., Deeves, M., Kothari, K.U., Storr, J., Allegranzi, B., Reilly, J., Price, L. (2024). Interventions for preventing or controlling health care-associated infection among health care workers or patients within primary care facilities: A scoping review. American Journal of Infection Control, 52(4), 479-487. [CrossRef]
  9. A scoping review on infection prevention and control (IPC) interventions within primary healthcare facilities. (2022). OSF Preprints.
  10. Talukder, A., Roy, A., Islam, M.N., Chowdhury, M.A.K., Sarker, M., Chowdhury, M., Chowdhury, I.A., Hasan, M., Latif, A.H.M.M. (2023). Prevalence and correlates of knowledge and practices regarding infection prevention and control, and triage in primary healthcare settings: A cross-sectional study in Bangladesh. Infection Prevention in Practice, 5(1), 100258. [CrossRef]
  11. Cornistein, W., Machado, F.R., Marra, A.R., Almeida, M.F.S., Da Silva, R.D., Zavascki, A.P. (2023). Synergy between infection control and antimicrobial stewardship programs to control carbapenem-resistant Enterobacterales. Antimicrobial Stewardship & Healthcare Epidemiology, 3(1), e162. [CrossRef]
  12. Shrestha, A.J., Zahra, F., Cannady, P. (2025). Antimicrobial stewardship. National Center for Biotechnology Information. Retrieved in 2024 from https://www.ncbi.nlm.nih.gov/. Accessed date: 10.11.2024.
  13. Soucy, J.P.R., Daneman, N., Bronskill, S.E., Born, K., Costa, A.P. (2021). Evaluation of an automated feedback intervention to improve antimicrobial prescribing among primary care physicians (OPEN Stewardship): Protocol for an interrupted time-series and usability analysis in Ontario, Canada, and Southern Israel. BMJ Open, 11(1), e039810. [CrossRef]
  14. Büchler, A.C., Haddad Galas, M., Buetti, N., Alp, E., Apisarnthanarak, A., Dziekan, G., Vanhems, P., Harbarth, S. (2024). Challenges and success stories of the implementation of infection control and antimicrobial stewardship strategies: Proceedings of the 5th global ministerial summit on patient safety, 2023. Antimicrobial Resistance & Infection Control, 13(1), 13. [CrossRef]
  15. World Health Organization. (2019). Antimicrobial stewardship programmes in health-care facilities in low- and middle-income countries: A WHO practical toolkit. Retrieved in 2024 from https://iris.who.int/handle/. Accessed date: 10.11.2024.
  16. World Health Organization. (2021). Antimicrobial stewardship interventions: A practical guide. Retrieved in 2024 from https://www.who.int/europe/publications/. Accessed date: 10.11.2024.
  17. Abel, K., Agnew, E., Amos, J., Armstrong, N., Armstrong-James, D., Ashfield, T., Ashiru-Oredope, D., Atun, R. (2024). System-wide approaches to antimicrobial therapy and antimicrobial resistance in the UK: The AMR-X framework. Lancet Microbe, 5(5), e500-e507. [CrossRef]
  18. Brink, A.J., Richards, G.A. (2022). Antimicrobial stewardship: Leveraging the “butterfly effect” of hand hygiene. Antibiotics, 11(10), 1348. [CrossRef]
  19. World Health Organization. (2021). WHO policy guidance on integrated antimicrobial stewardship activities. Retrieved in 2024 from https://www.who.int/publications/. Accessed date: 10.11.2024.
  20. El-Sokkary, R., Erdem, H., Kullar, R., Pekok, A.U., Amer, F., Grgić, S., Zeynep, M., Almasoud, A. (2022). Self-reported antibiotic stewardship and infection control measures from 57 intensive care units: An international ID-IRI survey. Journal of Infection and Public Health, 15(9), 950-954. [CrossRef]
  21. Van Katwyk, S.R., Grimshaw, J.M., Nkangu, M., Nagi, R., Mendelson, M., Taljaard, M., Hoffman, S.J. (2019). Government policy interventions to reduce human antimicrobial use: A systematic review and evidence map. PLoS Medicine, 16(6), e1002819. [CrossRef]
  22. Knowles, R., Chandler, C., O’Neill, S., Sharland, M., Mays, N. (2024). A systematic review of national interventions and policies to optimize antibiotic use in healthcare settings in England. Journal of Antimicrobial Chemotherapy, 79(6), 1234-1247. [CrossRef]
  23. Gágyor, I., Hay, A.D. (2022). Outcome selection in primary care antimicrobial stewardship research. Journal of Antimicrobial Chemotherapy, 77(1), 7-12. [CrossRef]
  24. Lee, C., Jafari, M., Brownbridge, R., Phillips, C., Vanstone, J.R. (2020). The viral prescription pad-A mixed methods study to determine the need for and utility of an educational tool for antimicrobial stewardship in primary health care. BMC Family Practice, 21(1), 42. [CrossRef]
  25. March-López, P., Madridejos, R., Tomas, R., Boix, L., Arcenillas, P., Gómez, L., Morros, R., Móra, R. (2020). Impact of a multifaceted antimicrobial stewardship intervention in a primary health care area: A quasi-experimental study. Frontiers in Pharmacology, 11, 398. [CrossRef]
  26. Gönen, M., Aksoy, M., İşli, F., Gürpınar, U.E., Göbel, P., Gürsöz, H., Ergönül, Ö. (2021). Assessment of quarter billion primary care prescriptions from a nationwide antimicrobial stewardship program. Scientific Reports, 11(1), 94308. [CrossRef]
  27. Müller, S.A., Landsmann, L., Diallo, A.O.K., Wood, R., Rocha, C., Tounkara, O. (2022). Is the World Health Organization multimodal hand hygiene improvement strategy applicable and effective at the primary care level in resource-limited settings? A quantitative assessment in healthcare centers of Faranah, Guinea. IJID Regions, 3, 27-33. [CrossRef]
  28. Qureshi, M.O., Chughtai, A.A., Seale, H. (2022). Recommendations related to occupational infection prevention and control training to protect healthcare workers from infectious diseases: A scoping review of infection prevention and control guidelines. BMC Health Services Research, 22(1), 7673. [CrossRef]
  29. Truppa, C., Alonso, B., Clezy, K., Deglise, C., Dromer, C., Garelli, S. (2023). Antimicrobial stewardship in primary health care programs in humanitarian settings: The time to act is now. Antimicrobial Resistance & Infection Control, 12(1), 1301. [CrossRef]
  30. Baur, D., Gladstone, B.P., Burkert, F., Carrara, E., Foschi, F., Döbele, S., Tacconelli, E. (2017). Effect of antibiotic stewardship on the incidence of infection and colonization with antibiotic-resistant bacteria and Clostridium difficile infection: A systematic review and meta-analysis. The Lancet Infectious Diseases, 17(9), 990-1001. [CrossRef]
  31. Lee, C.F., Cowling, B.J., Feng, S., Aso, H., Wu, P., Fukuda, K., Seto, W.H. (2018). Impact of antibiotic stewardship programmes in Asia: A systematic review and meta-analysis. Journal of Antimicrobial Chemotherapy, 73(4), 844-851. [CrossRef]
  32. Nori, P., Madaline, T., Munjal, I., Bhar, S., Guo, Y., Seo, S.K., (2017). Developing interactive antimicrobial stewardship and infection prevention curricula for diverse learners: A tailored approach. Open Forum Infectious Diseases, 4(3), ofx117. [CrossRef]
  33. Mbamalu, O., Surendran, S., Nampoothiri, V., Bonaconsa, C., Edathadathil, F., Zhu, N. (2023). Survey of healthcare worker perceptions of changes in infection control and antimicrobial stewardship practices in India and South Africa during the COVID-19 pandemic. IJID Regions, 6, 90-98. [CrossRef]
  34. Kuruc Poje, D., Kuharić, M., Posavec Andrić, A., Mađarić, V., Poje, J.V., Payerl-Pal, M. (2024). Perspectives of primary care physicians on academic detailing for antimicrobial stewardship: Feasibility and impact assessment. Journal of International Medical Research, 52(1), 1222242. [CrossRef]
  35. Harrigan, J.J., Hamilton, K.W., Cressman, L., Bilker, W.B., Degnan, K.O., David, M.Z. (2024). Antibiotic prescribing patterns for respiratory tract illnesses following the conclusion of an education and feedback intervention in primary care. Clinical Infectious Diseases, 78(5), 1120-1127. [CrossRef]
  36. Dutcher, L., Degnan, K., Adu-Gyamfi, A.B., Lautenbach, E., Cressman, L., David, M.Z. (2022). Improving outpatient antibiotic prescribing for respiratory tract infections in primary care: A stepped-wedge cluster randomized trial. Clinical Infectious Diseases, 74(6), 947-956. [CrossRef]
  37. Motta, M., Wilcock, M. (2023). Improving antimicrobial stewardship in general practice. Prescriber, 34(2), 17-20. [CrossRef]
  38. OECD. (2018). Stemming the superbug tide: Just a few dollars more. OECD Health Policy Studies. OECD Publishing, Paris, p.130. Retrieved November 12, 2024, from https://www.oecd.org/en/. Accessed date: 12.11.2024.