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

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.