Multidisciplinary Strategies for Antimicrobial Stewardship and Combating Antimicrobial Resistance in Healthcare

Abstract

Background: Antimicrobial resistance (AMR) has emerged as one of the most pressing global public health threats of the twenty-first century, with estimates suggesting 1.3 million deaths directly attributable to bacterial AMR in 2019 alone. The problem is disproportionately severe in low- and middle-income countries (LMICs) and conflict-affected settings, where healthcare infrastructure is limited and antimicrobial misuse is prevalent.

Aim: This review aims to synthesize current evidence on multidisciplinary strategies for antimicrobial stewardship (AMS) and combating AMR in healthcare settings, with particular emphasis on implementation challenges, successful interventions, and the evolving roles of various healthcare professionals.

Methods: A comprehensive narrative review was conducted synthesizing evidence from peer-reviewed literature, WHO guidelines, and proceedings of international patient safety summits published between 2020 and 2026. Key databases including PubMed, Scopus, and Cochrane Library were searched for studies addressing AMS implementation, multidisciplinary approaches, and AMR containment strategies.

Results: Antimicrobial stewardship programs consistently demonstrate significant reductions in antibiotic consumption and improve adherence to prescribing guidelines, with substantial cost savings. Key successful interventions include prospective audit and feedback, formulary restriction, education and training, and guideline implementation. However, implementation barriers remain substantial, particularly in resource-limited settings, including insufficient staffing, lack of microbiology laboratory support, limited leadership commitment, and cultural resistance to change. The WHO AWaRe classification has emerged as a critical tool for optimizing antibiotic selection, with studies demonstrating significant shifts from Watch to Access category antibiotics following stewardship interventions. Nurses play an indispensable role in AMS through patient assessment, specimen collection, medication management, and prompting antibiotic review—activities grounded in patient advocacy and nursing leadership.

Conclusion: Effective AMS requires a multidisciplinary approach integrating physicians, pharmacists, nurses, microbiologists, and infection prevention specialists. Tailored strategies addressing local barriers, sustained political commitment, and investment in healthcare infrastructure are essential for sustainable implementation. The expansion of AMS into primary care, humanitarian settings, and long-term care facilities represents a critical frontier for global AMR containment efforts.