The latent system factors that influence antimicrobial use and governance in healthcare: a scoping review of high-income health systems.

ABSTRACT:

Background

Inappropriate antimicrobial use accelerates antimicrobial resistance (AMR), creating tensions between antimicrobial stewardship and timely treatment. Despite global calls to action, gaps between recommendations and practice persist, largely due to system factors shaping clinical work. This review examines how systems approaches have been applied to the use and governance of antimicrobials.

Methods

This scoping review followed PRISMA-ScR. Eligible sources included empirical studies, reviews, protocols, theses/dissertations, and improvement projects across healthcare settings in high-income countries. Studies required explicit use of systems approaches. EMBASE, MEDLINE, and CINAHL were searched in November 2024. Grey literature was added in February 2025. Search was

SUBMITTER: Lounsbury O 

PROVIDER: S-EPMC12495420 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature