A systematic review: antimicrobial consumption surveillance and stewardship efforts in the former USSR countries

Background/Objectives: Antimicrobial consumption (AMC) and stewardship (AMS) are effective strategies to combat increasing antimicrobial resistance rates worldwide. Post-Soviet countries (Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, the Russian Federation, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan) have implemented essential components for AMC and AMS to different extents to inform and guide decision-making and amend their policies. This review assesses and characterizes the existing systems in post-Soviet countries.

Methods: Papers were searched in PubMed, Google Scholar, Embase, CINAHL, CyberLeninka, and Scopus according to the inclusion criteria. This search also included gray literature covering the official sites of international and national health organizations. Three reviewers screened and then carefully assessed the articles using the JBI and AACODS appraisal checklists.

Results: Eleven (73.3%) countries with updated national action plans for combatting antimicrobial resistance defined AMC and AMS as strategic directions or objectives. Fifteen (100%) countries submit antimicrobial consumption data to international networks. Yet considerable disparities exist in the complexity of the monitoring systems and data sources employed across the region, except for in Georgia, which does not use AMC data for policy adjustments. Across these nations, disparities exist in the implementation of key elements supporting AMS, with no related policies reported in Tajikistan; well-established guidelines and feedback mechanisms are reported in Belarus, Estonia, Kazakhstan, and the Russian Federation; ten countries (66.7%) document only the partial implementation of stewardship practices.

Conclusions: The review provides key insights into the existing AMC and AMS implementation in the former USSR countries. Further efforts are needed to strengthen and expand antimicrobial stewardship programs, improve surveillance systems, and address key challenges in these regions.