The Implementation of Antimicrobial Consumption Surveillance and Stewardship in Human Healthcare in Post-Soviet States: A Systematic Review
1
School of Medicine, Nazarbayev University, Astana, Kazakhstan
Popul. Med. 2026;8(Supplement Supplement 1):A217
ABSTRACT
BACKGROUND:
Antimicrobial consumption (AMC) surveillance and antimicrobial stewardship (AMS) are core strategies for mitigating the global burden of antimicrobial resistance (AMR).¹–³ Despite international commitments, evidence from post-Soviet countries remains fragmented, rendering the region a persistent blind spot in global AMR monitoring frameworks.⁴ This systematic review aims to assess and characterise the implementation of AMC surveillance and AMS in post-Soviet countries.
METHODS:
A systematic search was conducted in PubMed, Embase, Scopus, Google Scholar, and regional databases, supplemented by grey literature from international and national health authorities. Eligible sources included peer-reviewed publications and official policy documents addressing AMC surveillance and AMS in human health systems of post-Soviet countries.
RESULTS:
Following screening and critical appraisal, three peer-reviewed publications and 31 policy and technical documents were included. Eleven of the fifteen countries with updated national action plans on AMR explicitly defined AMC surveillance and AMS as strategic objectives.⁵–⁷ All reviewed countries reported submission of antimicrobial consumption data to international surveillance platforms and the existence of regulatory frameworks governing antibiotic sales. However, substantial heterogeneity was observed in the scope, digitalisation, and operational maturity of surveillance systems, with high-income countries demonstrating more comprehensive implementation than lower-middle-income counterparts.⁸,⁹
CONCLUSIONS:
Significant disparities persist in AMC surveillance and AMS implementation across post-Soviet countries. While regulatory frameworks are formally established, enforcement gaps—particularly regarding over-the-counter antibiotic access—continue to undermine policy effectiveness.¹⁰ Strengthening governance mechanisms, expanding digital surveillance infrastructures, and investing in workforce capacity are critical to closing implementation gaps. Sustainable progress requires long-term political commitment, regular policy review cycles, and blended financing models that support transition from external to domestic funding.¹¹–¹³
Antimicrobial consumption (AMC) surveillance and antimicrobial stewardship (AMS) are core strategies for mitigating the global burden of antimicrobial resistance (AMR).¹–³ Despite international commitments, evidence from post-Soviet countries remains fragmented, rendering the region a persistent blind spot in global AMR monitoring frameworks.⁴ This systematic review aims to assess and characterise the implementation of AMC surveillance and AMS in post-Soviet countries.
METHODS:
A systematic search was conducted in PubMed, Embase, Scopus, Google Scholar, and regional databases, supplemented by grey literature from international and national health authorities. Eligible sources included peer-reviewed publications and official policy documents addressing AMC surveillance and AMS in human health systems of post-Soviet countries.
RESULTS:
Following screening and critical appraisal, three peer-reviewed publications and 31 policy and technical documents were included. Eleven of the fifteen countries with updated national action plans on AMR explicitly defined AMC surveillance and AMS as strategic objectives.⁵–⁷ All reviewed countries reported submission of antimicrobial consumption data to international surveillance platforms and the existence of regulatory frameworks governing antibiotic sales. However, substantial heterogeneity was observed in the scope, digitalisation, and operational maturity of surveillance systems, with high-income countries demonstrating more comprehensive implementation than lower-middle-income counterparts.⁸,⁹
CONCLUSIONS:
Significant disparities persist in AMC surveillance and AMS implementation across post-Soviet countries. While regulatory frameworks are formally established, enforcement gaps—particularly regarding over-the-counter antibiotic access—continue to undermine policy effectiveness.¹⁰ Strengthening governance mechanisms, expanding digital surveillance infrastructures, and investing in workforce capacity are critical to closing implementation gaps. Sustainable progress requires long-term political commitment, regular policy review cycles, and blended financing models that support transition from external to domestic funding.¹¹–¹³
| eISSN: | 2654-1459 |
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