SYSTEMATIC REVIEW OF COMMUNITY-BASED INTERVENTIONS TO REDUCE ANTIBIOTIC RESISTANCE

Abstract

Background: Antibiotic resistance represents a critical public health challenge globally, driven by inappropriate antibiotic use and inadequate public awareness. Community-based interventions have emerged as a key strategy to mitigate resistance by addressing misuse at its root. These interventions engage diverse stakeholders, including patients, healthcare providers, and pharmacists, and target behavioral, educational, and diagnostic gaps in antibiotic stewardship. Understanding the effectiveness and scope of such interventions is essential for guiding future policy and research.

Objective: This systematic review aims to evaluate the effectiveness of community-based interventions in reducing antibiotic resistance and to identify factors influencing their success across diverse populations and settings.

Methods: A comprehensive search was conducted across PubMed, Scopus, Google Scholar, Cochrane Library, and Embase, using MeSH terms and keywords such as “antibiotic resistance,” “community-based interventions,” and “antimicrobial stewardship.” Inclusion criteria encompassed peer-reviewed studies published between 2018 and 2023, focusing on human populations and measurable outcomes related to antibiotic use. Data extraction followed a standardized protocol, and effect sizes were pooled using a random-effects model. Heterogeneity was assessed using the I² statistic, and sensitivity analyses were performed to ensure robustness.

Results: Ten studies met inclusion criteria, reporting an average odds ratio (OR) of 0.85 (95% CI: 0.75–0.95, p = 0.03) for reducing resistance. Pharmacist-led interventions achieved the highest impact (OR = 0.78; 95% CI: 0.68–0.88). Educational strategies showed an average compliance improvement of 20%, while diagnostic-driven interventions reduced resistance by up to 24%. The I² statistic of 35% indicated low heterogeneity, enhancing reliability.

Conclusion: Community-based interventions are effective in mitigating antibiotic resistance, with multifaceted approaches demonstrating the greatest success. Future efforts should address regional disparities and scalability challenges to maximize global impact.