Evidence map›Paper›PMID 40931120›Full record

ReviewNature reviews. Microbiology2026

Antimicrobial stewardship from a One Health perspective.

Rodney James, Laura Y Hardefeldt, Courtney Ierano, Esmita Charani, Leslie Dowson, Sri Elkins, Karin Thursky

Abstract readReview
PubMed Publisher
In one paragraph

Review in Nature reviews. Microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed.

  1. Article
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  7. [Requirements for the rational use of antibiotics based on antibiotic stewardship].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026
    Review
  8. Review
  9. Review
  10. Article
  11. Review
  12. Article
  13. Review
  14. Article
  15. Article
  16. Article
  17. Review
  18. Chemical Constituents and Pharmacological Effects ofMolecules (Basel, Switzerland) · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Rodney JamesNational Centre for Antimicrobial Stewardship, Department of Infectious Diseases, Melbourne Medical School, The University of Melbourne, Carlton, Victoria, Australia. Rod.james@unimelb.edu.au.ORCID http://orcid.org/0000-0003-1425-029X
Laura Y HardefeldtNational Centre for Antimicrobial Stewardship, Department of Infectious Diseases, Melbourne Medical School, The University of Melbourne, Carlton, Victoria, Australia.ORCID http://orcid.org/0000-0001-5780-7567
Courtney IeranoNational Centre for Antimicrobial Stewardship, Department of Infectious Diseases, Melbourne Medical School, The University of Melbourne, Carlton, Victoria, Australia.
Esmita CharaniDivision of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
Leslie DowsonNational Centre for Antimicrobial Stewardship, Department of Infectious Diseases, Melbourne Medical School, The University of Melbourne, Carlton, Victoria, Australia.
Sri ElkinsNational Centre for Antimicrobial Stewardship, Department of Infectious Diseases, Melbourne Medical School, The University of Melbourne, Carlton, Victoria, Australia.
Karin ThurskyNational Centre for Antimicrobial Stewardship, Department of Infectious Diseases, Melbourne Medical School, The University of Melbourne, Carlton, Victoria, Australia. Karin.thursky@unimelb.edu.au.ORCID http://orcid.org/0000-0002-7400-232X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The global rise of antimicrobial resistance (AMR) poses a profound threat to human, animal and environmental health. Although antimicrobials have revolutionized modern medicine, their overuse and misuse have accelerated AMR, necessitating urgent, multisectoral action. Antimicrobial stewardship (AMS), a set of coordinated strategies that promote responsible antimicrobial use, has emerged as a key intervention in managing AMR. In this Review, we explore AMS within a One Health framework, emphasizing interconnectedness across sectors. We examine clinical, economic, sociocultural and environmental drivers of antimicrobial use, highlighting disparities between high-income and low-income settings and identifying context-specific challenges to implementation. We also discuss the importance of governance, financing, digital innovation, surveillance and behavioural science in shaping sustainable AMS programmes, and we consider core components, such as policy integration, surveillance of appropriateness, and context-aware interventions. This Review ultimately advocates for equity-focused strategies that better account for structural barriers, support marginalized populations, and ensure global access to high-quality antimicrobials. By aligning political will, funding and scientific innovation, AMS programmes can be scaled effectively to preserve antimicrobial efficacy, mitigate AMR, improve health outcomes, and promote global health security. The paper concludes with key recommendations for embedding AMS across sectors as a sustainable response to AMR.

Indexed as

Anti-Bacterial AgentsAntimicrobial StewardshipOne HealthAnimalsGlobal HealthHumansAnti-Bacterial Agents

Identifiers

PMID40931120

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.