Antimicrobial stewardship resourcing and programme outcomes: a scoping review.

Background: Antimicrobial stewardship programmes (ASPs) are essential to mitigate antimicrobial resistance, yet inadequate human and financial resourcing is a persistent barrier limiting their implementation. While ASPs are associated with improved outcomes, the relationship between the extent of resourcing and outcomes is less clear. This scoping review described the evidence on the association between ASP resourcing and antimicrobial use, patient, programmatic and economic outcomes. Methods: A scoping review was conducted in accordance with PRISMA-ScR guidance (protocol: https://osf.io/hbe59). Medline, EMBASE, Scopus and CINAHL were searched from inception, supplemented by grey literature searches. Eligible studies evaluated at least two models of ASP resourcing and associated outcomes. Screening and extraction were performed in duplicate, and quality assessed using Joanna Briggs Institute tools. Outcomes were synthesized descriptively. Results: Of 2447 citations screened, 32 studies were included. Most studies were observational, hospital-based and from high-income countries. Resourcing comparisons included: coverage models ( Conclusion: While increased ASP resourcing appears to be associated with improved antimicrobial use and cost outcomes in many studies, evidence remains heterogeneous. These findings underscore the need for rigorous, prospective studies and evidence-based recommendations to guide optimal ASP staffing.