A scoping review on best practices of antibiotic resistance control in the private health sector and a case study in Vietnam

Abstract

Abstract Introduction Antimicrobial resistance (AMR) is a pressing global health concern that threatens the efficacy of antibiotics and compromises the treatment of infectious diseases. The private health sector, including private hospitals, private clinics, private doctors, and private drug stores, play crucial roles in accessing antibiotics at the primary health care level, particularly in low- and middle-income countries (LMICs), however, it also brings high risks of AMR to communities, for example, non-prescriptive antibiotic sales. In Vietnam, AMR is highly prevalent  due to the inappropriate use or overuse of antibiotics in clinical settings and in the community. This study aimed to assess the regulatory framework governing antibiotic resistance in Vietnam’s private health sector by examining international and national successful strategies and approaches to control AMR in the private health sector. Methods The literature search was used to gather international experiences and official Vietnamese documents related to AMR control in the private health sector. Web of Science, PubMed, and Cochrane were utilized as the main sources for academic database, meanwhile, Google Search Engine was used as the additional source for grey literature and international guidelines and reports. The methodological framework of the scoping review was based on Arksey and O'Malley’s guidelines. The selection criteria were articles and documents pertinent to AMR control, antibiotic use and dispensing regulations in the private health sector. Results Analysis from 118 documents (79 of them on international experience) revealed various successful strategies employed by countries worldwide to combat AMR in the private health sector, including the establishment of surveillance networks, antibiotic stewardship programs, interagency task forces, public‒private partnerships, and educational initiatives. Challenges in AMR control policies in Vietnam’s private health sector existed in AMR surveillance, intersectoral coordination, public‒private cooperation, resource allocation, and regulatory enforcement on the sale of antibiotics without prescriptions. Conclusion The findings highlight the role of surveillance, medical education, regulatory enforcement in antibiotic prescription and sales, and public‒private partnerships in promoting rational antibiotic use and reducing the burden of AMR in the private health sector. Addressing AMR in Vietnam’s private health services requires a multifaceted approach that includes regulatory enforcement, surveillance, and educational initiatives for private health providers and communities.