Strengthening antimicrobial stewardship in Swiss primary care using WHO’s scoping tool

Issue/problem

Antimicrobial resistance is a national public health priority in Switzerland, supported by longstanding surveillance systems and clinical guidelines. However, antimicrobial stewardship in primary care remains unevenly implemented and weakly governed. Responsibilities are fragmented across federal and cantonal levels, and existing initiatives lack coordination, limiting their impact on prescribing practices.

Description of the problem

The Antimicrobial Stewardship in Ambulatory Care Platform (ASAP) is a national Swiss initiative established in 2023 in the post‑COVID‑19 context, at a time when antibiotic consumption in ambulatory care was returning to pre‑pandemic levels. To support its strategic planning, ASAP conducted a national scoping analysis using the WHO primary health care–oriented scoping tool, combined with a multistakeholder workshop. ASAP functioned as a convening and integrative structure, mapping governance, actors, tools and gaps affecting stewardship in Swiss primary care and facilitating joint prioritization of feasible implementation actions.

Results

The analysis identified strong regulatory foundations and comprehensive surveillance as enabling factors, but highlighted major gaps, including the absence of a coordinated stewardship framework for primary care, limited feedback of prescribing data to clinicians, insufficient cantonal ownership and minimal patient involvement. Through ASAP, stakeholders agreed on priority actions, including structured prescriber feedback, harmonised access to clinical guidance, integration of stewardship into continuing education and reinforcement of cantonal–national collaboration.

Lessons

ASAP demonstrates the added value of a national platform in transforming fragmented stewardship activities into coordinated, practice‑relevant action. In decentralised health systems, platform‑based governance can accelerate implementation without creating new regulatory structures.

Key messages

• Surveillance alone is insufficient to ensure antimicrobial stewardship in primary care without clear governance and implementation structures.

• A national multisectoral platform can transform fragmented stewardship activities into coordinated, practice relevant action.