Antibiotic stewardship in Norway: are strategies for rational use of antibiotics followed in Norwegian healthcare system?

Abstract

Objective: Resistance has been a major challenge since the development of antibiotics and countries have been working to curb it. As part of this effort, Norway has been striving to maintain low consumption of antibiotics and drug resistance. This paper aims to review the findings of studies in this regard as an attempt to investigate if the impacts of antibiotic stewardship strategies are in line with the intention. Method: A literature review was performed by searching MEDLINE/PubMed to identify peer reviewed articles which dealt with antibiotic use and resistance in Norway. Studies conducted after the year 2000, when a comprehensive national action plan against antibiotic resistance was initiated, were included and the search terms were antibiotic, antimicrobials, resistance and Norway. Results: A total of 229 articles were identified of which 75 were included in the review. In primary healthcare settings, hospitals and nursing homes, research themes like adherence to specific institutional guidelines, consumption of antibiotics, patterns of antibiotic resistance, infection prevention/control, as well as resistance profiling were taken up by investigators. Most of the findings highlighted that healthcare facilities are striving to adhere to guidelines and implement strategies outlined in the national strategic plan, despite some challenges. This has resulted in restricting the use of antibiotics thereby maintaining favorable environment to promote their prudent use. Conclusion: By and large, the findings affirm that the Norwegian healthcare system is characterized by a conservative use of antibiotics that has a positive impact on resistance containment. The authorities need to work further on issues such as adherence to guidelines and infection prevention/control so as to further maximize the prevailing good conditions.