ANTIMICROBIAL DRUG MANAGEMENT MODEL AT THE PRIMARY HEALTH CARE LEVEL

Abstract

Purpose: to substantiate and develop a model for managing antibiotic use at the primary health care level. Materials and Methods. The study was conducted in two stages. First, 48 documents from the World Health Organization, World Bank, European Centre for Disease Prevention and Control, Food and Agriculture Organization of the United Nations, United States Centers for Disease Control and Prevention, and data on global and Ukrainian antibiotic use practices were analyzed to identify key components of rational use. Second, a management model for primary health care was developed using systems analysis, bibliographic and semantic analysis, and conceptual modeling. Results. Eleven key components of the rational use of antimicrobials in the healthcare system have been identified: global and national policy; legislative and regulatory framework; evidence-based clinical decision-making; microbiological diagnostics; antimicrobial stewardship; resistance and consumption surveillance; infection prevention and control; access to quality medicines; education of health professionals; public awareness; veterinary and agricultural control. The model envisages establishing an Antibiotic Stewardship Group composed of physicians trained in infection prevention and control to optimize prescriptions, train personnel, inform the public, and conduct surveillance. Functioning is ensured through interaction with health authorities, the Expert Center of the Ministry of Health of Ukraine, and the Center for Disease Control and Prevention, and is supported by medical information systems as well as financial and non-financial incentives from the National Health Service of Ukraine. Conclusions. The proposed model at the primary health care level ensures prescription optimization, increased awareness, and effective antibiotic use monitoring within an integrated multi-component strategy.