Strategies to optimize antimicrobial use and control antimicrobial resistance: an evidence- informed policy process

Background Antimicrobial resistance (AMR) is a public health priority in Colombia and worldwide, with implications for human, animal, and environmental health. This study presents an evidence-informed policy process designed to support the Colombian Ministry of Health (CMoH) in identifying and implementing strategies against AMR. Methods We explored three policy options to address this problem, guided by priorities set by CMoH decision-makers: (1) strengthening regulatory activities; (2) delivering education to professionals in relevant sectors from the One Health perspective; and (3) implementing community-oriented educational initiatives. Following a systematic approach, we synthesized the research evidence about those options in a policy brief. To ensure the inclusion of public perspectives, we convened two citizen panels—one urban and one rural— integrating their values and preferences into the brief. This document subsequently informed a policy dialogue, where stakeholders examined the options and discussed implementation considerations for addressing the AMR problem. Results Sixty-nine documents informed the evidence brief. The main strategies identified for the intersectoral regulation of AMR, framed within National Action Plans (NAPs) were: Legislative reforms, antimicrobial stewardship programs (ASPs), infection prevention and control (IPC) programs, and monitoring and surveillance. Educational interventions targeting health professionals—such as training, audit/feedback mechanisms, and treatment protocols—improve rational prescribing and reduce AMR, whereas community-based interventions addressing inappropriate antimicrobial (AM) use and AMR demonstrate short-term effectiveness. Citizen panels and policy dialogue provided context-specific insights and proposed approaches tailored to the Colombian context. Although areas of consensus emerged, the policy dialogue adopted a more institutional and systems-level perspective, whereas the citizen panels—particularly those in rural areas—focused on practical and equity-oriented concerns. Conclusion ASPs, IPC programs, and educational interventions contribute to AM use optimization and AMR reduction. However, most strategies and their implementation have not been formally evaluated, limiting their value for policy planning. The absence of governmental guidelines on AM uses and AMR in the animal and environmental sectors highlights gaps between existing legislation and regulatory needs at both the national and organizational levels, whereas evidence on educational strategies targeting these sectors remains insufficient. Citizen panels and policy dialogue provided context-specific insights and proposed approaches tailored to the Colombian context.