Exploring antibiotic stewardship interventions within a One Health context: a scoping review

This scoping review examines antibiotic stewardship interventions through a One Health lens, recognizing that antibiotic resistance (ABR) arises from interconnected human, animal, and environmental systems and is driven largely by antibiotic overuse and misuse. Reviewing 29 policy interventions, the study maps the current stewardship landscape and assesses interventions across 26 characteristics, including scope, implementation, One Health integration, equity, and impact. Most interventions focus on communication and awareness, access and appropriate use of antibiotics, and safe disposal. While interventions vary in cross-sector collaboration, private-sector engagement, and equity considerations, human health objectives still dominate. Key facilitators of success include strong livestock industry involvement, supportive legal and institutional frameworks, and availability of alternatives to antibiotics. Overall, the review underscores the need for stronger One Health integration and more robust evaluation to better understand what drives effective, equitable stewardship and measurable impacts on antibiotic use, resistance, and animal health.