Presentation (CTI)

OBJECTIVES: To synthesize evidence on the economic and resource-use outcomes associated with hospital-based antimicrobial stewardship programs (ASPs) implemented in South Asia and Gulf Cooperation Council (GCC) countries.
METHODS: A systematic literature review was conducted in accordance with PRISMA 2020 guidelines. PubMed and Google Scholar were searched for studies published between 2015 and 2025 evaluating hospital-based ASP interventions in South Asia or GCC countries. Eligible studies reported economic outcomes or resource-use indicators including antimicrobial expenditure, defined daily doses (DDD), days of therapy (DOT), or antimicrobial consumption. Due to heterogeneity in study design and outcome reporting, findings were narratively synthesized.
RESULTS: Five studies met inclusion criteria, including pre-post interventional studies and systematic reviews conducted in India, Oman, and Saudi Arabia. Stewardship interventions commonly included prospective audit and feedback, formulary restriction, guideline implementation, pharmacist-led review, and multidisciplinary stewardship teams. Across studies, ASP implementation was consistently associated with reductions in antimicrobial consumption and improved resource utilization. Gulf-region studies, particularly pharmacist-led models, demonstrated clearer reporting of direct antimicrobial cost savings. Studies from South Asia reported reductions in antimicrobial use and prescribing variability, although formal cost-effectiveness analyses remained limited.
CONCLUSIONS: Hospital-based ASPs in South Asia and the Gulf region are associated with favorable economic and resource-use outcomes, including reduced antimicrobial consumption and potential cost savings. Standardized economic evaluation methods and harmonized reporting frameworks are needed to strengthen the evidence base and support sustainable stewardship implementation in resource-constrained healthcare systems.