Work

Economic evaluation of antimicrobial stewardship programme in primary care in Kosovo: study protocol

Year: 2026

Type: article

Abstract: Introduction Antimicrobial resistance poses a major challenge to both public health and economic stability in many countries. In response, antimicrobial stewardship programmes are essential for optimising antibiotic use and reducing antimicrobial resistance, particularly in primary care settings where most antibiotics are prescribed. Kosovo, like many countries, is increasingly affected by the growing threat of antimicrobial resistance and must strengthen its strategies to address this problem. Although national action plans on antimicrobial resistance and stewardship have been completed, there is limited evidence on the economic impact of antimicrobial stewardship interventions in Kosovo, as is the case in many low- and middle-income country contexts. This study thus aims to evaluate the cost-effectiveness of antimicrobial stewardship programme in Kosovo, and the cost of implementing this programme in primary care settings in Kosovo. Methods and analysis First, for the cost-effectiveness component of the study, we will use a quasi-experimental interrupted time series design focusing on patients ≥18 years old diagnosed with upper respiratory tract infections at intervention and control sites in Kosovo’s primary care system, to analyse changes in antibiotic consumption measured in defined daily doses, and estimate the corresponding monetary value to determine cost-effectiveness. Second, we will use a bottom-up costing method to estimate the costs associated with implementing the antimicrobial stewardship programme, including resources required across intervention and control sites. Cost data for both components will be collected from the implementing institutions and the main family medicine centres, serving as the intervention and control sites. Ethics and dissemination The Ethical Committee of the Kosovo Chamber of Medical Doctors approved the protocol of our study (Number: 122/2024). Moreover, the results from this study will be published and disseminated as a peer-reviewed publication.

Source: BMJ Open

DOI: 10.1136/bmjopen-2026-124661