STEWARDSHIP BRASIL : desenvolvimento e implementação de estratégias para o controle de infecções e gerenciamento de antimicrobianos na Atenção Primária à Saúde.

Abstract

The development and implementation of strategies aimed at infection control and antimicrobial stewardship in primary health care are essential to ensure safe and effective care. These actions seek to optimize the use of antimicrobials, reduce bacterial resistance, and promote a coordinated approach to address health challenges, contributing to public health in a sustainable way. The objective of this thesis was to evaluate, develop, and implement strategies focused on infection control and antimicrobial stewardship in primary health care at the national level. Article 1, titled "Development and validation of a questionnaire on the use of antimicrobials in primary health care", addresses antimicrobial resistance (AMR) as one of the greatest global public health challenges, intensified by the inappropriate and excessive use of antimicrobials. Given the lack of studies in Brazil on infection prevention and control (IPC) strategies and antimicrobial stewardship in primary health care (PHC), the study aimed to develop and validate an assessment tool to investigate practices adopted in PHC services. Conducted between February and April 2022, the study followed five stages: literature review, question development, expert validation, questionnaire refinement, and dissemination. The final questionnaire, consisting of 102 questions, was improved based on expert feedback, resulting in enhanced language and structure, and achieved an overall Content Validity Index (CVI) of 0.74, indicating good representativeness and agreement. The tool proved to be accurate and reliable for assessing strategies related to infection control and antimicrobial use in PHC, providing critical data to improve healthcare practices, reduce AMR, and strengthen the health system. The study highlights the importance of research in this area to promote the rational use of antimicrobials and improve the quality of health services.