# Strengthening Antimicrobial Stewardship Programs in Latin America Through Telementoring: Results From the TEACH PROA-ECHO Initiative

## TL;DR

A telementoring program called TEACH PROA-ECHO helped improve antimicrobial stewardship in 73 Latin American healthcare institutions, boosting their capabilities and knowledge in managing antibiotic use.

## Contribution

The TEACH PROA-ECHO initiative demonstrates that telementoring is an effective and scalable method to strengthen antimicrobial stewardship in resource-limited settings.

## Key findings

- 73 out of 80 institutions completed the telementoring program, with significant improvements in antimicrobial stewardship scores.
- Participants showed high satisfaction and a notable increase in knowledge after the sessions.
- The proportion of institutions with intermediate or advanced stewardship development rose from 56.2% to 83.6%.

## Abstract

Antimicrobial resistance (AMR) is a major global health threat, with a disproportionate impact on low- and middle-income countries. The TEACH PROA-ECHO (Telementoring, Equity & Advocacy Collaboration for Health through Antimicrobial Stewardship) initiative aimed to strengthen antimicrobial stewardship programs (ASPs) in Latin America using the ECHO telementoring model.

From March to December 2024, 80 healthcare institutions from 10 Latin American countries participated in biweekly telementoring sessions focused on case-based learning guidance on stewardship interventions and collaborative problem-solving related to antimicrobial prescribing and surveillance. A validated self-assessment tool was used to categorize baseline ASP development and monitor progress over time. Learning activities were evaluated using Moore's framework, and participating teams identified local barriers and enablers for stewardship activities.

Of the 80 institutions, 73 (91%) completed the program. A total of 322 professionals were registered in the project, accounting for 2166 attendances. Moore's indicators showed high satisfaction (Net Promoter Score 79) and significant knowledge improvement after sessions (97.3% vs 81.4%; P < .0001). Mean ASP self-assessment scores increased from 53.1 to 64.0 (P < .0001). The proportion of institutions with intermediate or advanced ASP development rose from 56.2% to 83.6% (P < .001). Higher baseline scores were associated with for-profit institutions, ASP implementation longer than 5 years, and program continuity (lack of ASP interruptions in the last 5 years).

Telementoring is an effective and scalable approach to strengthening antimicrobial stewardship in Latin America. The TEACH PROA-ECHO model represents a valuable strategy to support national AMR action plans in resource-limited settings.

The TEACH PROA-ECHO telementoring project improved antimicrobial stewardship programs in 73 Latin American institutions, significantly raising their development scores, and knowledge of the participants, demonstrating a scalable, effective approach to support national AMR action plans in resource-limited settings.