Inappropriate antimicrobial use represents one of the main drivers of the emergence and dissemination of antimicrobial resistance. This study aims to assess the level of implementation of antimicrobial stewardship programs in Latin American hospitals and to identify weaknesses that may support the development of future strategies.

This was a prospective, multicenter study (pre-intervention phase) including a non-probabilistic sample of 22 hospitals from 10 Latin American countries. Data were collected from March to May 2025 through a validated self-assessment instrument for antimicrobial stewardship programs. Scores ranged from 0 to 100 and were grouped by percentiles.

Among participating hospitals, 91% belonged to the public health network. Of the 127 professionals involved, 76% were women. Physicians accounted for 35%, while clinical pharmacists and microbiologists each represented 20%. The overall score was 55.4 (50th percentile). The domain “strategies to optimize antimicrobial prescribing” achieved the highest score in the baseline assessment, likely reflecting the activity of hospital infection control committees. Conversely, the “education” domain had the lowest score, underscoring the need for ongoing training of physicians, patients, and family members — a critical point identified in this analysis. Among the evaluated components, “executive leadership support,” “validated treatment protocols,” and “antimicrobial use process indicators” also received low scores, limiting program consolidation since many actions depend on formal endorsement from hospital administration. The absence of therapeutic protocols tailored to the institutional microbiological profile poses clinical risks, increases costs, and contributes to microbial resistance.

Antimicrobial stewardship programs in Latin America remain, for the most part, only partially implemented. Phases II and III of this study will provide indicators of the effectiveness of structured, periodic online mentoring for stewardship professionals in participating hospitals by re-assessing scores using the same validated self-assessment tool at the end of the study in August 2026.