Barriers and Facilitators to Antimicrobial Stewardship in Antibiotic Prescribing and Dispensing by General Practitioners and Pharmacists in Malta: A Systematic Review

Prescribing in Malta is shaped by diagnostic uncertainty, entrenched habits, patient expectations, and structural gaps. Although the evidence base was limited and partly overlapping, consistent findings across mixed method designs highlighted that effective stewardship will require rapid diagnostics, e-prescribing, over-the-counter enforcement, and GP-pharmacist collaboration, supported by policy reforms aligning indemnity and sick-leave systems with AMR goals.