Improving antimicrobial prescribing among surgeons and surgical trainees: a scoping review of educational approaches

BACKGROUND: Antimicrobial resistance causes ∼700,000 deaths annually. Surgeons are essential to infection prevention but often misuse antibiotics due to limited antimicrobial stewardship (AMS) training. Educational AMS interventions may address limitations of traditional programs in the surgical context by empowering surgeons and trainees. This review synthesizes evidence on educational strategies to improve surgical antimicrobial prescribing. METHODS: A scoping review following Arksey and O'Malley's framework and PRISMA-Scr guidelines was registered on OSF. PubMed, Embase, Medline, and Web of Science were searched until June 5th, 2025. Studies evaluating educational antimicrobial stewardship interventions for surgeons and surgical trainees that reported on antimicrobial prescribing outcomes were included. Non-surgical populations, non-educational interventions, and non-original studies were excluded. RESULTS: Seventeen of 4338 articles were included, mostly from high-income countries, tertiary hospitals using pre-post designs. Common educational methods included lectures, guidelines, and posters, often in multimodal interventions. Significant improvements were most linked to antibiotic selection, timing, and duration. CONCLUSION: Educational AMS interventions improve surgical antimicrobial prescribing habits particularly regarding antibiotic selection, timing and duration.