Antimicrobial resistance in the Russian Federation: ways to solve the problem

Introduction. Antimicrobial resistance is one of the leading threats to public health and to the sustainability of healthcare systems, and its containment has been designated a national priority of the Russian Federation. The purpose of the study: to systematize modern ideas about the scale and driving factors of antimicrobial resistance in the Russian Federation and to justify the transition from a list of disparate measures to an integrated model of its containment. Materials and methods. The analytical review is based on domestic and foreign publications for 2017–2025, regulatory legal acts and data from the national multicenter sustainability monitoring. The sources were searched in the repositories PubMed, CyberLeninka, eLibrary.RU, as well as through the Google search engine. Logical, comparative, structural methods and content analysis were used to study the generated array of relevant publications. Results. According to the data obtained, there is a tendency to increase the resistance of pathogens, mainly gram-negative ones, in hospital settings. At the same time, the key limitation remains not the lack of scientific knowledge, but the gap between evidence-based approaches and their actual implementation in practice, which is mainly behavioral and organizational in nature. National surveillance information infrastructure and specific vaccine prevention are considered as underestimated, but complementary points of application that can reduce the need for antimicrobials and limit the selection of resistant strains. Conclusion. Antimicrobial resistance cannot be contained by a single instrument; a sustainable outcome is provided by a systemic loop combining resistance monitoring, rational pharmacotherapy, vaccination and a managed digital environment for their implementation, individual elements of which are already being created in the Russian Federation and require organisational and informational integration.