A rapid systematic scoping review of the levels of bacterial antimicrobial resistance and antibiotic use among people in contact with the criminal justice system.

BACKGROUND: Antimicrobial resistance (AMR) poses a significant public health threat. Individuals in contact with the criminal justice system, including individuals in custody, prisons, jails or youth offending institutions, may be particularly vulnerable due to living conditions, behaviours and pre-existing health issues. This review assesses bacterial AMR and antibiotic use in this population.

METHODS: A rapid systematic scoping review was conducted (OSF: https://doi.org/10.17605/OSF.IO/XHCFJ). Embase, Medline and Scopus were searched for studies published between 1 January 2010 and 28 September 2023. One author screened all records, with 10% dual screened. Included studies examined AMR bacteria or antibiotic use among people in contact with the criminal justice system (including people in custody, prisons, jails or youth offending institutes). Study quality was assessed using the Newcastle-Ottawa Scale and STROBE AMS checklist. Findings were synthesized narratively as evidence was limited and heterogeneous, which prohibited planned meta-analyses.

RESULTS: Sixteen papers met inclusion criteria; eight were at lower risk of bias. Three studies examined antibiotic use, reporting common inappropriate prescribing ( = 1) and associations between recent antibiotic use and resistant infections ( = 2). Fourteen papers reported AMR findings, most with a focus onand. Drug-resistant TB prevalence in prison populations ranged from 5.2% to 37% ( = 4). Methicillin resistantcolonization ranged from 8.1% to 8.8% ( = 4). Other bacteria examined includedspp.,spp.,, and.

CONCLUSIONS: People in contact with the criminal justice system face heightened risks of resistant bacterial infections. However, with only three studies addressing antibiotic use, evidence is limited. Addressing AMR in this group requires collaborative and targeted public health interventions.