Background/Objectives: Antimicrobial resistance (AMR) poses a global health threat, especially in low- and middle-income countries. Community Health Workers (CHWs) play a crucial role in infection management and health promotion, but their role in antimicrobial stewardship (AMS) is unclear. This study aims to assess CHWs’ roles in AMS, examine their training and support, and evaluate outcomes regarding antibiotic use and resistance.

Methods: A scoping review was conducted to explore the roles, education, training, and antimicrobial-related outcomes of CHWs. The review followed the PRISMA guidelines, with the protocol registered in OSF. Databases including PubMed, EMBASE, and CINAHL were searched for studies published in English and Spanish. A narrative synthesis was applied to the identified articles, and the ICROMS tool was employed to assess the risk of bias.

Results: Seven studies were identified, conducted in Uganda, Tanzania, Zambia, Pakistan, Bangladesh, and Kenya. CHWs' are involved in various AMS activities, such as infection prevention, detection, and treatment of conditions such as pneumonia, and gastrointestinal infections. CHWs contributed to health education, antibiotic prescription (when authorised), and improved adherence to guidelines. Positive outcomes included reduced inappropriate antibiotic use and in-creased community awareness of AMR. However, the effectiveness of these interventions varies depending on the local context and resources.

Conclusions/Recommendations: CHWs are crucial to improving antibiotic use and combating AMR. Expanding their roles, enhancing training, and providing better support are essential to maximise their impact. Further research is needed to optimise CHW interventions and assess their long-term effects.