Implementation of antimicrobial stewardship programmes in African countries: a systematic literature review

5 July, 2020

Citation, abstract and comment from me below.

CITATION: Implementation of antimicrobial stewardship programmes in African countries: a systematic literature review

Mary Richard Akpana, Nsisong Udom, Isemina, Arit Esio Udohb, Diane Ashiru-Oredopec

Journal of Global Antimicrobial Resistance, Volume 22, September 2020, Pages 317-324


Objective: Antimicrobial stewardship is one of the strategic objectives of the WHO global action plan on antimicrobial resistance. This paper sought to review the extent of implementation of antimicrobial stewardship programmes (ASPs) in African countries and the reported outcomes.

Methods: We searched five electronic databases, including PubMed, Scopus, Cochrane library, African Journal Online, CINAHL and Google scholar for papers published between 1990 and March 2019...

Results: Of 1752 titles identified, 13 studies met the criteria for inclusion. Seven of the studies were conducted in South Africa, three in Kenya and one each in Sudan, Tanzania and Egypt. Eleven studies were of high quality with low risk of bias. The included studies mainly assessed the outcome using process measures and these were associated with improved compliance with antibiotic guidelines, appropriateness of prescribing, reduction in antibiotic use and cost savings. Decrease in rate of surgical site infections and nonsignificant change in mortality and 30-day readmission rate were reported in two studies respectively.

Conclusion: Findings of this review show the paucity of data on implementation of ASPs in African countries. Although the continent is faced with challenges which impact on effective implementation of ASPs, the successes reported in the included studies show that other African countries can implement these programmes.

COMMENT (NPW): Although not mentioned in this paper, the ongoing Commonwealth Partnerships for Antimicrobial Stewardship promises to provide further insights.

Best wishes, Neil

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