Work

Impact of antimicrobial stewardship on healthcare-associated infections and antibiotic prescriptions in African countries: Systematic review and meta-analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Background: An antimicrobial stewardship programme (AMS) aims to combat antimicrobial resistance and healthcare-associated infections (HCAIs). While studies in developed countries show AMS's effectiveness in reducing AMR and HCAIs, its impact in African countries, given differing socioeconomics, remains unclear. Objectives: To review the impact of AMS on HCAIs, antibiotic prescriptions, cost of antimicrobial procurement, and compliance with diagnostic measures for detecting resistant HCAIs in African countries. Methods: Two reviewers (S.S. and U.C.) searched databases like CINAHL, Medline, and PubMed for studies on AMS interventions in African countries, focussing on their impact on healthcare-associated infections (HCAIs) and antibiotic prescriptions. We excluded studies on outpatients, children, or those not in English and conducted a meta-analysis using data collected from changes in HCAIs before and after intervention using a random-effects model. Results: The search identified 1153 studies, of which 14 were included in the review, while four eligible studies were included in the meta-analysis. Thirteen of the 14 studies were designed using pre- and post-study methods, and one study employed a case-control method. AMS interventions effectively reduce antibiotic consumption, the cost of antibiotic procurement, and improve diagnostic measures for the detection of resistant microorganisms. The forest plot suggested a 34% reduction in HCAIs. Conclusions: In Africa, AMS interventions, whether combined or single, reduce HCAIs and antibiotic prescriptions in healthcare settings. Surgical antibiotic prophylaxis lowers HCAIs in hospitals by one-third. However, findings are cautiously generalised due to the varied quality of studies and the limited number of African countries involved.

Source: Journal of Infection Prevention

DOI: 10.1177/17571774251377205

Authors: Sikiru Shuayb, Judith Sixsmith, Chika Robinson Okoyeuche

Institution: University of Dundee

Language: English

Topic: Antibiotic Use and Resistance

Subfield: Applied Microbiology and Biotechnology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,900