A Systematic Review of Pharmacist-Led Antimicrobial Stewardship Programs in Sub-Saharan Africa
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Background . The misuse of antibiotics contributes significantly to antimicrobial resistance (AMR). Higher treatment costs, longer hospital stays, and clinical failure can all result from AMR. According to projections, Africa and Asia will bear the heaviest burden of AMR‐related mortalities in the coming years. Antimicrobial stewardship (AMS) programmes are therefore critical in mitigating the effects of AMR. Pharmacists may play an important role in such programmes, as seen in Europe and North America, but the impact, challenges, and opportunities of pharmacist‐led antimicrobial stewardship interventions in Sub‐Saharan African hospitals are unknown. The purpose of this systematic review was to assess the impact, challenges, and opportunities of pharmacist‐led antimicrobial stewardship interventions in Sub‐Saharan African hospitals. Methods . The Joanna Briggs Institute (JBI) guidelines were used to search for peer‐reviewed pharmacist‐led studies based in hospitals in Sub‐Saharan Africa that were published in English between January 2015 and January 2021. The PubMed, Embase, and Ovid databases were used. Results . Education and training, audits and feedback, protocol development, and ward rounds were identified as primary components of pharmacist‐led antimicrobial stewardship interventions in Sub‐Saharan Africa. The pharmacist‐led antimicrobial interventions improved adherence to guidelines and reduced inappropriate prescribing, but were hampered by a lack of laboratory and technological support, limited stewardship time, poor documentation, and a lack of guidelines and policies. Funding, mentorship, guidelines, accountability, continuous monitoring, feedback, multidisciplinary engagements, and collaborations were identified as critical in the implementation of pharmacist‐led antimicrobial stewardship programmes. Conclusions . These findings suggest that pharmacists in Sub‐Saharan African hospitals can successfully lead antimicrobial stewardship programmes but their implementation is limited by lack of mentorship, accountability, continuous monitoring, feedback, collaborations, and poor funding.
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This result appears consistent with findings from other systematic reviews both within and outside SSA, as none of the reviews reported AMR interventions specifically tailored to accommodate persons living with disabilities.
“This result appears consistent with findings from other systematic reviews both within and outside SSA, as none of the reviews reported AMR interventions specifically tailored to accommodate persons living with disabilities.11 13 16 20 21”
From Public-targeted interventions addressing antimicrobial resistance and antibiotic use in Sub-Saharan Africa: a scoping review (2025) · cites this paper as [13]
The Results (section 3.1) describe the included hospital studies and their clinical focuses, but do not address whether any intervention was tailored for persons living with disabilities. Searches for disability and tailored interventions found no passage making that finding. This review also cannot establish what the other reviews within or outside SSA reported. (LLM, conf=0.72)
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- Authors
- Otieno, P. A., Campbell, S., Maley, S., Obinju Arunga, T., & Otieno Okumu, M.
- Affiliations
- University of Glasgow (GB)
- Venue
- International Journal of Clinical Practice
- Publisher
- Wiley
- Published
- 2022-01
- Volume
- 2022
- Issue
- 1
- Pages
- 3639943-3639943
- ISSN
- 1368-5031 (ISSN-L)
- 1742-1241
- PMC
- PMC9584722
- OpenAlex
- W4306151979
- Cited by
- 92
- References
- 71
- Citations by year
- 2026: 24 · 2025: 31 · 2024: 19 · 2023: 16 · 2022: 2
- FWCI
- 0.96
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- International Journal of Clinical Practice (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- antimicrobial resistance, antibiotic misuse, sub-Saharan Africa, hospital pharmacy, inappropriate prescribing, guideline adherence, ward rounds, protocol design, implementation barriers, mentoring, multidisciplinary collaboration
- MeSH terms
- Antimicrobial Stewardship, Anti-Infective Agents, Anti-Bacterial Agents, Humans, Pharmacists, Africa South of the Sahara
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