A Systematic Review of Pharmacist-Led Antimicrobial Stewardship Programs in Sub-Saharan Africa

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 co...

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Main Authors: Phanice Ajore Otieno, Sue Campbell, Sonny Maley, Tom Obinju Arunga, Mitchel Otieno Okumu
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:International Journal of Clinical Practice
Online Access:http://dx.doi.org/10.1155/2022/3639943
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author Phanice Ajore Otieno
Sue Campbell
Sonny Maley
Tom Obinju Arunga
Mitchel Otieno Okumu
author_facet Phanice Ajore Otieno
Sue Campbell
Sonny Maley
Tom Obinju Arunga
Mitchel Otieno Okumu
author_sort Phanice Ajore Otieno
collection DOAJ
description 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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spelling doaj-art-4d4fa0951aaa440491a1ba10679f8e8a2025-08-20T02:38:38ZengWileyInternational Journal of Clinical Practice1742-12412022-01-01202210.1155/2022/3639943A Systematic Review of Pharmacist-Led Antimicrobial Stewardship Programs in Sub-Saharan AfricaPhanice Ajore Otieno0Sue Campbell1Sonny Maley2Tom Obinju Arunga3Mitchel Otieno Okumu4College of MedicalCollege of MedicalCollege of MedicalDepartment of Health InformaticsDepartment of HealthBackground. 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.http://dx.doi.org/10.1155/2022/3639943
spellingShingle Phanice Ajore Otieno
Sue Campbell
Sonny Maley
Tom Obinju Arunga
Mitchel Otieno Okumu
A Systematic Review of Pharmacist-Led Antimicrobial Stewardship Programs in Sub-Saharan Africa
International Journal of Clinical Practice
title A Systematic Review of Pharmacist-Led Antimicrobial Stewardship Programs in Sub-Saharan Africa
title_full A Systematic Review of Pharmacist-Led Antimicrobial Stewardship Programs in Sub-Saharan Africa
title_fullStr A Systematic Review of Pharmacist-Led Antimicrobial Stewardship Programs in Sub-Saharan Africa
title_full_unstemmed A Systematic Review of Pharmacist-Led Antimicrobial Stewardship Programs in Sub-Saharan Africa
title_short A Systematic Review of Pharmacist-Led Antimicrobial Stewardship Programs in Sub-Saharan Africa
title_sort systematic review of pharmacist led antimicrobial stewardship programs in sub saharan africa
url http://dx.doi.org/10.1155/2022/3639943
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