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Antimicrobial resistance, antibiotic prescribing practices and antimicrobial stewardship in South Africa: a scoping
Suwayda Ahmed1, Rukshana Ahmed1, Razia Zulfikar Adam2
1Department of Prosthodontics, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa.
Introduction:
Antimicrobial resistance (AMR) is an emerging global threat, with notable impact evident in low- and middle-income countries. Indiscriminate antibiotic prescribing is recognized as the key factor responsible for the continued spread of AMR.
Objectives:
To comprehensively map published data of evidence of AMR in healthcare settings in South Africa, encompassing the exploration of antibiotic prescribing practices and the implementation of antimicrobial stewardship initiatives.
Methods:
The scoping review methodology was based on the guidelines outlined by Arksey and O'Malley. The protocol for this scoping review has been registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/PWMFB). The search strategy was documented using the protocol outlined within the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR). Databases used were Science Direct, Scopus, PubMed, Wiley, Directory of Open Access Journals; and health organizations such as the WHO. In addition, the Google search engine was used to search for grey matter. The search was restricted to peer-reviewed articles in English on human studies for the period 2019-24.
Results:
The search yielded a total of 529 articles from electronic databases and search engines. Twenty-nine articles were accepted for inclusion following the application of the study protocol. The majority of the articles were primary research papers.
Conclusions:
The findings reveal that South Africa has measures in place to combat AMR; however, inconsistencies were found between the private and public health sectors, in addition to the lack of adherence to guidelines and limitations in AMR education among healthcare workers and students.
Insights
Antimicrobial resistance (AMR) is a growing global problem, particularly in South Africa. This study found inconsistent efforts to combat AMR and poor adherence to guidelines, highlighting a need for better education and standardized practices in healthcare settings.
Area of Science:
- Public Health
- Infectious Diseases
- Pharmacology
Background:
- Antimicrobial resistance (AMR) poses a significant global health threat, disproportionately affecting low- and middle-income countries.
- Indiscriminate antibiotic prescribing is a primary driver of AMR spread.
Purpose of the Study:
- To map published evidence on AMR in South African healthcare settings.
- To investigate antibiotic prescribing patterns.
- To assess antimicrobial stewardship initiatives in South Africa.
Main Methods:
- A scoping review methodology based on Arksey and O'Malley guidelines.
- Protocol registered on Open Science Framework (OSF.IO/PWMFB).
- Searches conducted across major databases (PubMed, Scopus, etc.) and Google, limited to English, human studies (2019-2024).
Main Results:
- 529 articles were initially identified; 29 were included in the final review.
- The majority of included articles were primary research papers.
- South Africa has implemented measures against AMR, but significant inconsistencies exist between public and private sectors.
Conclusions:
- Despite existing measures, adherence to antimicrobial stewardship guidelines is inconsistent in South Africa.
- Gaps in AMR education for healthcare workers and students were identified.
- Addressing these inconsistencies and educational limitations is crucial for effective AMR control.
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