ReviewJournal of pharmaceutical policy and practice2023
Adherence to evidence-based implementation of antimicrobial treatment guidelines among prescribers in sub-Saharan Africa: a systematic review and meta-analysis.
Review in Journal of pharmaceutical policy and practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Inappropriate antibiotic prescribing in Ethiopian hospitals: a systematic review.International journal of clinical pharmacy · 2026Pooled it
- Inappropriate ceftriaxone utilization and predictor factors in Ethiopia: a systematic review and meta-analysis.Scientific reports · 2024Pooled it
- Surveillance of antimicrobial utilization in Africa: a systematic review and meta-analysis of prescription rates, indications, and quality of use from point prevalence surveys.Antimicrobial resistance and infection control · 2024Pooled it
- The Applicability of AWaRe-Based Antibiotic Quality Indicators to Assess the Appropriateness of Antibiotic Prescribing in Primary Healthcare in South Africa: A Multicentre Point Prevalence Study and Implications for the Future.Antibiotics (Basel, Switzerland) · 2026Article
- Evaluating the appropriateness of prescribing antibiotics among persons with HIV (PWH) in an Urban HIV outpatient clinic in Uganda.Antimicrobial resistance and infection control · 2026Article
- Barriers to and facilitators of adherence to evidence-based standard antimicrobial treatment guidelines among physicians in Ethiopia: a formative qualitative study.Scientific reports · 2026Article
- Development of AWaRe-Based Quality Indicators to Assess the Appropriateness of Antibiotic Prescribing in Primary Healthcare in South Africa.Antibiotics (Basel, Switzerland) · 2026Article
- Antimicrobial Stewardship Program Implementation, Perceptions, and Barriers in Zambia: A Cross-Sectional Study Among Healthcare Professionals.Antibiotics (Basel, Switzerland) · 2025Article
- Strengthening antimicrobial stewardship in public health facilities in Malawi through a participatory epidemiology approach.JAC-antimicrobial resistance · 2025Article
- Status and implications of the knowledge, attitudes and practices towards AWaRe antibiotic use, resistance and stewardship among low- and middle-income countries.JAC-antimicrobial resistance · 2025Review
- Antimicrobial Stewardship Impact on Antibiotic Use in Three Tertiary Hospitals in Zambia: A Comparative Point Prevalence Survey.Antibiotics (Basel, Switzerland) · 2025Article
- Supervision, performance assessment, and recognition strategy (SPARS) - a multipronged strategy to strengthen medicines management in Nepal: pilot study methods and baseline results.Journal of pharmaceutical policy and practice · 2025Article
- Global variation in antibiotic prescribing guidelines and the implications for decreasing AMR in the future.Frontiers in pharmacology · 2025Review
- "We have theoretical knowledge, but these are not things we do regularly": District hospital's healthcare workers' experiences and perceptions on gestational diabetes mellitus screening in Tanzania.PLOS global public health · 2025Article
- High Prevalence of Antimicrobial Prescribing Among Public Health Facilities in Central Uganda: Findings from Point Prevalence Survey.Infection and drug resistance · 2025Article
- Article
- Perspectives on the Regional Strategy for Implementation of National Action Plans on Antimicrobial Resistance in the WHO African Region.Antibiotics (Basel, Switzerland) · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdherence to evidence-based standard treatment guidelines (STGs) enable healthcare providers to deliver consistently appropriate diagnosis and treatment. Irrational use of antimicrobials significantly contributes to antimicrobial resistance in sub-Saharan Africa (SSA). The best available evidence is needed to guide healthcare providers on adherence to evidence-based implementation of STGs. This systematic review and meta-analysis aimed to determine the pooled prevalence of adherence to evidence-based implementation of antimicrobial treatment guidelines among prescribers in SSA.
methodsThe review followed the JBI methodology for systematic reviews of prevalence data. CINAHL, Embase, PubMed, Scopus, and Web of Science databases were searched with no language and publication year limitations. STATA version 17 were used for meta-analysis. The publication bias and heterogeneity were assessed using Egger's test and the I
resultsTwenty-two studies with a total of 17,017 study participants from 14 countries in sub-Saharan Africa were included. The pooled prevalence of adherence to evidence-based implementation of antimicrobial treatment guidelines in SSA were 45%. The pooled prevalence of the most common clinical indications were respiratory tract (35%) and gastrointestinal infections (18%). Overall prescriptions per wards were inpatients (14,413) and outpatients (12,845). Only 391 prescribers accessed standard treatment guidelines during prescription of antimicrobials.
conclusionsHealthcare professionals' adherence to evidence-based implementation of STG for antimicrobial treatment were low in SSA. Healthcare systems in SSA must make concerted efforts to enhance prescribers access to STGs through optimization of mobile clinical decision support applications. Innovative, informative, and interactive strategies must be in place by the healthcare systems in SSA to empower healthcare providers to make evidence-based clinical decisions informed by the best available evidence and patient preferences, to ultimately improving patient outcomes and promoting appropriate antimicrobial use.
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Registered trials
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