ArticleAntimicrobial resistance and infection control2024
Reported antibiotic use among patients in the multicenter ANDEMIA infectious diseases surveillance study in sub-saharan Africa.
Article in Antimicrobial resistance and infection control, 2024. 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.
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Who cites it
17 citing papers in PubMed, 3 syntheses or guidelines pooled it, 13 citations in OpenAlex.
- National and regional challenges of antibiotic prescribing patterns in pediatric populations across Africa: a systematic review and meta-analysis.Systematic reviews · 2026Pooled it
- A systematic review and meta-analysis of antibiotic resistance of foodborne pathogenic bacteria.BMC infectious diseases · 2025Pooled it
- Antimicrobial resistance in community-acquired enteric pathogens among children aged ≤ 10-years in low-and middle-income countries: a systematic review and meta-analysis.Frontiers in microbiology · 2025Pooled it
- Article
- Mind the governance gap: a one health scoping review of national AMR performance indicators.npj antimicrobials and resistance · 2026Article
- Development of AWaRe-Based Quality Indicators to Assess the Appropriateness of Antibiotic Prescribing in Primary Healthcare in South Africa.Antibiotics (Basel, Switzerland) · 2026Article
- Patterns of antibiotic use for acute febrile illness in resource-limited settings: a multicenter study in DR Congo, Kenya and Uganda.Frontiers in public health · 2026Article
- Comparison between model global AWaRe-based quality indicators and quality indicators developed to assess the appropriateness of antibiotic prescribing in primary healthcare in South Africa.Frontiers in public health · 2026Article
- Community-level Monitoring of Antimicrobial Resistance following Mass Administration of Azithromycin to Reduce Child Mortality in Côte d'Ivoire: Results from Two Rounds of Surveillance.Gates open research · 2026Article
- Prevalence and Associated Factors for Purchasing Antibiotics Without a Prescription Among Patients in Rural South Africa: Implications for Addressing Antimicrobial Resistance.Antibiotics (Basel, Switzerland) · 2025Article
- Improvements in Prescribing Indicators and Antibiotic Utilization Patterns Following Antimicrobial Stewardship Intervention at a District Hospital in Ghana.Tropical medicine and infectious disease · 2025Article
- Artificial intelligence-enhanced biosurveillance for antimicrobial resistance in sub-Saharan Africa.International health · 2025Review
- Increasing the use of the WHO AWaRe system in antibiotic surveillance and stewardship programmes in low- and middle-income countries.JAC-antimicrobial resistance · 2025Review
- Knowledge, Attitudes, Motivations, Expectations, and Systemic Factors Regarding Antimicrobial Use Amongst Community Members Seeking Care at the Primary Healthcare Level: A Scoping Review.Antibiotics (Basel, Switzerland) · 2025Review
- Multicountry surveillance study of acute febrile disease of unknown cause in sub-Saharan Africa.BMJ public health · 2025Article
- Antibiotic prescribing practices according to the AWaRe classification among children under 5 of age attending public primary care centres in four West African countries: a cross-sectional study (AIRE project, 2021-2022).BMJ paediatrics open · 2024Article
- Hospital prescribing patterns of antibiotics in Zambia using the WHO prescribing indicators post-COVID-19 pandemic: findings and implications.JAC-antimicrobial resistance · 2024Article
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Authors and funding
21 authors at 9 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExposure to antibiotics has been shown to be one of the drivers of antimicrobial resistance (AMR) and is critical to address when planning and implementing strategies for combatting AMR. However, data on antibiotic use in sub-Saharan Africa are still limited. Using hospital-based surveillance data from the African Network for Improved Diagnostics, Epidemiology and Management of Common Infectious Agents (ANDEMIA), we assessed self-reported antibiotic use in multiple sub-Saharan African countries.
methodsANDEMIA included 12 urban and rural health facilities in Côte d'Ivoire, Burkina Faso, Democratic Republic of the Congo, and Republic of South Africa. Patients with acute respiratory infection (RTI), acute gastrointestinal infection (GI) and acute febrile disease of unknown cause (AFDUC) were routinely enrolled, and clinical, demographic, socio-economic and behavioral data were collected using standardized questionnaires. An analysis of ANDEMIA data from February 2018 to May 2022 was conducted. Reported antibiotic use in the ten days prior to study enrolment were described by substance and by the WHO AWaRe classification ("Access", "Watch", "Reserve", and "Not recommended" antibiotics). Frequency of antibiotic use was stratified by location, disease syndrome and individual patient factors.
resultsAmong 19,700 ANDEMIA patients, 7,258 (36.8%) reported antibiotic use. A total of 9,695 antibiotics were reported, including 54.7% (n = 5,299) from the WHO Access antibiotic group and 44.7% (n = 4,330) from the WHO Watch antibiotic group. The Watch antibiotic ceftriaxone was the most commonly reported antibiotic (n = 3,071, 31.7%). Watch antibiotic use ranged from 17.4% (56/322) among RTI patients in Côte d'Ivoire urban facilities to 73.7% (630/855) among AFDUC patients in Burkina Faso urban facilities. Reported antibiotic use included WHO Not recommended antibiotics but no Reserve antibiotics.
conclusionsReported antibiotic use data from this multicenter study in sub-Saharan Africa revealed a high proportion of WHO Watch antibiotics. Differences in Watch antibiotic use were found by disease syndrome, country and health facility location, which calls for a more differentiated approach to antibiotic use interventions including further evaluation of accessibility and affordability of patient treatment.
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