• John Njuma Libwea, Che Henry Ngwa, Armelle Viviane Ngomba, Frankline Sevidzem Wirsiy, Limkile Mpofu, Chanceline Bilounga Ndongo, Sinata Koulla-Shiro, Stephen Graham, Lionelle Patricia Tchokokam Djieuya, Nadia Mandeng, MballaGeorges Alain EtoundiGAEDirectorate for Disease Control, Epidemics and Pandemics Ministry of Public Health, Yaoundé, Cameroon.Public Health Emergency Operation Center, Yaoundé, Cameroon., Eman Sobh, Bright I Nwaru, Paul Koki Ndombo, and Emilienne Epee.
• Directorate for Disease Control, Epidemics and Pandemics Ministry of Public Health, Yaoundé, Cameroon.
• Medicine (Baltimore). 2023 May 12; 102 (19): e33697e33697.

BackgroundAntimicrobial resistance (AMR) remains one of the leading threats to global public health and this may increase following COVID-19 pandemic. This is particularly the case in Africa where regulations on antimicrobial usage are weak. This protocol outlines the steps to undertake a systematic review to synthesize evidence on drivers of AMR and evaluate existing approaches to strengthening antimicrobial stewardship (AMS) programs in Sub-Saharan Africa (SSA). On the basis of the evidence generated from the evidence synthesis, the overarching goal of this work is to provide recommendations to support best practices in AMS implementation in SSA.MethodsA systematic search will be conducted using the following databases: Global Health Library, PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, Google Scholar, Global Health, Embase, African Journals Online Library, Web of Science, antimicrobial databases (WHO COVID-19, TrACSS, NDARO, and JPIAMR), and the Cochrane databases for systematic reviews. Studies will be included if they assess AMR and AMS in SSA from January 2000 to January 31, 2023.ResultsThe primary outcomes will include the drivers of AMR and approaches to AMS implementation in SSA. The Preferred Reporting Items for Systematic Reviews and Meta-analyses will guide the reporting of this systematic review.ConclusionsThe findings are expected to provide evidence on best practices and resource sharing for policy consideration to healthcare providers and other stakeholders both at the local and international levels. Additionally, the study seeks to establish drivers specific to AMR during the COVID-19 era in the SSA, for example, with the observed increasing trend of antimicrobial misuse during the first or second year of the pandemic may provide valuable insights for policy recommendation in preparedness and response measures to future pandemics.Prospero Registration NumberCRD42022368853.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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