Antimicrobial resistance, antibiotic prescribing practices and antimicrobial stewardship in South Africa: a scoping review

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.