Wesangula Evelyn, Chizimu Joseph Yamweka, Mapunjo Siana, Mudenda Steward, Seni Jeremiah, Mitambo Collins, Yamba Kaunda, Gashegu Misbah, Nhantumbo Aquino, Francis Emiliana, Moremi Nyambura, Athiany Henry, Matu Martin
East Central and Southern Africa Health Community, Arusha P.O. Box 1009, Tanzania.
Zambia National Public Health Institute, Antimicrobial Resistance Coordinating Committee, Lusaka 10101, Zambia.
Antibiotics (Basel). 2025 Mar 5;14(3):266. doi: 10.3390/antibiotics14030266.
Antimicrobial stewardship (AMS) programs optimize the use of antimicrobials and reduce antimicrobial resistance (AMR). This study evaluated the implementation of AMS programs in Africa using a harmonized regional approach. This was an exploratory cross-sectional study across five countries involving 32 hospitals using an adapted Periodic National and Hospitals Assessment Tool from the World Health Organization (WHO) policy guidance on integrated AMS activities in human health. This study found baseline scores for AMS core elements ranging from 34% to 79% at the baseline which improved to 58% to 92% at the endline. At baseline, Drugs and Therapeutics Committee (DTC) functionality in updating facility-specific medicines and medical devices ranged from 58% to 100%, and this ranged from 79 to 100% at endline. Classifying antibiotics by WHO AWaRe, classification ranged from 33% to 83% at baseline and 64% to 100% at endline. Leadership commitment scores were 47% at baseline and 66% at endline. Education and training scores were 42% and 63% at baseline and endline, respectively. Reporting and feedback scores were 34% at baseline and 58% at endline. Our study showed that understanding context and standardizing regional stewardship approaches enhanced cross-country learning and improved AMS implementation. Although the challenges in Low- and Middle-Income Countries (LMICs) are similar, they vary by country and can be addressed by strengthening AMS regulatory frameworks and surveillance systems.
抗菌药物管理（AMS）计划可优化抗菌药物的使用并降低抗菌药物耐药性（AMR）。本研究采用统一的区域方法评估了非洲AMS计划的实施情况。这是一项涉及五个国家32家医院的探索性横断面研究，使用了世界卫生组织（WHO）关于人类健康综合AMS活动的政策指南中经过改编的国家和医院定期评估工具。本研究发现，AMS核心要素的基线得分在基线时为34%至79%，在终线时提高到58%至92%。基线时，药物和治疗委员会（DTC）在更新特定机构药品和医疗设备方面的功能范围为58%至100%，终线时为79%至100%。按照WHO的AWaRe对抗生素进行分类，基线时的分类范围为33%至83%，终线时为64%至100%。领导力承诺得分在基线时为47%，终线时为66%。教育和培训得分在基线和终线时分别为42%和63%。报告和反馈得分在基线时为34%，终线时为58%。我们的研究表明，了解背景并规范区域管理方法可促进跨国学习并改善AMS的实施。尽管低收入和中等收入国家（LMICs）面临的挑战相似，但因国家而异，可以通过加强AMS监管框架和监测系统来解决。
