Background Antimicrobial resistance (AMR) is a global health crisis, particularly acute in Africa where infectious disease burdens are high and resources limited. Inappropriate antibiotic use, driven by factors like easy access and inadequate diagnostics, fuels AMR. Antimicrobial stewardship programs (ASPs) offer a key intervention, but their implementation and impact in Africa remain poorly understood. This systematic review and meta-analysis evaluates the association between ASPs and antibiotic use in Africa, aiming to inform policy and practice by synthesizing existing evidence and identifying research gaps.

Methods This systematic review and meta-analyses will include all original articles that will examine antimicrobial stewardship programs (ASPs) in Africa. Non-English articles, qualitative studies, editorials, comment pieces and expert opinion and review articles will be excluded. Initially limited search of MEDLINE (PubMed) and CINAHL (EBSCO) will be conducted to identify articles on the topic. The text words contained in the titles and abstracts of relevant articles, and the index terms used to describe the articles will be used to develop a full search strategy for reporting the name of the relevant databases/information sources. Data extraction will be performed by 2 independent reviewers on the articles selected for inclusion. The different characteristics of studies will be extracted. The quality of included studies will be reported using Effective Public Health Practice Project (EPHPP) quality assessment tool. Summary of the extracted data will be presented in tabular format and graphs.

Discussion This protocol is expected to convey pooled evidence on association of targeted ASPs with antimicrobial consumption. Evidence from this review will be used to tackle current global problem related with anti-microbial resistance. Therefore, our review will call for government and non-government interventions in reducing current challenge of global issue related with anti-microbial resistance in resource limited settings like Africa.

Systematic review registration number PROSPERO CRD420251003018.

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

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