Themes for data extraction and charting.

IntroductionThe global prevalence of antimicrobial resistance transcends geographical and economic boundaries, affecting populations worldwide. Excessive and incorrect use of antibiotics encourages antimicrobial resistance which leads to complex treatment strategies for infectious diseases and possible failure of treatment. The incorrect and unnecessary prescribing of antibiotics places a burden on healthcare costs and thus, antimicrobial resistance is evident globally as a major public health concern. The impact is particularly pronounced in low to middle-income countries, where limited access to healthcare exacerbates the crisis. This scoping review aims to comprehensively map the evidence of antimicrobial resistance in healthcare settings, encompassing the exploration of antibiotic prescribing practices and the implementation of antimicrobial stewardship initiatives in South Africa.MethodologyThis protocol has been registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/PWMFB). This review will consider all types of study designs, conducted within South Africa. Studies that are published in English for the period 2019–2024, and that explore antimicrobial resistance (AMR) evidence in healthcare in South Africa, including antibiotic prescribing trends and antimicrobial stewardship and surveillance initiatives will be included. Non-English publications, studies outside of South Africa, animal and environmental studies will be excluded. The criteria for the scoping review will be set by two reviewers. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) tool will be used. Studies will be identified through an extensive search of peer-reviewed and grey literature databases. The results of the review will be tabulated and include a narrative synthesis of the findings.引言 全球抗菌素耐药性（antimicrobial resistance）的流行态势已跨越地理与经济边界，对全球各人群均造成影响。过度及不当使用抗生素会催生抗菌素耐药性，使得传染病治疗策略趋于复杂，甚至可能导致治疗失败。不当且不必要的抗生素处方会加重医疗成本负担，因此抗菌素耐药性已成为全球范围内的重大公共卫生关切问题。这一影响在中低收入国家尤为显著，当地有限的医疗可及性进一步加剧了这一危机。本范围界定综述（scoping review）旨在全面梳理医疗环境下抗菌素耐药性的相关证据，涵盖对南非抗生素处方实践以及抗菌素管理（antimicrobial stewardship）举措的探索。 研究方法 本方案已在开放科学框架（Open Science Framework）注册（https://doi.org/10.17605/OSF.IO/PWMFB）。本综述将纳入2019-2024年间以英语发表、在南非开展的所有类型研究设计，旨在探索南非医疗环境中的抗菌素耐药性（AMR）证据，包括抗生素处方趋势、抗菌素管理与监测举措。非英语出版物、南非以外的研究、动物及环境相关研究将被排除。本范围界定综述的纳入排除标准将由两名评审人员共同制定。本研究将采用系统综述与Meta分析范围综述首选报告条目（Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews，PRISMA-ScR）工具。研究将通过全面检索同行评审文献及灰色文献数据库来识别相关文献。综述结果将以表格形式呈现，并包含对研究发现的叙述性综合分析。