Methodologies

Two expert panels convened to develop treatment recommendations for adult and pediatric patient populations, respectively. The first panel consisted of 9 clinicians and convened in August 2019 at AU headquarters in Addis, Ababa, Ethiopia to develop treatment recommendations for adult patient populations. A subsequent panel, consisting of 19 experts, was held via virtual webinar in October 2020 to develop treatment recommendations for pediatric patients.

 

The development of the guidelines was informed by a review of 28 national or standard treatment guidelines (STGs) published by 17 African Union (AU) member states which described antimicrobial therapy recommendations including drug selection, dosage, and duration for the treatment of common infectious diseases excluding HIV, malaria, Tuberculosis, and other infections or syndromes addressed by national or vertical disease control programs. A library of STGs is available here.

 

Panelists also reviewed antimicrobial agent selections in the WHO Model List of Essential Medicines (MLEM, 21st List, 2019) and MLEM for Children (7th List; 2019) to aid in the assessment of drug availability across the continent. Panelists also reviewed all available antimicrobial resistance (AMR) prevalence data, available at ResistanceMap. Overall, there was a paucity of available AMR data which prevented it from heavy consideration during the development of treatment recommendations. In the future, with a more robust evidence-base, resistance prevalence and trends overtime at the facility, regional, and national level must be considered when developing treatment guidelines.

 

The guidelines underwent an external review process where clinicians, pharmacists, and other stakeholders across the continent who were not involved in the guidelines development were invited to review the treatment recommendations and provide feedback.

 

Our expert panelists and external reviewers are listed here.

 

To ensure that the African Antimicrobial Treatment Guidelines continue to reflect AU member states’ priority health areas, CDDEP and Africa CDC will convene a multi-disciplinary expert panel every five years to review newly available national AMR data and antibiotic treatment recommendations and to update our guidelines as needed.