Electronic clinical decision support systems for antimicrobial stewardship in Africa: a scoping review

Antimicrobial resistance (AMR) represents a major and growing public health threat in Africa, where access to diagnostics, specialist expertise, and formal antimicrobial stewardship (AMS) programmes remains limited in many settings. Electronic clinical decision support systems (eCDSS) have been proposed as a potential strategy to support rational antibiotic prescribing and strengthen antimicrobial stewardship by providing point-of-care guidance to healthcare providers. While electronic decision support tools for antimicrobial stewardship have been increasingly studied in high-income settings, the extent, nature, and characteristics of such systems in African healthcare contexts remain unclear. This scoping review aims to systematically map the available literature on electronic clinical decision support systems for antimicrobial stewardship in Africa, describe their key characteristics and implementation contexts, summarise reported outcomes, barriers, and facilitators, and identify gaps to inform future research, implementation, and policy.