Antimicrobial Prescribing in Acute Care Hospitals in the Middle East: a Systematic Review and Meta-Analysis of Point-Prevalence Studies

Understanding antimicrobial prescribing practices is a prerequisite for developing effective antimicrobial stewardship programs. A comprehensive analysis of point-prevalence studies of antimicrobial prescribing among hospitalised patients in the Middle East Region is currently lacking. To determine the pooled point-prevalence of antimicrobial prescribing among hospitalised patients in the Middle East Region, and to assess the indications, classes and types of antimicrobial agents prescribed. In addition, this study evaluated the quality indicators of antimicrobial prescribing. This systematic review and meta-analysis adhered to the PRISMA 2020 Statement. Electronic bibliographic search was conducted on PubMed, Scopus and Google Scholar using antimicrobial/antibiotic prescribing, antimicrobial/antibiotic use, point-prevalence and the names of countries in the Middle East as search terms. Primary literature published in English language describing the point-prevalence and types of antimicrobial prescribing in inpatients from the inception of the databases to December 2025 were included. Data were synthesised using qualitative and quantitative methods. RevMan version 5.4 was used for a random-effect meta-analysis. Thirty-one eligible studies out of 1515 identified studies were included with most studies conducted in Saudi Arabia (n = 7) and Turkey (n = 6). The pooled point-prevalence of antimicrobial prescribing was 58.6