Background: Antimicrobial resistance is one of the major global health problems that has beenrnworsened due to poor antibiotic stewardship by health workers and improper use ofrnantimicrobial by the patients among other factors. Quality data representative of the extent ofrnpoor antimicrobial stewardship in low- and middle-income countries is scanty, but highrnincidences of antimicrobial resistance are increasingly reported in many settings across thernglobe. The objective of the present study was, therefore, to evaluate prescriptions forrnantimicrobials in East Africa. rnMethods: A comprehensive literature search strategy that includes text words and medicalrnsubject headings was developed and applied to predefined electronic databases. Twornresearchers independently screened the titles and abstracts of the outputs of the literaturernsearch. Full texts were then independently reviewed by the two researchers. Extracted datarnfrom included studies were pooled using meta-analysis. rnResults: Majority of the included studies (30.8%) were retrieved from Ethiopia, followed byrnSudan, Kenya and Tanzania each contributing 19.2%. The overall proportion of encounter withrnantimicrobials reported was 57% (95%CI 42%; 73%). Ethiopia had an overall patient encounterrnwith antimicrobials of 63% [95%CI: 50%, 76%] followed by Sudan with an overall encounterrnwith antimicrobials of 62% [95%CI: 34%, 85%]. Studies included from Kenya reported thernoverall encounter with antimicrobials of 54% [95%CI: 15%, 90%], whereas studies fromrnTanzania reported an overall patient encounter with antimicrobials of 40% [95%CI: 21%,rn60%]. rnConclusion: Prescription patterns demonstrated in this review significantly deviate from WHOrnrecommendations suggesting inappropriate antimicrobial use in the East African countries.rnConsidering the global threat posed by antimicrobial resistance, perhaps countries with fewrnresearch being carried out on antimicrobial use patterns and resistance should focus morernresources on this important research agenda as a matter of public health priority.