Antimicrobial stewardship at Prince Mshiyeni Memorial Hospital in KwaZulu-Natal – A pharmacist’s perspective on this multidisciplinary strategy
Abstract
In the fight against the ever-increasing problem of antimicrobial resistance (AMR), we have reached the end of the antibiotic pipeline and very few lifesaving interventions remain. Surveillance of multidrug-resistance pathogens is essential in obtaining a comprehensive picture of antimicrobial resistance and identifying areas in which actions are required.1 Globally, many countries lack essential pathogen surveillance required to address antimicrobial resistance.2 Many countries also have poor implementation of core antimicrobial stewardship strategies. Reasons for this range from poor resources and infrastructure, to a lack of trained experts and poor financial backing. This is especially noted for countries in Africa. The implementation of any intervention such as an antimicrobial stewardship programme is always challenging, more so for countries with resource constraints. South Africa has taken bold steps in answering the call to combat antimicrobial resistance. An antimicrobial resistance national strategy framework 2014–2024 has been developed to join the international community in combating the threat of antimicrobial resistance.3 Additionally, the Guidelines for the Prevention and Containment of AMR in South African Hospitals is a practical guide in addressing AMR with essential infection prevention and control (IPC) measures as well as antimicrobial stewardship (AMS) in a hospital.4 The success of antimicrobial stewardship relies on interested clinicians, microbiologists, pharmacists, infection prevention and control practitioners, nurses and ultimately the patient. Patients need to be educated and understand that antibiotics may not be the answer to every medical ailment. Additionally, pathogen surveillance and the knowledge of local resistance patterns, coupled with an antimicrobial policy that optimises the choice, dose and duration of therapy is essential.5
