Antimicrobial stewardship at Prince Mshiyeni Memorial Hospital in KwaZulu-Natal – A pharmacist’s perspective on this multidisciplinary strategy

  • H B Nansook Prince Mshiyeni Memorial Hospital
  • N Parbhoo Prince Mshiyeni Memorial Hospital
  • G Steele KwaZulu-Natal Department of Health
  • T Mhlongo Prince Mshiyeni Memorial Hospital
  • N Naidoo KwaZulu-Natal Department of Health
  • R J Ramjee KwaZulu-Natal Department of Health
  • M Reddy ⁶Centre for the AIDS Programme of Research in South Africa
  • Y Ramsamy National Health Laboratory Services
Keywords: antimicrobial, antibiotic, antimicrobial resistance, antimicrobial stewardship, multidisciplinary

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

Author Biographies

H B Nansook, Prince Mshiyeni Memorial Hospital

Department of Pharmaceutical Services, Prince Mshiyeni Memorial Hospital and KwaZulu-Natal Department of Health, South Africa

N Parbhoo, Prince Mshiyeni Memorial Hospital

Department of Pharmaceutical Services, Prince Mshiyeni Memorial Hospital and KwaZulu-Natal Department of Health, South Africa

G Steele, KwaZulu-Natal Department of Health

KwaZulu-Natal Department of Health and Department of Infection Prevention and Control, Prince Mshiyeni Memorial Hospital, South Africa

T Mhlongo, Prince Mshiyeni Memorial Hospital

Department of Pharmaceutical Services, Prince Mshiyeni Memorial Hospital and KwaZulu-Natal Department of Health, South Africa

N Naidoo, KwaZulu-Natal Department of Health

KwaZulu-Natal Department of Health and Department of Paediatrics, University of KwaZulu-Natal, Durban, South Africa

R J Ramjee, KwaZulu-Natal Department of Health

KwaZulu-Natal Department of Health and Department of Anaesthetics, Prince Mshiyeni Memorial Hospital, University of Kwazulu-Natal, South Africa

M Reddy, ⁶Centre for the AIDS Programme of Research in South Africa

Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa

Y Ramsamy, National Health Laboratory Services

Department of Medical Microbiology, Prince Mshiyeni Memorial Hospital, National Health Laboratory Services and Antimicrobial Research Unit, School of Health Sciences, University of KwaZulu-Natal, South Africa

Published
2019-09-11
Section
Original Research