Status of antimicrobial stewardship programmes in Nigerian tertiary healthcare facilities: findings and implications
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Date
2019
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of global antimicrobial resistance
Abstract
Objectives:
The problem of antimicrobial resistance (AMR) is increasing worldwide, with health-related and
economic consequences. This is a concern in Africa, including Nigeria, the most populous
country in Africa, with its high rates of infectious diseases. Approaches to reducing AMR include
instigating antimicrobial stewardship programmes (ASPs) in hospitals. Currently, no
information is available regarding the extent of ASPs in Nigerian hospitals. Consequently, the
objective was to address this starting in tertiary hospitals.
Methods:
This was a cross-sectional, questionnaire-based study among tertiary healthcare facilities.
Tertiary hospitals were chosen initially since if there are concerns in these training hospitals,
such concerns will likely to be exacerbated in other hospitals.
Results:
Completed questionnaires were received from 17 of 25 tertiary healthcare facilities across five of
the six geopolitical regions of Nigeria. Ten (59%), four (24%), two (12%) and one (6%)
respondents were in internal medicine, infectious diseases, medical microbiology and clinical
pharmacology, respectively. Only six healthcare facilities (35%) had a formal organisational
structure and a team responsible for ASP. Facility-specific treatment recommendations, based
on local AMR patterns, were available in only four facilities (24%). Policies on approval for
prescribing specified antimicrobials and formal procedures for reviewing their appropriateness
after 48 h were present in only two facilities (12%). A cumulative antimicrobial susceptibility
report for the previous year was available in only two facilities (12%), and only one facility
routinely monitored antimicrobial use.
Conclusion:
Significant inadequacies in the availability of ASPs were observed. This needs to be urgently
addressed to reduce AMR rates in Nigeria.
Description
Keywords
Antimicrobial resistance, Susceptibility testing, Stewardship
Citation
Fadare, J.O., Ogunleye, O., Iliyasu, G., Adeoti, A., Schellack, N., Engler, D., Massele, A. and Godman, B., 2019. Status of antimicrobial stewardship programmes in Nigerian tertiary healthcare facilities: findings and implications. Journal of global antimicrobial resistance, 17, pp.132-136.