Pharmacists require proper training for proper antimicrobial stewardship participation in Nigeria
Sunday Omeike PhD FASLN
Global health is continuously threatened by increasing antibiotic resistance and the lack of new drugs. Healthcare authorities and researchers, therefore, advocate for improved mitigation methods that could prevent escalation of these two factors.
This includes programs designed to ensure appropriate antibiotic usage and preservation of its effectiveness in a coordinated intervention known as antimicrobial stewardship (AMS).
Global health watchdogs, including the World Health Organization (WHO), have stated the importance of this multidisciplinary AMS program that includes microbiologists, healthcare workers and, especially, pharmacists, according to the American Society of Health-System Pharmacists.
In Nigeria, the government's National antimicrobial resistance action plan 2017-2022 incorporates AMS. Still, there has been a lack of evidence that pharmacists, a critical group in proper antibiotic dispensing and advice, are properly seen as an important part of a successful plan until this recent study.
Usman Abubakar, from the Pharmacy Department, IBB Specialist Hospital, Minna, Niger State, in collaboration with Balamurugan Tangiisuran from the School of Pharmaceutical Sciences, Universiti Sains Malaysia, and their findings were published in a recent issue of the Journal of Global Antimicrobial Resistance.
The collaborators evaluated activities and barriers faced by hospital pharmacists’ in AMS programs, using 37 tertiary hospitals in Nigeria. They showed that although most tertiary hospitals in Nigeria lack established AMS teams and their pharmacists are actively involved in hospital AMS activities, they lack proper training and are still short of personnel for effective AMS in their institution.
The investigation, carried out using respondents from government tertiary hospitals including teaching, medical centres and specialist hospitals, showed that the pharmacists used strategies such as drug monitoring, education, guidelines and feedback. However, there is also the lack of pharmacists that specialize in Infectious diseases, and no support from both hospital administrators and physicians.
Furthermore, over two-third respondents stated that antibiotics are misused in their hospitals, and agreed that presence in, and active participation of pharmacists at ward rounds should be considered as strategies to improve their involvement in AMS.
The study concluded that while most common pharmacist activities in public hospitals are evaluating the appropriateness of antibiotic prescription and monitoring antibiotic consumption, there is the need for further funding to break the barrier of pharmacists’ involvement in AMS programs in Nigeria.
American Society of Health System Pharmacists. ASHP (2010). ASHP statement on the pharmacist's role in antimicrobial stewardship and infection prevention and control. American Journal of Health-System Pharmacy, 67: 575–577.