Ongoing Efforts to Improve Antimicrobial Utilization in Hospitals among African Countries and Implications for the Future
Zikria Saleem,
Brian Godman,
Aislinn Cook,
Muhammad Arslan Khan,
Stephen M. Campbell,
Ronald Andrew Seaton,
Linda Siachalinga,
Abdul Haseeb,
Afreenish Amir,
Amanj Kurdi,
Julius C. Mwita,
Israel Abebrese Sefah,
Sylvia A. Opanga,
Joseph O. Fadare,
Olayinka O. Ogunleye,
Johanna C. Meyer,
Amos Massele,
Dan Kibuule,
Aubrey C. Kalungia,
Moyad Shahwan,
Hellen Nabayiga,
Giuseppe Pichierri,
Catrin E. Moore
Affiliations
Zikria Saleem
Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
Brian Godman
Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
Aislinn Cook
Centre for Neonatal and Paediatric Infection, St. George’s University of London, London SW17 0RE, UK
Muhammad Arslan Khan
The Indus Hospital, Bedian Road, Lahore 54000, Pakistan
Stephen M. Campbell
Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
Ronald Andrew Seaton
Queen Elizabeth University Hospital, Govan Road, Glasgow G51 4TF, UK
Linda Siachalinga
College of Pharmacy, Yeungnam University, Daehak-Ro, Gyeongsan, Gyeongbuk 38541, Republic of Korea
Abdul Haseeb
Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia
Afreenish Amir
Department of Microbiology, Armed Forces Institute of Pathology, National University of Medical Sciences, Rawalpindi 46000, Pakistan
Amanj Kurdi
Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
Julius C. Mwita
Department of Internal Medicine, Faculty of Medicine, University of Botswana, Private Bag 0713 UB, Gaborone 00704, Botswana
Israel Abebrese Sefah
Pharmacy Practice Department, School of Pharmacy, University of Health and Allied Sciences, Volta Region, Hohoe PMB 31, Ghana
Sylvia A. Opanga
Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, University of Nairobi, Nairobi P.O. Box 19676-00202, Kenya
Joseph O. Fadare
Department of Pharmacology and Therapeutics, Ekiti State University, Ado Ekiti 362103, Nigeria
Olayinka O. Ogunleye
Department of Pharmacology, Therapeutics and Toxicology, Lagos State University College of Medicine, Ikeja, Lagos 100271, Nigeria
Johanna C. Meyer
Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
Amos Massele
Department of Clinical Pharmacology and Therapeutics, Hurbert Kairuki Memorial University, 70 Chwaku Road Mikocheni, Dar Es Salaam P.O. Box 65300, Tanzania
Dan Kibuule
Department of Pharmacology & Therapeutics, Busitema University, Mbale P.O. Box 236, Uganda
Aubrey C. Kalungia
Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka P.O. Box 50110, Zambia
Moyad Shahwan
Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
Hellen Nabayiga
Management Science Department, Strathclyde Business School, University of Strathclyde, 199 Cathedral Street, Glasgow G4 0QU, UK
Giuseppe Pichierri
Microbiology Department, Torbay and South Devon Foundation Trust, Lowes Bridge Torbay Hospital, Torquay TQ2 7AA, UK
Catrin E. Moore
Centre for Neonatal and Paediatric Infection, St. George’s University of London, London SW17 0RE, UK
There are serious concerns with rising antimicrobial resistance (AMR) across countries increasing morbidity, mortality and costs. These concerns have resulted in a plethora of initiatives globally and nationally including national action plans (NAPs) to reduce AMR. Africa is no exception, especially with the highest rates of AMR globally. Key activities in NAPs include gaining a greater understanding of current antimicrobial utilization patterns through point prevalence surveys (PPS) and subsequently instigating antimicrobial stewardship programs (ASPs). Consequently, there is a need to comprehensively document current utilization patterns among hospitals across Africa coupled with ASP studies. In total, 33 PPS studies ranging from single up to 18 hospitals were documented from a narrative review with typically over 50% of in-patients prescribed antimicrobials, up to 97.6% in Nigeria. The penicillins, ceftriaxone and metronidazole, were the most prescribed antibiotics. Appreciable extended prescribing of antibiotics up to 6 days or more post-operatively was seen across Africa to prevent surgical site infections. At least 19 ASPs have been instigated across Africa in recent years to improve future prescribing utilizing a range of prescribing indicators. The various findings resulted in a range of suggested activities that key stakeholders, including governments and healthcare professionals, should undertake in the short, medium and long term to improve future antimicrobial prescribing and reduce AMR across Africa.
