ANTIMICROBIAL STEWARDSHIP – Raising local voices to combat a global health menace

CONTEXT

Antimicrobial resistance is a global health threat. The natural process of a microorganism’s (a bug) ability to evade and survive the drugs made to kill them means these germs can continually spread and potentially cause devastating effects, not only in hospital settings, but in communities as well. Expertise among prescribers and other healthcare professionals would therefore have to be developed and education of consumers is imperative in tackling this threat. This will ensure the survival of future generations particularly in a University Hospital like KNUST with a reported high usage of antibiotics.

INTERVENTION

The AMS team conducted three Point Prevalence Surveys (PPS) at various points during the project to assess the usage of antibiotics among inpatients of the hospital. It also developed an antibiogram- a chart that shows local resistance and sensitivity patterns of antibiotics frequently used at the hospital and what organisms were cultured from the biological fluids collected such as urine and blood, despite scarce resources and limited access to data tools for analysis. The team also organized 3 seminars for hospital employees; one hybrid seminar for sensitization in AMS/AMR and a second on Infection Prevention and Control using both local and international facilitators. The last seminar was a dissemination seminar on the activities of the committee to the hospital and university communities.

All committee members were locked-in on achieving the targets set, and this reflected in participation of hospital employees at the seminars. To date, the first seminar is on record as the most highly attended hybrid seminar in the hospital’s history; a testament to the team’s communication and dedication, but also an appreciation of the employees’ willingness to take up the challenge of AMS/AMR.

The virtual delivery of topics of international facilitators offered a broader perspective on the impact of this global threat. However, technological challenges in the form of poor internet connectivity and other logistical challenges sometimes made delivery cumbersome.

IMPACT

The impact of this committee cannot be understated, with a few outlined below

1. Producing the first antibiogram for the KNUST hospital
2. Organizing point prevalence surveys which, after dissemination, led to a decline in the inappropriate prescription and use of antibiotics
3. Training of hospital employees with focus on gender equity on AMS/AMR and IPC
4. Development of AMS Guidelines and policies on the use of antibiotics
5. AMS ward rounds to create awareness and educate prescribers on the rational use of antibiotics.
6. Development of communication and writing skills through minutes, report writing, in-person, virtual meetings and three potential publications in journals
7. Improvement in project management skills
8. Improving interpersonal skills and team-building efforts

CONCLUSION

The AMS project at the KNUST hospital signifies collaboration as one of the cornerstones for its success, bringing on board doctors, nurses, pharmacists, microbiologists and administrative staff as committee members to ensure its success. Health partnerships are important because as the world has become a “Global Village”, a single seemingly small act can have a major ripple effect, affecting billions. The hope is for the continued existence and extension of activities of the AMS committee, with an excellent research, development and project implementation infrastructure.  We look forward to a continuous synergy with THET/CwPAMS, our significant partners, to offer financial, technical and logistical support in this regard.

“It is easy to break a single broomstick, but not a bunch”. – Akan Proverb.