The journey to institutionalising Antimicrobial Stewardship (AMS) in a resource-constrained tertiary healthcare facility in Lagos, Nigeria

*1Oduyebo, O. O., 2Fajolu, I. B., 3Oluwarotimi, C. A., [1]Toye, A. K., 5Olugbake, O. A., 1Oshun, P. O.,

4Roberts, A. A., 5Soremekun, R. O., 1Osuagwu, C. S., 5Joda, A. E.,  6Rotimi,  M. K., 2Akintan, P. E., 7Chuka-Ebene, V., +LUTH AMSC., 2Temiye, E. A.,  1Akodu, B. A., 8Bode, C. O., 3Adeyemo, W. L., 9Oreagba, I. A., 10Ajuluchukwu, J. N., and 11,12Nnoaham, K. E.

1Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Nigeria

2Department of Paediatrics, College of Medicine, University of Lagos, Nigeria

3Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Lagos, Nigeria

4Department of Community Health and Primary Care, College of Medicine, University of Lagos, Nigeria

5Department of Clinical Pharmacy and Biopharmacy, Faculty of Pharmacy, University of Lagos, Nigeria

6Department of Anaesthesia, College of Medicine, University of Lagos, Nigeria

7Department of Pharmacy, Lagos University Teaching Hospital, Lagos, Nigeria

8Department of Surgery, College of Medicine, University of Lagos, Nigeria

9Department of Pharmacology, Therapeutics and Toxicology, College of Medicine, University of Lagos, Nigeria

10Department of Medicine, College of Medicine, University of Lagos, Nigeria

11Faculty of Public Health, United Kingdom

12School of Medicine, Cardiff University, United Kingdom

*Correspondence to: ooduyebo@unilag.edu.ng; oyinoduyebo@yahoo.com

+list of members at the end of the article

Abstract:  

Background: Antimicrobial stewardship (AMS) is one of the main strategies to stem the global tide of antimicrobial resistance (AMR). While developed nations have successfully implemented antimicrobial stewardship programmes, such initiatives remain underdeveloped in many Nigerian healthcare institutions. This is a report of a project to improve the AMS programme at the Lagos University Teaching Hospital (LUTH), Nigeria, by strengthening the antimicrobial stewardship committee (AMSC) and antimicrobial stewardship team (AMST) of the hospital.

Methodology: The Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) facility assessment tool was used to identify gaps in the AMS programme (ASP) of LUTH, and activities to address the gaps were conducted over a 3-year period (2021-2024).                                                       Results: The results of the activities to address the identified gaps in the ASP were the expansion of AMS activities from 3 to 10 departments of the hospital, a strong management commitment and support, consistent antibiotic consumption calculations, strategic training of professionals, and increased knowledge and awareness of AMS among staff and students. However, major challenges identified included shortage of staff and lack of functional electronic medical records.

Conclusion: Continuing pre- and in-service training of staff, AMS activities and monitoring, and incorporation of AMS actions and interventions performed with the electronic medical records are recommended for sustaining AMS in the hospital.

Keywords: AMS programme, gaps, activities, interventions, institionalise, resource-constrained

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The journey to institutionalising Antimicrobial Stewardship (AMS) in a resource-constrained tertiary healthcare facility in Lagos, Nigeria