Assessment of Adherence to the Core Elements of Hospital Antimicrobial Stewardship Programs: A Survey of Fourteen Hospitals in Nigeria

Abstract

Introduction Antimicrobial resistance occurs when antimicrobial drugs are no longer effective against the target microorganism and this poses a global public health threat especially in low and middle-income countries (LMICs), including Nigeria. This study aimed to assess hospitals core elements AMS implementation in 14 secondary and tertiary hospitals in Nigeria. Methods Centre for Initiative and Development (CFID) in collaboration with the Nigeria Centre for Disease Control (NCDC), employed cross-sectional intervention study across 14 target hospitals in Nigeria. The study adopted the WHO Core Elements Hospital AMS self-assessment tool. Paired-samples t-test was used and a p-value less than 0.05 was considered as statistically significance. Results Results from the baseline assessment revealed inadequate implementation of AMS programs in most hospitals, emphasizing key deficiencies in areas such as leadership commitment, tracking antibiotic use, and reporting outcomes. However, following CFID AMS intervention, a significant positive shift in performance of hospitals AMS core elements was observed, with hospitals showing improvements in leadership commitment, accountability, and prescriber education. The paired-samples t-test demonstrated a statistically significant decrease in the measured variable, reinforcing the impact of the intervention and a substantial increase in mean scores of post-intervention. Conclusions It is imperative to acknowledge the potential implications of these positive shifts, not only in the context of individual hospitals but also in the broader landscape of public health. Addressing the challenges identified in this study is crucial for mitigating the global public health threat posed by antimicrobial resistance, particularly in resource-constrained settings. Future research and continued collaborative efforts will be essential to sustain and further improve the effectiveness of AMS interventions, ultimately contributing to the global effort to combat antimicrobial resistance.