Abstract
BackgroundPromoting evidence-based antibiotic prescribing through successful antimicrobial stewardship (AMS) programmes is critical to preserving the effectiveness of antibiotics for common infections in primary care. This requires a coordinated multidisciplinary effort. Such pharmacist–prescriber partnerships have been effective in high-income countries (HICs). Yet, evidence generated in such countries is not always applicable because of different social determinants of health.MethodsA multidisciplinary workshop was conducted with pharmacists and clinicians (doctors, nurses) on community-based antibiotic stewardship, the purpose of which was to explore how and where such partnerships might work in publicly funded primary care clinics in the greater Cape Metro region.ResultsParticipants perceived that promoting effective AMS was a priority for South African primary healthcare. However, it was clear that there are many hurdles to overcome working in settings that are relatively resource-poor. Prescribing guidelines needed to be harmonised. Participants felt that staff training on the principles of AMS should be mandatory. Research was urgently needed to better understand their community’s understanding of antibiotic use and AMS, and to champion outreach projects in the community.ConclusionImportant stakeholder perspectives in the community were highlighted to promote a multidisciplinary approach to AMS initiatives in primary care. These will need to be addressed to optimise antibiotic prescribing in the community.
Highlights
Promoting evidence-based antibiotic prescribing through successful antimicrobial stewardship (AMS) programmes is critical to preserving the effectiveness of antibiotics for common infections in primary care
The country has a blueprint for the steps to be taken by healthcare practitioners and others to enact antibiotic stewardship at all levels of healthcare[4] and practical steps to address the governance framework needed at each level of the health system.[5]
We invited any practising frontline pharmacists, nurses involved in prescribing, and doctors working in Community Health Centres (CHCs) or Community Day Centres (CDCs)
Summary
Promoting evidence-based antibiotic prescribing through successful antimicrobial stewardship (AMS) programmes is critical to preserving the effectiveness of antibiotics for common infections in primary care. Antibiotic resistance is an important societal health issue requiring global yet context-specific solutions. Overprescribing and inappropriate prescribing of antibiotics are the principal modifiable drivers of antibiotic resistance.[1] Most antibiotics (75%) are prescribed in the community for common infections, and antibiotic-resistant infections make patients sicker for longer in the community.[2] Promoting evidence-based antibiotic prescribing through antibiotic stewardship programmes is critical and requires a coordinated multidisciplinary effort.[3]. This will become increasingly important in the transition to the country’s anticipated National Health Insurance (NHI) where pharmacists are likely to expand their role for primary healthcare services to increase access.[6]
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