Abstract
Antimicrobial stewardship encompasses a wide range of processes and interventions designed to ensure that antimicrobials are used in the most effective manner. An important, but often neglected process to include is medicine procurement within hospitals, as the untimely administration of antimicrobials has a direct impact on patient care and antimicrobial resistance. A tender system (an open Request for Proposal, RFP) in South Africa is used in the procurement process to supply medicines and pharmaceutical supplies, whereas in the United States, each hospital is responsible for their own procurement processes. Possible key challenges facing countries to ensure a sustainable medical procurement are poor procurement practices, outdated information systems, and unavailability of human resources to support the current system. This article describes the need for adequate pharmacist–led inventory management systems, for sustainable antimicrobial delivery and the successful implementation of antimicrobial stewardship programs. Strategies to improve inventory control and medication delivery for public sector hospitals in South Africa include the development of national pharmaceutical data management standards. Pharmacist involvement in inventory management principles will ensure that antimicrobials are consistently in adequate supply for patient use, hence promoting safe and effective use while decreasing antimicrobial resistance.
Highlights
The Global Action Plan (GAP) on antimicrobial resistance (AMR) provides a “One Health” blueprint for national action plan development and calls for enhancing the use of antimicrobial medicines in human and animal health through surveillance and research [1]
The South African Antimicrobial Resistance Strategy Framework reports over 50% of hospital-acquired S. aureus isolated from the blood in 2010 were found to be methicillinresistant Staphylococcus aureus (MRSA) [17], and up to 75% of K. pneumoniae isolated from the blood of hospitalized patients were extended spectrum beta-lactamase (ESBL) producing [17]
This paper aims to emphasize the importance of pharmacistinvolvement in the pharmaceutical supply chain to ensure and sustain adequate supply of antimicrobials as part of Antimicrobial Stewardship (AMS), having a direct impact on the AMR issues described
Summary
The Global Action Plan (GAP) on antimicrobial resistance (AMR) provides a “One Health” blueprint for national action plan development and calls for enhancing the use of antimicrobial medicines in human and animal health through surveillance and research [1]. Essential medicine shortages are a growing problem worldwide stressing global health systems, increasing cost, and jeopardizing patients who are in direct need of essential medicines [3] especially for multidrug resistant bacteria, fungi, Human Immunodeficiency Virus (HIV), and Tuberculosis (TB) due to the ubiquitous expansion of AMR [4] The latter is true for parts of South Africa (SA), where access to antimicrobials rather than the excessive use of antimicrobials is a challenge. Communication between stakeholders, procurement practices and information systems is addressed by the establishment of a National Surveillance Centre, an innovative early warning system implemented in selected pilot areas in SA, where dashboards displays medicine stock levels at primary health care facilities, hospitals and suppliers all around the country. The American Society of Health-System Pharmacists (AHSP) publishes an annual Pharmacy Forecast which assists pharmacy managers in projecting future drug budgets
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