Microbiology Department, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria.
Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Lagos State, Nigeria.
J Glob Antimicrob Resist. 2021 Jun;25:162-170. doi: 10.1016/j.jgar.2021.02.034. Epub 2021 Apr 1.
Optimising antibiotic use in healthcare settings through antimicrobial stewardship programmes (ASPs) is critical to effectively treat infections, protect patients from harms caused by unnecessary antibiotic use, and combat antimicrobial resistance. This needs assessment was designed to provide the current status of ASPs in healthcare facilities in Lagos State and identify gaps for future interventions.
A descriptive cross-sectional survey was conducted using a self-administered questionnaire to ascertain the extent and nature of ongoing ASPs among selected healthcare facilities and identify gaps for future interventional studies.
Of 32 questionnaires distributed, 25 (78%) were completed and returned from three tertiary, six secondary, eleven primary and five private healthcare facilities. The mean years of practice of respondents was 13.96 ± 7.8 years (2-31 years). Six facilities (24%) had a team responsible for ASP operating at varying degrees of capacity, while five (20%) had a formal ASP. All six facilities with an antimicrobial stewardship (AMS) team had a medical doctor as the team lead, and 5 (20%) also had a pharmacist involved in implementation efforts. Routine pre-authorisation for specific antibiotic was performed in six facilities (24%), four of which monitor pre-authorisation interventions. Only two facilities (8%) performed prospective audit and feedback for specific antibiotic agents. Private healthcare facilities were more likely to have information technology (IT) capability to support the needs of AMS activities.
This study revealed minimal ASP activities in healthcare facilities in Lagos State and highlighted possibilities of leveraging on available IT resources for a co-ordinated AMS strategy.
通过抗菌药物管理计划（ASPs）优化医疗机构中的抗生素使用，对于有效治疗感染、保护患者免受不必要的抗生素使用带来的危害以及对抗抗菌药物耐药性至关重要。本需求评估旨在提供拉各斯州医疗机构中 ASP 项目的现状，并确定未来干预措施的差距。
采用描述性横断面调查，使用自我管理问卷来确定选定医疗机构中正在进行的 ASP 的程度和性质，并确定未来干预性研究的差距。
在分发的 32 份问卷中，有 25 份（78%）从三家三级医院、六家二级医院、十一家一级医院和五家私立医院完成并返回。受访者的平均执业年限为 13.96 ± 7.8 年（2-31 年）。有六家（24%）设施拥有负责 ASP 工作的团队，其运作能力各不相同，而有五家（20%）有正式的 ASP。六家设有抗菌药物管理团队的医院均有一名医生担任团队负责人，有 5 家（20%）还聘请了药剂师参与实施工作。有六家（24%）设施对特定抗生素进行常规预授权，其中四家对预授权干预措施进行监测。只有两家（8%）对特定抗生素进行前瞻性审核和反馈。私立医疗机构更有可能拥有支持 ASP 活动需求的信息技术（IT）能力。
本研究显示拉各斯州医疗机构中的 ASP 活动很少，强调可以利用现有的 IT 资源来制定协调的 ASP 策略。
