Nationwide survey of pharmacists’ involvement in antimicrobial stewardship programs in Nigerian tertiary hospitals

• Published in: Journal of global antimicrobial resistance. Vol. 21; pp. 148 - 153
• Main Authors: Abubakar, Usman, Tangiisuran, Balamurugan
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.06.2020; Elsevier
• Subjects: Antimicrobial stewardship; Hospital pharmacists; Nigeria; Tertiary hospitals; Tertiary hospitals; Antimicrobial stewardship; Hospital pharmacists; Nigeria
• ISSN: 2213-7165; 2213-7173
• DOI: 10.1016/j.jgar.2019.10.007

•Few tertiary hospitals in Nigeria had a formal antimicrobial stewardship (AMS) team.•All the hospitals with a formal AMS team had pharmacist representation.•Pharmacists participate in AMS activities regardless of the presence of a formal AMS team.•Lack of training in AMS, and lack of support from hospital administrators were barriers to pharmacists’ involvement in AMS programs in Nigeria. To evaluate the activities and barriers to hospital pharmacists’ participation in antimicrobial stewardship programs (ASP) in Nigerian tertiary hospitals. A cross-sectional nationwide online survey was conducted over a 6-week period between May and June 2019. Invitation was sent to all the Heads of pharmacy department or pharmacists in charge of infectious diseases (ID) or antimicrobial pharmacists in tertiary hospitals in Nigeria. A validated questionnaire that consist of 24-items was used for data collection. Forty-five hospitals were invited and 37 completed the survey (response rate, 82.2%). Five (13.5%) hospitals had a formal antimicrobial stewardship (AMS) team, with each of them having pharmacist representation. Regardless of the existence of an AMS team, hospital pharmacists have implemented AMS strategies, including evaluation of the appropriateness of antimicrobial prescriptions (54.1%) and monitoring of antimicrobial consumption (48.6%). The most common barriers to pharmacists’ involvement in ASP were lack of training in AMS and ID (51.4%), lack of pharmacists with ID specialisation (40.5%) and lack of support from hospital administrators (37.8%). The majority of the pharmacists recommended training in AMS and ID (100%), participation on ward rounds (89.2%) and employment of more pharmacists (73%) as strategies to improve pharmacists’ participation in ASP. Hospital pharmacists are actively involved in AMS activities despite the lack of established AMS teams in most tertiary hospitals in Nigeria. However, lack of training and personnel were major barriers to pharmacist’s involvement in ASP.