Antimicrobial Stewardship in Nigeria for a Healthier Tomorrow

Antimicrobial resistance (AMR) poses a big danger to community health worldwide. The public health crisis extends patient hospitalization periods while escalating healthcare expenses and increasing mortality rates.  One of the most effective methods to combat antimicrobial resistance in Nigeria is through Antimicrobial Stewardship ( AMS).

This means using antibiotics properly. Not overusing. Not misusing. It involves doctors, nurses, pharmacists, laboratories, hospital and clinic administrators, as well as patients. Across Nigeria, efforts are growing to increase AMS in the health care centers, and they have initiated responsible antibiotic usage programs. 

How do Antimicrobial Stewardship Programs Work

Antimicrobial stewardship is a set of actions based on knowledge of germs in the area . It ensures antibiotics are used only when needed. And in the right way. For example, it avoids giving antibiotics for viral infections like the flu. It also helps doctors choose the right medicine and dose for the right duration.

Where Does Antimicrobial Stewardship HAPPEN

Antimicrobial Stewardship programs are formally implemented in healthcare settings where patients are seen, and antimicrobials are prescribed.  But Healthcare personnel cannot do this alone. Additionally, pharmacists and the general public play a vital role in promoting antimicrobial stewardship within the community.

Where Does Antimicrobial Stewardship HAPPEN

Antimicrobial Stewardship programs are formally implemented in healthcare settings where patients are seen, and antimicrobials are prescribed.  But Healthcare personnel cannot do this alone. Additionally, pharmacists and the general public play a vital role in promoting antimicrobial stewardship within the community.

Local Research Drives Antimicrobial Stewardship Progress

Research studies and the identification of resistant organisms in various areas and regions of Nigeria will help guide antimicrobial stewardship and appropriate antibiotic use.   These studies will also help to formulate guidelines on antimicrobial use that can be implemented in different regions of the country. Some other  key research areas include:
  • How often are antibiotics wrongly prescribed
  • Who prescribes these antibiotics
  • Public knowledge about antibiotics and their use.
  • At patients. Many people do not know that misuse of antibiotics are fueling resistance  and killing fellow Nigerians.
These studies on antimicrobial stewardship in Nigeria support policy change. They guide training programs and government plans. Research gives us real data. That data helps shape stronger national action. These studies, however, can be costly and difficult to implement, and funding from government and private institutions is vital to their success.
antimicrobial stewardship in nigeria

National Strategies Supporting AMS in Nigeria

Nigeria is working to improve antimicrobial stewardship through strong national programs,  like the NAP 2.0 AMR (National Action Plan). This plan supports Nigerian antimicrobial stewardship in five key ways:
  • Raising public awareness
  • Training healthcare workers
  • Tracking antibiotic use and resistance
  • Setting treatment guidelines
  • Supporting research and innovation

Current Challenges Implementing AMS

Multiple obstacles obstruct the development of antimicrobial stewardship in Nigeria. The low level of awareness that mainly affects rural populations is one of the barriers. Most people obtain antibiotics without a required medical prescription. Healthcare facilities typically operate without sufficient staff to properly handle antibiotic administration. There are also inadequate systems to track antibiotics. Existing policies are not consistently enforced. Public misunderstandings actively play a contributing role in this challenge. Most people today consider antibiotics suitable for fighting every kind of illness, although they do not work against viruses. Some stop treatment early or share leftover medicine. These habits increase resistance and make future infections harder to treat. Without urgent action, misuse will continue to grow.

The Way Forward

Education plays a crucial role in enhancing antimicrobial stewardship across Nigeria. Healthcare practitioners require additional instruction about antibiotic usage protocols. The authorities need to implement stricter rules regarding the availability of antibiotics for public purchase. Specific awareness programs should work to correct widespread false beliefs in the population. The public outreach efforts will display situations in which antibiotic treatments are necessary. Hospitals must improve tracking of antibiotic use. Stronger systems are needed to monitor resistance. More funding is required to support AMS programs. National initiatives like NAP 2.0 AMR are important. By taking these actions, Nigeria can build a stronger AMS system. 

ANTIMICROBIAL STEWARDSHIP TEAMS

Infectious Disease doctors, Infectious Disease Pharmacists, Microbiology labs, Doctors from other fields, and Nurses are key personnel in the AMS programs.

Nigeria needs to train more infectious disease providers that can assist in AMS programs. Infectious Disease Providers are essential to the fight against AMR.

Infectious Disease Providers

A lot of people think infectious disease doctors treat only infectious diseases that are communicable, like Tuberculosis or malaria, but this is a bit of a misnomer because they treat all types of infections in every system.

They usually work in tertiary care center hospitals as clinical doctors where a lot of complicated infections are seen and they have superior knowledge of pathogens, infections, illnesses, and antimicrobials. They also work in universities, in research facilities, pharmaceutical and insurance companies, in the government to help drive policy, and in NGOs.

ID providers tend to be well-rounded in all aspects of medicine. They are trained in internal medicine or family practice as well as infectious diseases. and some have additional training in public health, epidemiology, microbiology, and tropical and travel medicine. In the hospitals, they are usually consulted by other medical providers, such as surgeons, internists, ob-gyns, and other medical providers, to advise and treat all types of infections. They give recommendations and treat infections in the joints and bones, including in patients that have had surgeries or joint replacements, skin and soft tissue infections, blood infections, pneumonias and other chest infections, infections of the genitourinary and Gastrointestinal systems, central nervous systems, etc.

They usually work hand in hand with clinical infectious disease pharmacists who have had some extra training in infectious diseases, infections, and antimicrobials and both are essential in antimicrobial stewardship programs to use their skills to advice other providers who needs to be treated with antimicrobials, which antimicrobials to give at the right dose for the right duration.
NNAST will help with increasing training programs in ID and scale up the number of ID providers and pharmacists in Nigeria in collaboration with medical institutions and universities, provide ID help remotely and otherwise until Nigeria can sustain this effort by itself.

Antimicrobial Stewardship TEAMS

Infectious Disease doctors, Infectious Disease Pharmacists, Microbiology labs, Doctors from other fields, and Nurses are the key personnel that should be in every AMS program.

Barriers and the Future of AMS in Nigeria

Antimicrobial stewardship in Nigeria is improving despite existing obstacles for its advancement. The existing obstacles create developmental problems which raise the likelihood of antibiotic drug resistance. Knowledge of these obstacles leads to constructing an improved system that safeguards public health throughout the years.

FAQs

What is antimicrobial stewardship?

Antimicrobial stewardship requires proper antibiotic treatment when necessary along with appropriate doses.

Why is antimicrobial stewardship important in Nigeria?

The frequent improper use of antibiotics produces resistant infections throughout the country.

What are the ongoing studies on AMS in Nigeria?

The research devotes attention to antibiotic prescriptions and public knowledge and hospital antimicrobial programs.

What is the role of pharmacists in antimicrobial stewardship programs?

Pharmacists support prescription verification processes while educating patients and fighting medication misuse.

How is Nigeria promoting antimicrobial stewardship?

Through national plans like NAP 2.0 AMR, training, public education, and stronger policies.



What is ANTIMICROBIAL STEWARDSHIP?

In the fight against antimicrobial resistance, there are multiple avenues where interventions can be applied. NNAST  will support the government and other agencies who are working to reduce the indiscriminate use of antibiotics.  We plan to scale up antimicrobial stewardship, surveillance, and research  in the field.

Antimicrobial stewardship is a program that aims to reduce the misuse and overuse of antibiotics and other antimicrobial medications to prevent microbial resistance.  These medications are essential for treating infections, but their misuse has led to antibiotic resistance, which occurs when bacteria and fungi develop the ability to resist the drugs that are meant to kill them.

Antimicrobial stewardship programs (ASPs) use a variety of strategies and techniques to optimize the use of antibiotics in hospitals. These programs aim to ensure that patients receive the correct antimicrobial for the right infection , no antimicrobial if there is no infection , at the right time, the right dose, and appropriate minimal duration for their diagnosis.

The task force’s activities in this field will include:

  • Working with healthcare facilities to establish and strengthen their antimicrobial stewardship programs

Improving the identification of resistant organisms

Coordinating research and surveillance activities on antimicrobial resistance (AMR)

  • Creating an AMR data platform

  • Promoting education and enlightenment on AMR  in both  healthcare personnel and the general public

Capacity building for the Nigerian healthcare systems on AMS.

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Dr. Omobosola Akinsete is a dedicated physician and a key member of the Nigerian Antimicrobial Stewardship Taskforce. She has been an internal medicine and adult Infectious Disease physician in the United States of America for 30  years . She graduated from Medical school at the University of Lagos, and has a masters in Public Health from Johns Hopkins school of Public Health. 

She did her Internal Medicine training at a Brown University hospital and her fellowship in Infectious Diseases  at the University of Minnesota where she is an associate professor. She has worked with the National Institutes of Health and Howard University a a coordinator for the Human Genome Project among other projects, she is a frequent public speaker and contributor to different types of media. She loves to advocate for healthcare in minority populations. She  has a lot of experience with  patients and health care providers on antimicrobial stewardship in her institution  HealthPartners in Minnesota U.S.A. Her expertise in the field of Infectious diseases and antimicrobial stewardship and her passion to improve health care in her home country will contribute significantly to the fight against antimicrobial resistance in Nigeria. Dr. Akinsete’s work with the taskforce focuses on leadership of the taskforce as chairperson and national coordinator, working closely with NCDC leadership, the Nigerian Federal Ministry of Health, stakeholders, and funding partners, and helping with capacity building of standardized antimicrobial stewardship and infectious disease educational programs. She will also use her expertise to guide providers and HealthCare institutions  on the ground . Her commitment to improving antimicrobial use and patient safety is invaluable to the nation’s public health efforts.