The journey to institutionalising Antimicrobial Stewardship (AMS) in a resource-constrained tertiary healthcare facility in Lagos, Nigeria Le cheminement vers l'institutionnalisation de la gestion des antimicrobiens (GAM) dans un établissement de soins de santé tertiaires aux ressources limitées à Lagos, au Nigéria

Abstract

Background: Antimicrobial stewardship (AMS) is one of the main strategies to stem the global tide of antimicrobial resistance (AMR). While developed nations have successfully implemented antimicrobial stewardship programmes, such initiatives remain underdeveloped in many Nigerian healthcare institutions. This is a report of a project to improve the AMS programme at the Lagos University Teaching Hospital (LUTH), Nigeria, by strengthening the antimicrobial stewardship committee (AMSC) and antimicrobial stewardship team (AMST) of the hospital.
Methodology: The Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) facility assessment tool was used to identify gaps in the AMS programme (ASP) of LUTH, and activities to address the gaps were conducted over a 3-year period (2021-2024).
Results: The results of the activities to address the identified gaps in the ASP were the expansion of AMS activities from 3 to 10 departments of the hospital, a strong management commitment and support, consistent antibiotic consumption calculations, strategic training of professionals, and increased knowledge and awareness of AMS among staff and students. However, major challenges identified included shortage of staff and lack of functional electronic medical records.
Conclusion: Continuing pre- and in-service training of staff, AMS activities and monitoring, and incorporation of AMS actions and interventions performed with the electronic medical records are recommended for sustaining AMS in the hospital.