PhD Student has Article Published in The Lancet
UKZN doctoral student, Consultant Clinical Microbiologist Dr Yogandree Ramsamy, has had an article she co-authored titled: “Antimicrobial Stewardship in South Africa: A Fruitful Endeavour”, published in The Lancet Infectious Diseases journal.
The editorial was based on a study conducted in South Africa by a group of investigators who explored the avenue of Antibiotic Stewardship by focusing on a few interventions.
‘I was extremely fortunate to be asked by The Lancet Infectious Diseases journal to submit a comment that would accompany the final published manuscript by Dr Arian Brink and colleagues titled: “Antimicrobial Stewardship Across 47 South African hospitals: an Implementation Study”,’ said Ramsamy.
She said Brink and colleagues highlighted the fact that by focusing on a few vital interventions referred to as “low- hanging fruit”, antimicrobial use decreased substantially. Interventions targeted prolonged antibiotic duration and stopping antibiotics with overlapping or duplicate spectra.
According to Ramsamy, antimicrobial resistance has become a massive problem and is one of the greatest challenges to global public health today. ‘It is a problem which threatens the lives of millions. With the antibiotic pipeline running dry, there are only a few options left for clinicians to use when faced with life-threatening sepsis.’
‘Antimicrobials help treat and cure infections. Increasing resistance to these lifesaving drugs essentially means that many people face a future of incurable infections. This in turn would result in millions dying as a result of these infections,’ said Ramsamy.
A review published by Ramsamy in the World Journal of Surgery earlier this year titled: “Surviving Sepsis in the Intensive Care Unit: The Challenge of Antimicrobial Resistance and the Trauma Patient”, highlights antimicrobial use in the ICU. The review focuses on antimicrobial therapy in patients admitted to the Intensive Care Unit, specifically the Trauma Intensive Care Unit. ‘From my previous studies carried out in this unit (the Trauma Intensive Care Unit at Inkosi Albert Luthuli Central Hospital in Durban) , it has come to light that the patient population admitted to an ICU must be considered prior to initiation of antimicrobial therapy.’
The review focused on specific factors that needed to be considered prior to choosing an antimicrobial agent and how to make an informed decision with regard to the initiation of empiric antimicrobial therapy. It highlights the importance of pathogen surveillance within a given intensive care unit.
‘Pathogen surveillance is used to guide empiric antimicrobial therapy and allows the clinician to make an informed decision regarding initial empiric antimicrobial therapy,’ said Ramsamy.
The review highlights the concept of Antimicrobial Stewardship and responsible antibiotic prescribing in the ICU. It also provides scientific evidence that narrower spectrum antimicrobials can be used in specific patient populations admitted to an Intensive Care Unit. ‘The use of empiric broad-spectrum antimicrobials may not be necessary in all patients admitted to the ICU,’ said Ramsamy. ‘This coupled with antimicrobial stewardship and surveillance may provide a solution to the problem of AMR.’
Ramsamy coauthored The Lancet Infectious Diseases editorial with Professor David Muckart and Professor Koleka Mlisana. ‘I was honored to have Professor Muckart and Professor Mlisana as my co-authors on this comment, both of whom are great mentors. Their guidance, wisdom, support and confidence in my ability are much appreciated.’
She said Muckart and Dr Timothy Hardcastle were instrumental in compiling her review published in The World Journal of Surgery. ‘They both provided a wealth of experience and invaluable knowledge.’