Antibiotic Resistance Deliberated by KZN Hospital Reps
The Infection Prevention and Control (IPC) Units of KwaZulu-Natal’s Provincial hospitals and Clinics recently united to commemorate World Antibiotic Awareness Week (WAAW) at a forum held at Inkosi Albert Luthuli Central Hospital.
Organised and chaired by UKZN/KZN DoH IPC Head, Professor Prashini Moodley, the 150 healthcare professionals deliberated on possible interventions to delay the emergence of antibiotic-resistant organisms and to stem the spread of antibiotic-resistant organisms in healthcare.
The discussion acknowledged that many antibiotics are prescribed in the healthcare and agriculture sectors for the wrong reasons, contributing to the overall antibiotic pressure and hence to resistance. Globally, an ever-increasing number of patients are becoming infected with antibiotic-resistant organisms, Moodley said, and the toll of morbidity and mortality from these infections has major repercussions.
Moodley emphasised that infection prevention and control strategies must work in tandem with antibiotic stewardship to prevent the emergence and spread of nosocomial infections.
The majority of public health facilities in KwaZulu-Natal have implemented antibiotic stewardship projects and 18 facilities were selected to present the results of interventions implemented. Townhill Hospital, represented by Mr Keith Rathnum, was awarded first prize. Over a 12 month period, the number of nosocomial infections as well as the amount of money spent on antibiotics decreased almost 50 percent by implementation of simple and sustainable interventions at this facility.
According to the World Health Organization, a global action plan to tackle the growing problem of resistance to antibiotics and other antimicrobial medicines was endorsed at the 86th World Health Assembly in May 2015. One of the key objectives of the plan is to improve awareness and understanding of antimicrobial resistance through effective communication, education and training.
Professor Willem Sturm, Professor Emeritus at UKZN’s School of LMMS, said the main goal of antimicrobial stewardship was to use antibiotics in a responsible manner so that resistance is prevented or delayed. Sturm encouraged attendees to avoid the use of antimicrobial agents unless absolutely necessary. Antibiotics were inappropriately used if administered when not needed, continued for longer than necessary, incorrectly dosed, were the incorrect choice for the infection, and broad-spectrum nostrums were used over narrow-spectrum agents.
Currently, many bacteria are still susceptible to many antibiotics, Sturm said, and antimicrobial stewardship programmes would slow down further development of resistance. However, a major challenge is that the majority of the causative agents of hospital-acquired infections was already multidrug resistance (MDR), leaving few therapeutic options for management of nosocomial infections.
‘The treatment of TB patients is difficult, expensive and leads to many adverse effects,’ said the second keynote speaker: the University of Pennsylvania Assistant Professor, Nicola Zetola, who shared preliminary findings from a study re-defining the treatment of MDR-TB in Botswana.
Among other factors in Zetola’s study, the researchers found that although they were using lower dosing regimens than recommended, their patients were experiencing adverse effects that were previously associated with higher doses.
From King Edward VII hospital, to Greys Hospital in Pietermaritzburg and as far out as Ladysmith Hospital in the Uthukela Health District and Mseleni Hospital in the north, delegates shared the challenges they faced with antibiotic resistance.
The theme for this year’s World Antibiotic Awareness Week is “Antibiotics: Handle With Care”. The hospitals made a pact to reduce resistance, morbidity, mortality and costs.