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• W3125762846 abstract "Background: Inappropriate use of antimicrobials (AMs) in primary care and hospital settings is a key driver of antimicrobial resistance (AMR). In 2011, a situational analysis of antibiotic use and resistance was conducted between South African stakeholders and the Global Antibiotic Resistance Partnership. In 2014, South Africa launched its National AMR Strategy Framework, followed by implementation guidelines in 2017. A baseline survey amongst 26 public sector facilities indicated sub-optimal compliance with the framework. This follow-up study aimed to identify the strengths and/or challenges of current antimicrobial stewardship programs (AMSPs). Methods and materials: Facilities were identified according to the percentage compliance with the framework (≥70%; 51–69%; ≤50%). Participants were purposively selected. A FGD guide was used, the discussion audio-recorded and transcribed verbatim. Data saturation were reached after ten twelve (46%) discussions. A thematic content analysis was performed, using open coding with NVivo®12. Results: Based on provisional data analysis, five key themes with sub-categories emerged. (i) Accountability relates to structures, including infection prevention and control (IPC), PTC and AMS. Although in place at many facilities, it was not necessarily active. Effective multidisciplinary collaboration is still not optimal in all facilities; (ii) Education is seriously lacking pertaining to the community and a definite need exists to grasp the seriousness of AMR; (iii) Surveillance is neglected, mainly due to a lack of resources and non-availability of microbiology. The majority had no knowledge regarding antibiograms and the necessity thereof; (iv) Resources is a major complaint. The active and timeous involvement of an infectious diseases specialist and microbiologist is a definite requirement, collaborating with a specific person responsible for AMS, e.g. a microbial champion. The latter was non-existing in the majority of facilities. Especially in PHC, the lack of information technology, electronic systems and access to WiFi is a major concern; (v) Private vs. Public sectors formed a thread throughout, fueled by patient expectation. Conclusion: Based on the themes identified, targeted interventions can be designed to strengthen the role, impact and activities of AMSPs. The success and sustainability of the framework depends on the commitment of all health care professionals responsible for patient outcome, both directly and indirectly." @default.
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• W3125762846 date "2020-12-01" @default.
• W3125762846 modified "2023-09-25" @default.
• W3125762846 title "Current antimicrobial stewardship programmes in public sector facilities across South Africa: Has the National AMR Strategy Framework made an impact?" @default.
• W3125762846 doi "https://doi.org/10.1016/j.ijid.2020.09.269" @default.
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