KENYA – Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) has recorded a rising percentage of antibiotic (antimicrobial) resistance in the facility.

Currently at 40 per cent of the first-line amoxicillin drugs, a similar pattern is also seen in the sensitivity of Cefazolin, a second-line agent in bacteria disease treatment.

“This increase is driven by ‘over the counter, antibiotics purchase devoid of doctors’ prescriptions,” Dr. Neto Obala, head of the pharmacy at JOOTRH pointed out.

JOOTRH spends 10 per cent of its annual budget resources allocated to drugs on anti-biotics. Its data on resistance is drawn from the lab accruing from resistance to locally available antibiotics.

In response to this scenario, the facility constituted an active Anti-Microbial Stewardship Committee which has championed baseline and continued laboratory Culture and sensitivity data that aids evidence-based practice.

“The committee advises on the purchase of cefazolin for pre-operative administration,” Dr. Obala added.

He said that the Antimicrobial Committee conducts ward rounds a fortnight, accompanied by a physician, clinical pharmacist, a nurse, and a laboratory technologist.

The criteria for patients’ selection while undertaking the ward rounds is based on referrals from wards and major ward rounds, requests from the laboratory department, patients not responding to first-line medication, and patients having an isolated superbug of interest in MDR, A baumanii, XDR and ESBL.

Through the interventions by this team, led by Dr. Matilda Wendo, the facility gets benefits from multi-disciplinary teamwork, better patient outcomes, and reduced hospital stay.

According to WHO, antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness, and death.

As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat. Researchers estimated that AMR in bacteria caused an estimated 1.27 million deaths in 20191.

A global action plan to tackle the growing problem of resistance to antibiotics and other antimicrobial medicines was endorsed at the Sixty-eighth World Health Assembly in May 2015.

One of the key objectives of the plan is to improve awareness and understanding of AMR through effective communication, education, and training.

Antimicrobial resistance (AMR) is a threat to humans, animals, plants, and the environment. It affects us all. This is why this year’s theme calls for collaboration across sectors to preserve the efficacy of these critical medicines. Fighting AMR is a truly global endeavor and must be addressed through a One Health approach.

One Health is a collaborative, multisectoral, and transdisciplinary approach — working at the local, regional, national, and global levels — with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment.

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