pharmacist antimicrobial stewardship
Antimicrobial resistance is a growing global health concern and Nigeria faces an urgent need to address it across all states. One critical solution to this issue is pharmacist antimicrobial stewardship which refers to the coordinated efforts of pharmacists in promoting the optimal use of antimicrobial medications. These initiatives are designed not only to improve patient outcomes but also to reduce microbial resistance and the spread of infections caused by multidrug-resistant organisms.
What is Pharmacist Antimicrobial Stewardship
Pharmacist antimicrobial stewardship involves a range of practices implemented by trained pharmacists to ensure that antimicrobials are prescribed only when necessary and that they are administered properly in correct dosages and durations. This approach helps minimize the development of resistance in pathogens and preserves the effectiveness of available drugs.
In Nigeria this stewardship is part of a broader framework under the National Action Plan for Antimicrobial Resistance spearheaded by the Federal Ministry of Health. Pharmacists are frontline healthcare professionals and their active participation ensures a strategic approach to rational drug use in hospitals and communities.
Why Pharmacists are Vital in Stewardship Programs
Pharmacists are uniquely positioned in both community and hospital settings where they can monitor prescriptions advise prescribers and counsel patients. They also provide critical feedback on drug interactions dosing adjustments and alternatives for patients with comorbidities. In the context of antimicrobial resistance surveillance their role is crucial in reporting medication outcomes and resistance patterns to help shape national data trends.
In 2025 Nigeria’s National Antimicrobial Stewardship Strategy emphasizes the inclusion of pharmacists in every stewardship team. This move reflects growing recognition of their importance in guiding clinical decisions that help prevent resistance.
Which States are Leading in Pharmacist Antimicrobial Stewardship
While all Nigerian states are included in the national agenda for combating antimicrobial resistance some have made more visible progress. Lagos Oyo Rivers Kaduna and the Federal Capital Territory have reported stronger implementation of stewardship programs within tertiary hospitals. In these regions pharmacists are embedded in AMS committees contributing actively to drug policy development and training programs.
In states such as Enugu Kano and Borno local pharmacy boards have partnered with public health departments to enhance pharmacist involvement in outpatient antimicrobial protocols. These initiatives aim to bridge gaps in urban and rural healthcare delivery ensuring equal participation across state lines.
Who is Responsible for Coordinating Stewardship
Pharmacist antimicrobial stewardship efforts in Nigeria are coordinated by the Nigeria Centre for Disease Control in collaboration with the Nigeria National Antimicrobial Stewardship Technical Working Group. This group oversees the training and deployment of pharmacy-led AMS teams in hospitals.
Institutions like the Nigerian Association of Pharmacists and the National Antimicrobial Stewardship Program provide guidance support and resources. Training workshops held throughout 2024 and into 2025 have focused on equipping pharmacists with diagnostic tools knowledge on resistance trends and implementation protocols.
Where Do Pharmacists Practice Stewardship
Pharmacists practice antimicrobial stewardship in diverse healthcare environments. In tertiary hospitals they are part of antimicrobial stewardship committees that approve or review antimicrobial prescriptions. In primary care settings pharmacists promote rational drug use through patient education and engagement with prescribers.
Community pharmacists are increasingly recognized as critical players especially in rural states like Nasarawa Ebonyi and Taraba where formal health systems are limited. Here they counsel patients on appropriate medication use and refer cases of suspected resistance.
When Did Nigeria Begin Prioritizing Pharmacist-Led Stewardship
Nigeria’s formal journey into pharmacist-led stewardship gained momentum with the launch of the first National Action Plan on Antimicrobial Resistance in 2017. However it was in 2020 during the COVID–19 pandemic that widespread misuse of antimicrobials triggered an urgent response. Pharmacists were called upon to manage drug supply and ensure rational use.
By 2023 the National Council on Health mandated that all tertiary hospitals form antimicrobial stewardship committees including pharmacists. The implementation of this policy across all states progressed steadily and by early 2025 over 70 percent of major hospitals now have functional AMS teams with pharmacists leading interventions.
How Pharmacist Antimicrobial Stewardship Functions in Practice
In practical terms pharmacist antimicrobial stewardship works through several key strategies. These include:
Prescription Audits and Feedback
Pharmacists conduct regular audits of antibiotic prescriptions to identify patterns of misuse or overuse. They provide feedback to prescribers and engage in collaborative decision-making to correct inappropriate practices.
Education and Training
Pharmacists lead training sessions for healthcare workers on antimicrobial resistance and appropriate use of antibiotics. These training modules are integrated into the continuous professional development plans in several states.
Dose Optimization
Through close review of patient records and lab results pharmacists adjust dosages and recommend switching from intravenous to oral therapy when appropriate. This reduces cost and improves patient comfort without compromising treatment.
Surveillance and Reporting
Pharmacists participate in antimicrobial resistance surveillance by documenting resistance patterns and treatment outcomes. These reports contribute to national and global surveillance databases which inform public health policies.
Patient Engagement
Pharmacists also educate patients about completing antibiotic courses avoiding self-medication and recognizing the risks of drug resistance. Public education campaigns in markets and schools across Nigeria’s six geopolitical zones have included pharmacists as key speakers.
Whose Responsibility is it to Expand Stewardship Nationwide
While national leadership is vital the success of pharmacist antimicrobial stewardship ultimately depends on joint responsibility. Hospitals must support pharmacists with resources and authority. Medical professionals must accept collaborative practice. Policy-makers must ensure consistency in implementation across all 36 states and the FCT.
Professional organizations like the Pharmaceutical Society of Nigeria also have a critical role in maintaining ethical standards and fostering a culture of continuous learning among pharmacists.
Challenges Still Affecting Pharmacist Stewardship in Nigeria
Despite considerable progress pharmacist antimicrobial stewardship still faces barriers. These include inadequate funding for stewardship programs limited access to diagnostic tools and resistance by some prescribers to pharmacist-led interventions.
In states with limited healthcare infrastructure pharmacists sometimes work without access to electronic medical records or culture sensitivity data making it difficult to guide treatments effectively. There is also a shortage of pharmacists trained specifically in infectious diseases which limits the depth of stewardship efforts.
Conclusion
As Nigeria continues to battle antimicrobial resistance across its healthcare system pharmacist antimicrobial stewardship offers a science-based patient-centered solution. With pharmacists involved in surveillance prescribing audits education and patient care this approach represents a cornerstone of the national strategy.
Ongoing support from federal agencies professional associations and hospital administrators is essential to expand and sustain these efforts. By 2025 pharmacist-led interventions are helping to slow resistance improve outcomes and protect the effectiveness of life-saving medications across all Nigerian states.
