By Lorraine Anyango

Resisting Resistance.

Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) has recorded a rise in resistance, currently staggering at 40 percent to the first-line amoxicillin drugs.

The facility has also recorded a similar pattern of resistance in the sensitivity of Cefazolin a second-line agent in bacteria disease treatment.

JOOTRH spends 10 percent 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.

“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.

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.

The committee held a sensitization workshop for staff at jootrh as well as joined the rest of the country to mark world antimicrobial awareness week.

During the walk, residents of Kisumu were sensitized to the fact that human, animal, and environmental health are intertwined hence as far as the mitigation of antimicrobial resistance is concerned.

The team shared leaflets, with key messages on the appropriate use of antimicrobials and the safe disposal of medicine.

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.

World Antimicrobial Awareness Week (WAAW) is a global campaign that is celebrated annually to improve awareness and understanding of AMR and encourage best practices among the public, One Health stakeholders, and policymakers, who all play a critical role in reducing the further emergence and spread of AMR.

This year, the theme of WAAW is “Preventing Antimicrobial Resistance Together.” We call on all sectors to encourage the prudent use of antimicrobials and to strengthen preventive measures addressing AMR, working together collaboratively through a One Health approach.

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.

To curb it effectively, all sectors must join forces and encourage the prudent use of antimicrobials, as well as preventive measures. Strengthening infection prevention and control in health care facilities, farms, and food industry premises, ensuring access to vaccines, clean water, sanitation, and hygiene, implementing best practices in food and agriculture production, and guaranteeing the sound management of waste and wastewater from key sectors are critical to reducing the need for antimicrobials and minimizing the emergence and transmission of AMR.

The slogan of World Antimicrobial Awareness Week remains ‘Antimicrobials: Handle with Care. WAAW is celebrated from 18 to 24 November every year.