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The Mbeya Antimicrobial Stewardship Team: Implementing Antimicrobial Stewardship at a Zonal-Level Hospital in Southern Tanzania.
Pharmacy (Basel). 2020 Jun 24; 8(2)P

Abstract

Background:

In 2017, Mbeya Zonal Referral Hospital (MZRH) and the University of South Carolina (UofSC) agreed to collaboratively strengthen antimicrobial prescribing in the southern highlands of Tanzania and train a new generation of clinicians in responsible antimicrobial use.

Methods:

Key stakeholders and participants were identified and the Mbeya Antimicrobial Stewardship Team (MAST) was created. The team identified assets brought by the collaborators, and four investigations of baseline needs were developed. These investigations included (a) a baseline clinician survey regarding antimicrobial resistance and stewardship, (b) a serial chart review of inpatient antimicrobial prescribing practices, (c) an investigation of antimicrobial resistance rates using existing isolates at the MZRH laboratory, and (d) a survey of antimicrobial availability at community pharmacies in the city.

Results:

91% of physicians believe antimicrobial resistance is problem in Tanzania, although only 29% of physicians were familiar with the term "antimicrobial stewardship". Escherichia coli isolates had resistance rates of over 60% to the commonly used agents ciprofloxacin, trimethoprim-sulfamethoxazole, and ceftriaxone. Thirteen out of 14 community pharmacies offered over-the-counter antibiotics for upper respiratory symptoms.

Conclusions:

International antimicrobial stewardship collaborations can successfully identify opportunities and needs. Evaluating the team's efforts to improve patient outcomes will be essential.

Authors+Show Affiliations

School of Medicine, University of South Carolina, Columbia, SC 29209 USA. College of Pharmacy, University of South Carolina, Columbia, SC 29208, USA.College of Pharmacy, University of South Carolina, Columbia, SC 29208, USA.College of Pharmacy, University of South Carolina, Columbia, SC 29208, USA.School of Medicine, University of South Carolina, Columbia, SC 29209 USA.Mbeya Zonal Referral Hospital, Mbeya PO Box 419, Tanzania.Mbeya Zonal Referral Hospital, Mbeya PO Box 419, Tanzania.Mbeya Zonal Referral Hospital, Mbeya PO Box 419, Tanzania.Mbeya Zonal Referral Hospital, Mbeya PO Box 419, Tanzania.Sarasota Memorial Health Care System, Sarasota, FL 34239, USA.School of Medicine, University of South Carolina, Columbia, SC 29209 USA.College of Pharmacy, University of South Carolina, Columbia, SC 29208, USA.Mbeya Zonal Referral Hospital, Mbeya PO Box 419, Tanzania.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32599699

Citation

Hall, Jeffrey W., et al. "The Mbeya Antimicrobial Stewardship Team: Implementing Antimicrobial Stewardship at a Zonal-Level Hospital in Southern Tanzania." Pharmacy (Basel, Switzerland), vol. 8, no. 2, 2020.
Hall JW, Bouchard J, Bookstaver PB, et al. The Mbeya Antimicrobial Stewardship Team: Implementing Antimicrobial Stewardship at a Zonal-Level Hospital in Southern Tanzania. Pharmacy (Basel). 2020;8(2).
Hall, J. W., Bouchard, J., Bookstaver, P. B., Haldeman, M. S., Kishimbo, P., Mbwanji, G., Mwakyula, I., Mwasomola, D., Seddon, M., Shaffer, M., Shealy, S. C., & Nsojo, A. (2020). The Mbeya Antimicrobial Stewardship Team: Implementing Antimicrobial Stewardship at a Zonal-Level Hospital in Southern Tanzania. Pharmacy (Basel, Switzerland), 8(2). https://doi.org/10.3390/pharmacy8020107
Hall JW, et al. The Mbeya Antimicrobial Stewardship Team: Implementing Antimicrobial Stewardship at a Zonal-Level Hospital in Southern Tanzania. Pharmacy (Basel). 2020 Jun 24;8(2) PubMed PMID: 32599699.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Mbeya Antimicrobial Stewardship Team: Implementing Antimicrobial Stewardship at a Zonal-Level Hospital in Southern Tanzania. AU - Hall,Jeffrey W, AU - Bouchard,Jeannette, AU - Bookstaver,P Brandon, AU - Haldeman,Matthew S, AU - Kishimbo,Peter, AU - Mbwanji,Godlove, AU - Mwakyula,Issakwisa, AU - Mwasomola,Davance, AU - Seddon,Megan, AU - Shaffer,Mark, AU - Shealy,Stephanie C, AU - Nsojo,Anthony, Y1 - 2020/06/24/ PY - 2020/05/11/received PY - 2020/06/11/revised PY - 2020/06/18/accepted PY - 2020/7/1/entrez PY - 2020/7/1/pubmed PY - 2020/7/1/medline KW - East Africa KW - Low to Middle Income Countries (LMIC) KW - Tanzania KW - antimicrobial resistance KW - antimicrobial stewardship KW - global health JF - Pharmacy (Basel, Switzerland) JO - Pharmacy (Basel) VL - 8 IS - 2 N2 - Background: In 2017, Mbeya Zonal Referral Hospital (MZRH) and the University of South Carolina (UofSC) agreed to collaboratively strengthen antimicrobial prescribing in the southern highlands of Tanzania and train a new generation of clinicians in responsible antimicrobial use. Methods: Key stakeholders and participants were identified and the Mbeya Antimicrobial Stewardship Team (MAST) was created. The team identified assets brought by the collaborators, and four investigations of baseline needs were developed. These investigations included (a) a baseline clinician survey regarding antimicrobial resistance and stewardship, (b) a serial chart review of inpatient antimicrobial prescribing practices, (c) an investigation of antimicrobial resistance rates using existing isolates at the MZRH laboratory, and (d) a survey of antimicrobial availability at community pharmacies in the city. Results: 91% of physicians believe antimicrobial resistance is problem in Tanzania, although only 29% of physicians were familiar with the term "antimicrobial stewardship". Escherichia coli isolates had resistance rates of over 60% to the commonly used agents ciprofloxacin, trimethoprim-sulfamethoxazole, and ceftriaxone. Thirteen out of 14 community pharmacies offered over-the-counter antibiotics for upper respiratory symptoms. Conclusions: International antimicrobial stewardship collaborations can successfully identify opportunities and needs. Evaluating the team's efforts to improve patient outcomes will be essential. SN - 2226-4787 UR - https://www.unboundmedicine.com/medline/citation/32599699/The_Mbeya_Antimicrobial_Stewardship_Team:_Implementing_Antimicrobial_Stewardship_at_a_Zonal-Level_Hospital_in_Southern_Tanzania L2 - https://www.mdpi.com/resolver?pii=pharmacy8020107 DB - PRIME DP - Unbound Medicine ER -
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