What is the Importance of Antimicrobial Stewardship

Antimicrobial stewardship is one of the most critical interventions in global public health today. In Nigeria, where antibiotic misuse is widespread and resistant infections are on the rise, understanding the importance of antimicrobial stewardship is essential to protecting future generations. It is not only a medical initiative but also a national responsibility.

What is Antimicrobial Stewardship

Antimicrobial stewardship refers to coordinated interventions designed to improve and measure the appropriate use of antimicrobial agents. This involves selecting the optimal antimicrobial drug regimen including dosing duration and route of administration. The goal is to achieve the best clinical outcomes while minimizing toxicity and other adverse events.

In the Nigerian context this practice is essential due to the increasing burden of infectious diseases and the misuse of antibiotics in hospitals pharmacies and among the general population.

Why is Antimicrobial Stewardship Important

The importance of antimicrobial stewardship lies in its ability to combat antimicrobial resistance preserve the effectiveness of existing drugs reduce healthcare costs and improve patient outcomes. With the growing threat of antibiotics resistance in Nigeria antimicrobial stewardship serves as a protective shield.

Antimicrobial resistance occurs when microorganisms such as bacteria evolve to resist the effects of medications making infections harder to treat. This leads to prolonged illness disability and increased mortality.

Nigeria is particularly vulnerable due to inadequate diagnostic tools poor regulatory controls over antibiotic sales and self-medication practices. As of 2025 surveillance data from the Nigeria Centre for Disease Control show that resistance to commonly used antibiotics such as ciprofloxacin amoxicillin and ceftriaxone is alarmingly high in many states.

Who is Responsible for Antimicrobial Stewardship

Antimicrobial stewardship is a shared responsibility involving various stakeholders. Physicians pharmacists microbiologists nurses healthcare administrators and policymakers all play unique roles.

In Nigeria pharmacists are at the forefront of implementing antimicrobial stewardship programs. They assess prescriptions provide recommendations and guide the rational use of antibiotics. The Federal Ministry of Health supports these efforts through national policies and training programs.

Professional bodies such as the Nigerian Society for Antimicrobial Stewardship and academic institutions are also central to the campaign. They train professionals and disseminate guidelines on best practices.

Where is Antimicrobial Stewardship Practiced

Antimicrobial stewardship is practiced in hospitals clinics community pharmacies laboratories and even veterinary settings. In Nigeria tertiary hospitals in Lagos Kano Enugu and Abuja have established antimicrobial stewardship teams.

Public and private healthcare facilities are encouraged to set up antimicrobial stewardship committees. These committees monitor antibiotic prescribing patterns review resistance trends and ensure compliance with treatment guidelines.

In rural areas where healthcare access is limited community health workers are being trained to educate people about the dangers of improper antibiotic use.

When Should Antimicrobial Stewardship be Implemented

Antimicrobial stewardship should be implemented immediately and continuously. It is not a one-time intervention but a sustained program that evolves with emerging data.

In Nigeria antimicrobial stewardship should begin from the first point of patient care. Whether in the emergency room outpatient department or during community outreach campaigns appropriate antibiotic use must be ensured.

Early implementation helps prevent the spread of resistant organisms reduce infection rates and improve recovery outcomes. National policies now recommend incorporating antimicrobial stewardship education into undergraduate curricula and professional training from 2025 onwards.

How is Antimicrobial Stewardship Implemented

Implementing antimicrobial stewardship in Nigeria requires a multidisciplinary approach. Hospitals establish Antimicrobial Stewardship Programs which include clear objectives policies and team structures.

Key strategies include:

Developing evidence-based treatment guidelines

Monitoring antimicrobial prescribing and resistance trends

Educating healthcare providers and patients

Promoting infection prevention and control

Reviewing antimicrobial therapy based on lab results

Technological tools such as electronic prescribing systems and laboratory information management systems support data collection and analysis.

The National Action Plan for Antimicrobial Resistance 2022–2026 which remains active in 2025 prioritizes strengthening antimicrobial stewardship in all 36 Nigerian states and the Federal Capital Territory.

Which Populations Are Most Affected by Poor Stewardship

Children the elderly immunocompromised individuals and patients with chronic illnesses are most affected by poor antimicrobial stewardship. These groups are more susceptible to infections and face higher risks from resistant bacteria.

In Nigeria maternal and child health services are especially vulnerable. Reports from the National Health Management Information System show increasing neonatal sepsis cases resistant to first-line antibiotics.

Moreover people living in densely populated urban areas and internally displaced persons in camps are exposed to greater infection risks due to overcrowding and poor sanitation.

Whose Role is Most Crucial in Improving Stewardship

While all healthcare providers have a role pharmacists are uniquely positioned to lead antimicrobial stewardship efforts in Nigeria. They are trained in pharmacology understand resistance mechanisms and work closely with both prescribers and patients.

Pharmacists in tertiary hospitals are involved in real-time review of antibiotic prescriptions identifying inappropriate use and suggesting alternatives. In community settings they educate the public about correct dosage durations and the risks of self-medication.

Collaboration with laboratory scientists ensures that prescribing is based on accurate diagnosis and susceptibility results. Policymakers and regulators support this system by enforcing laws against over-the-counter antibiotic sales.

What is Being Done in Nigeria in 2025

In 2025 Nigeria is actively expanding its antimicrobial stewardship programs. The Nigeria Centre for Disease Control in collaboration with the World Health Organization and local NGOs is strengthening antimicrobial resistance surveillance and reporting systems.

Hospitals in Lagos Ogun Rivers and Kaduna states have piloted mobile-based antimicrobial prescribing audits. These projects are helping track resistance patterns and identify areas needing intervention.

New training modules for health workers on antimicrobial stewardship are being rolled out in partnership with the Nigerian Institute of Medical Research.

Furthermore public awareness campaigns have been intensified through radio social media and community outreach to promote responsible antibiotic use and reduce demand for unnecessary prescriptions.

Conclusion

Understanding the importance of antimicrobial stewardship is critical for addressing the growing challenge of antibiotics resistance in Nigeria. It saves lives protects antibiotics for future generations and ensures better health outcomes.

In 2025 Nigeria is making meaningful progress by involving all stakeholders from government agencies to pharmacists and community members. But more effort is needed to sustain these gains. Every healthcare worker and citizen has a role to play in preserving the power of antibiotics. The time to act is now.