Global Antimicrobial Stewardship: This important issue was in the focus of a webinar (hosted by CIDRAP) on Tuesday. One of the three participants: Prof. Dilip Nathwani (University of Dundee), one of the top speakers at the 2nd Semmelweis CEE Conference on March 7-8 in Budapest. Carola Timmel was listening the webinar and presents the key messages of the presentation.
„It is hard to change prescribing habits if you are not even aware that there is a problem“, says Dr. Debra Goff (Ohio State University). Many countries lack reliable data to track emerging microbial threats. “If antimicrobial stewardship was as easy as following guidelines or reading papers on stewardship then every hospital everywhere should have successful antimicrobial stewardship programs – Except they do not!”, says Goff. “The issue is just more difficult than reading papers.”
“Indeed the issue is very complex and must always be seen in the context”, says Dr. Dilip Nathwani: “Understanding what works, how, why, for how long – and also to ask the very important question what is missing.” We must be aware of the cultural background and act with the pattern adopt adapt transform: “One size does not fit all.” But the success for stewardship depends also in empowerment and risk: “We need to be prepared to take some risk, learn from failure and we must encourage and empower all professionals, government and society to take ownership of stewardship”, says Nathwani. A main global perspective could be: “How does someone working locally obtain a global perspective, and furthermore, connect to and adapt the global resources.”
Very interesting for us, the Semmelweis Foundation (focus on CEE-countries), is the contribution of Dr. Marc Mendelson (University of Cape Town, South Africa). He speaks about the greatest barriers to stewardship in low- and middle-income countries (LMICs). “If you talk about Antibiotic stewardship, in many LMICs they say that this is an issue but not a priority.” A big hurdle also are the existing social belief systems in many African countries. Antibiotics are considered as very important when you go to a doctor. “If you don’t have one after the surgery – people feel that their illness is not taken seriously.”