Combating antibiotic resistance using guidelines and enhanced stewardship in Kenya: a protocol for an implementation science approach
Introduction Antimicrobial resistance (AMR) is a growing problem globally especially in Sub-Saharan Africa including Kenya. Without any intervention, lower/middle-income countries (LMICs) will be most affected due to already higher AMR levels compared with higher income countries and due to the far...
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BMJ Publishing Group
2020-03-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/3/e030823.full |
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| author | Jesse Gitaka Moses Kamita Dominic Mureithi Davies Ndegwa Moses Masika Geoffrey Omuse Moses Ngari Francis Makokha Peter Mwaura Ronald Mathai Francis Muregi Matilu Mwau |
| author_facet | Jesse Gitaka Moses Kamita Dominic Mureithi Davies Ndegwa Moses Masika Geoffrey Omuse Moses Ngari Francis Makokha Peter Mwaura Ronald Mathai Francis Muregi Matilu Mwau |
| author_sort | Jesse Gitaka |
| collection | DOAJ |
| description | Introduction Antimicrobial resistance (AMR) is a growing problem globally especially in Sub-Saharan Africa including Kenya. Without any intervention, lower/middle-income countries (LMICs) will be most affected due to already higher AMR levels compared with higher income countries and due to the far higher burden of diseases in the LMICs. Studies have consistently shown that inappropriate use of antimicrobials is the major driver of AMR. To address this challenge, hospitals are now implementing antibiotic stewardship programmes (ASPs), which have been shown to achieve reduced antibiotic usage, to decrease the prevalence of resistance and lead to significant economic benefits. However, the implementation of the guideline is highly dependent on the settings in which they are rolled out. This study, employing an implementation science approach, aims to address the knowledge gap in this area and provide critical data as well as practical experiences when using antibiotic guidelines and stewardship programmes in the public health sector. This will provide evidence of ASP performance and potentially contribute to the county, national and regional policies on antibiotics use.Methods and analysis The study will be conducted in three geographically diverse regions, each represented by two hospitals. A baseline study on antibiotic usage, resistance and de-escalation, duration of hospital stay, rates of readmission and costs will be carried out in the preimplementation phase. The intervention, that is, the use of antibiotic guidelines and ASPs will be instituted for 18 months using a stepwise implementation strategy that will facilitate learning and continuous improvement of stewardship activities and updating of guidelines to reflect the evolving antibiotic needs.Ethics and dissemination Approvals to carry out the study have been obtained from the National Commission for Science, Technology and Innovation and the Mount Kenya University Ethics Review Committee. The approvals from the two institutions were used to obtain permission to conduct the study at each of the participating hospitals. Study findings will be presented to policy stakeholders and published in peer-reviewed scientific journals. It is anticipated that the findings will inform the appropriate antibiotic use guidelines within our local context. |
| format | Article |
| id | doaj-art-cdbaf82ef5fb4629a034e3886ab9d2dc |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-cdbaf82ef5fb4629a034e3886ab9d2dc2025-08-20T02:31:05ZengBMJ Publishing GroupBMJ Open2044-60552020-03-0110310.1136/bmjopen-2019-030823Combating antibiotic resistance using guidelines and enhanced stewardship in Kenya: a protocol for an implementation science approachJesse Gitaka0Moses Kamita1Dominic Mureithi2Davies Ndegwa3Moses Masika4Geoffrey Omuse5Moses Ngari6Francis Makokha7Peter Mwaura8Ronald Mathai9Francis Muregi10Matilu Mwau11Research and Innovation, Mount Kenya University, Thika, KenyaResearch and Innovation, Mount Kenya University, Thika, KenyaDepartment of Animal Health and Production, Maasai Mara University, Narok, KenyaDepartment of Medical Laboratory Sciences, Kenya Medical Training College, Nairobi, KenyaDepartment of Medical Microbiology, University of Nairobi College of Health Sciences, Nairobi, KenyaDepartment of Pathology, Aga Khan University, Nairobi, KenyaKEMRI-Wellcome Trust Research Programme, Kilifi, KenyaResearch and Innovation, Mount Kenya University, Thika, KenyaDirectorate of Research and Innovation, Mount Kenya University, Thika, KenyaResearch and Innovation, Mount Kenya University, Thika, KenyaResearch and Innovation, Mount Kenya University, Thika, KenyaCentre for Infectious and Parasitic Diseases Control Research, Kenya Medical Research Institute, Nairobi, KenyaIntroduction Antimicrobial resistance (AMR) is a growing problem globally especially in Sub-Saharan Africa including Kenya. Without any intervention, lower/middle-income countries (LMICs) will be most affected due to already higher AMR levels compared with higher income countries and due to the far higher burden of diseases in the LMICs. Studies have consistently shown that inappropriate use of antimicrobials is the major driver of AMR. To address this challenge, hospitals are now implementing antibiotic stewardship programmes (ASPs), which have been shown to achieve reduced antibiotic usage, to decrease the prevalence of resistance and lead to significant economic benefits. However, the implementation of the guideline is highly dependent on the settings in which they are rolled out. This study, employing an implementation science approach, aims to address the knowledge gap in this area and provide critical data as well as practical experiences when using antibiotic guidelines and stewardship programmes in the public health sector. This will provide evidence of ASP performance and potentially contribute to the county, national and regional policies on antibiotics use.Methods and analysis The study will be conducted in three geographically diverse regions, each represented by two hospitals. A baseline study on antibiotic usage, resistance and de-escalation, duration of hospital stay, rates of readmission and costs will be carried out in the preimplementation phase. The intervention, that is, the use of antibiotic guidelines and ASPs will be instituted for 18 months using a stepwise implementation strategy that will facilitate learning and continuous improvement of stewardship activities and updating of guidelines to reflect the evolving antibiotic needs.Ethics and dissemination Approvals to carry out the study have been obtained from the National Commission for Science, Technology and Innovation and the Mount Kenya University Ethics Review Committee. The approvals from the two institutions were used to obtain permission to conduct the study at each of the participating hospitals. Study findings will be presented to policy stakeholders and published in peer-reviewed scientific journals. It is anticipated that the findings will inform the appropriate antibiotic use guidelines within our local context.https://bmjopen.bmj.com/content/10/3/e030823.full |
| spellingShingle | Jesse Gitaka Moses Kamita Dominic Mureithi Davies Ndegwa Moses Masika Geoffrey Omuse Moses Ngari Francis Makokha Peter Mwaura Ronald Mathai Francis Muregi Matilu Mwau Combating antibiotic resistance using guidelines and enhanced stewardship in Kenya: a protocol for an implementation science approach BMJ Open |
| title | Combating antibiotic resistance using guidelines and enhanced stewardship in Kenya: a protocol for an implementation science approach |
| title_full | Combating antibiotic resistance using guidelines and enhanced stewardship in Kenya: a protocol for an implementation science approach |
| title_fullStr | Combating antibiotic resistance using guidelines and enhanced stewardship in Kenya: a protocol for an implementation science approach |
| title_full_unstemmed | Combating antibiotic resistance using guidelines and enhanced stewardship in Kenya: a protocol for an implementation science approach |
| title_short | Combating antibiotic resistance using guidelines and enhanced stewardship in Kenya: a protocol for an implementation science approach |
| title_sort | combating antibiotic resistance using guidelines and enhanced stewardship in kenya a protocol for an implementation science approach |
| url | https://bmjopen.bmj.com/content/10/3/e030823.full |
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