Antimicrobial stewardship in rural districts of South Africa: growing a positive culture

Abstract

Background: The success of medical specialist-led antimicrobial stewardship activities in urban tertiary health care settings has been well documented. The issue of antimicrobial resistance remains an ongoing concern. This has particular relevance in primary health care communities treated from sub-district health services, which are organised around level-one district hospitals. District hospitals are typically staffed by generalist clinicians or medical officers with minimal access to the medical specialist physicians and pathologists who are available in the urban academic centres. Coordinated team-based activities aimed at implementing the South African Antibiotic Stewardship Programme (SAASP) principles of antimicrobial use are necessary.