Swansea pharmacist supports hospitals to prescribe safely during Africa visit

A Swansea Bay pharmacist has visited hospitals in Africa to teach them about the importance of using antibiotics sensibly.

Consultant antimicrobial pharmacist Julie Harris visited five hospitals in Malawi to understand how their pharmacists worked.

The aim of the 11-day visit was to promote antibiotic stewardship - promoting and monitoring the use of antibiotics to preserve their future effectiveness - something Julie does in her role in Swansea Bay.

Prescribing antibiotics in a targeted way helps to reduce the risk of future resistance and minimise potential unpleasant side effects.

The trip was an extension of a project that started last year which saw Julie’s colleague Charlotte Richards visit three hospitals in Malawi.

Pictured: Julie Harris and colleagues visiting one of five hospitals.

Last year, the All-Wales Antimicrobial Pharmacists Group, which Julie and Charlotte are part of, formed a partnership with the Pharmaceutical Society of Malawi.

Both trips to the country were made possible after the all-Wales group, which includes antimicrobial pharmacists from other health boards, received grants from the Commonwealth Partnership for Antimicrobial Stewardship (CwPAMS).

Julie said: “This year we visited a further five hospitals in Malawi to promote antibiotic stewardship and being careful around prescribing antibiotics in hospital.

“We have been focusing on antibiotic prescribing in the UK for a long time but Malawi is really only just getting started on its journey.

“As part of the grant, we did an in-country visit so we could understand the challenges they face and make sure the hospital management will be supportive of the pharmacists as they start this work.

“We met the lead doctors, nurses and pharmacists in each hospital and they took us on a tour of some of the wards so we could understand how their systems worked.

“We also went to the hospitals’ pharmacies to understand how they work and what type of antibiotics they have access to and some of the challenges they face too.”

Zomba Central, Queen Elizabeth Central, Mchinji District, Dedza District and Ntcheu District were the hospitals visited during the visit.

The project will see each of them carry out an audit to understand which antibiotics have been prescribed and why.

Staff will then be trained to increase awareness around antimicrobial stewardship, so they understand the need to be careful when prescribing antibiotics to ensure they continue to work for as long as possible.

They will then repeat their audits to see if their training has helped to reduce or change antibiotic prescribing within their hospitals.

“During this trip, we started to concentrate on some of the smaller hospitals as they visited some of the big tertiary hospitals last time,” Julie added.

“We brought two new tertiary hospitals on board but also three smaller hospitals, to allow the bigger hospitals to support the smaller ones.

“What we saw during our visit was that the hospitals have a very inconsistent supply of antibiotics. They have limited access to the range they can use and quite regularly have significant periods where they can’t get hold of antibiotics.

“They also don’t have access to consistent lab services there either.

“Once they have completed their audits, we will work with the team in Malawi to adapt the training packages, given what we understand from our visit.”

Julie was accompanied by antimicrobial pharmacists from Betsi Cadwaladr University Health Board, Aneurin Bevan University Health Board and Hywel Dda University Health, who make up the all-Wales group.

They will soon hand over the training responsibilities to the pharmacy staff in Malawi to implement.

Pictured: Julie (left) with antimicrobial pharmacists Charlotte Makanga from BCUHB, Ceri Phillips from ABUHB and Zoe Kennerley from HDUHB.

There are already plans in the pipeline for the Malawi team to visit Wales next year, so they can better understand how pharmacy staff work in their hospital environments.

Julie said: “Part of the grant will see them come to our hospitals to show them how we do things in the Wales.

“They can then understand how our processes work and take back anything they can which they can implement in the hospitals in Malawi.

“Antibiotic resistance and the fact our antibiotics are becoming less effective over time really is a global problem.

“The support we can offer from countries like the UK, and the experience we’ve got to date, will help countries like Malawi to start working on it quicker and more effectively.

“They have high resistance rates in Malawi, which makes treatment of their patients very difficult, especially paired with their supply issues.

“With global travel, that will also impact us in the UK, as it does with other countries with high resistance rates as well.

“Supporting them and helping them tackle it as quickly as possible is important to benefit patient care in Malawi but also to help secure patient care for the future in the UK too.”