Combating antibiotic resistance using guidelines and enhanced stewardship in Kenya: a protocol for an implementation...

Area of Science:

• Implementation science
• Public health
• Infectious disease epidemiology

Background:

• Antimicrobial resistance (AMR) poses a significant global threat, disproportionately affecting lower/middle-income countries (LMICs) like Kenya.
• Inappropriate antimicrobial use is the primary driver of AMR, necessitating interventions like antibiotic stewardship programmes (ASPs).
• Successful ASP implementation is context-dependent, highlighting the need for setting-specific research.

Purpose of the Study:

• To address the knowledge gap in implementing antibiotic guidelines and ASPs within the public health sector in Kenya.
• To provide critical data and practical experiences on ASP performance in a real-world setting.
• To generate evidence that can inform county, national, and regional antibiotic use policies.

Main Methods:

• A prospective study conducted in six geographically diverse hospitals across three regions in Kenya.
• Baseline data collection on antibiotic usage, resistance patterns, de-escalation, hospital stay, readmissions, and costs.
• An 18-month intervention phase involving stepwise implementation of antibiotic guidelines and ASPs with continuous improvement.

Main Results:

• Data on antibiotic usage and resistance patterns pre- and post-intervention will be analyzed.
• Evaluation of the impact of ASPs on clinical outcomes and economic benefits.
• Insights into the challenges and facilitators of ASP implementation in public hospitals.

Conclusions:

• Findings are anticipated to demonstrate the effectiveness of ASPs in reducing antimicrobial use and resistance in the Kenyan public health sector.
• The study will provide evidence-based recommendations for optimizing antibiotic guidelines and stewardship practices.
• Results are expected to contribute to improved antibiotic use policies and combatting AMR in Kenya and similar LMICs.