Fighting AMR in a resource-limited setting: an integrated approach to infection prevention and antimicrobial stewardship is the “best-buy”

Healthcare-associated infections (HAI) and antimicrobial resistance (AMR) are significant global health issues, causing prolonged hospital stays, increased healthcare costs, and long-term disability. In 2019, 63.5% of global bacterial AMR deaths were due to HAI, with 136 million infections annually. Sub-Saharan African countries bear the highest burden of AMR, with Sierra Leone reporting 2,200 and 9,700 deaths. Combining antimicrobial stewardship (AMS) with effective infection prevention and control (IPC) is crucial for controlling AMR and preventing multidrug-resistant pathogens. Improving IPC programs in low- and middle-income countries could prevent at least 337,000 AMR-associated deaths annually, surpassing WASH and vaccination interventions. Combining IPC and AMS programs can address gaps in human resources and service integration. A study in Sierra Leone reviewed the joint reports of hospital pharmacists and IPC focal points in six secondary and tertiary hospitals in October 2024.