The association of previous antibiotic intake especially carbapenems among cases infected with CPE necessitates that hospitals should ensure that they have active antimicrobial stewardship programs, this should include restriction of carbapenem use.
Ideally, antibiotic stewardship in ICUs should include the rapid identification of bacterial etiology, optimization of treatment based on PK/PD characteristics of the antibiotic(s), avoidance of unnecessarily broad-spectrum antibiotics, shortening of treatment duration, and reduction in the number of patients receiving antibiotic therapy for non-infectious syndromes [ 43, 44].
Fourth, over 62.5% of the respondents stated that the NHFP components should include stewardship (oversight), revenue collection, revenue pooling and risk management, resource allocation and purchasing of health services, health economics research, and development of human resources for health.
According to majority of the respondents, the NHFP should include stewardship, revenue collection, revenue pooling and risk management, resource allocation and purchasing of health services, health economics research, and the development of human resources for health financing.
Prevention of acquisition in a given patient should include both antibiotic stewardship and cross-transmission prevention.
They also point to the need for a multidisciplinary effort to combat resistance, which should include improved antimicrobial stewardship, increased resources for infection control, and development of new antimicrobial agents with activity against multiresistant Gram-negative pathogens.
The government's role is key and should include provision of adequate funding, stewardship and looking for opportunities to utilize existing platforms to scale up such strategies.
These should include "narratives across: public policy, environmental stewardship, workforce development, community engagement, and, quantitative metrics across: job creation, quality of jobs & benefits offered (including wealth creating programs such as Employee Stock Ownership Plans), environmental metrics, supply chain accountability, among others.
