Passing the baton to pharmacists and nurses: New models of antibiotic stewardship for South Africa?

The optimisation of antibiotic use to maximise patient care and safety through antibiotic stewardship forms one of the cornerstones of the global response to antibiotic resistance. Stewardship efforts in low- and middle-income countries are challenged by lack of healthcare professionals trained in infection. Therefore, in resource-poor settings, the traditional model of infection specialist-led stewardship may be impractical, requiring new models to be developed. A recent South African study across 47 Netcare hospitals nationally highlighted the role of pharmacists in this regard, proving that non-specialised pharmacists can drive a prospective audit, feedback collaborative strategy and a range of improvement science principles to reduce antibiotic consumption by the same levels as that documented in high-resource, infection specialist-led stewardship programmes. This editorial discusses the hidden opportunities to engage non-infection specialists in programmes to combat antibiotic resistance, expanding the cadres of healthcare professionals to lead stewardship programmes.