South Africans trained here on antibiotic resistance
After 23 newborns died of a superbug infection at Chris Hani Baragwanath Hospital in South Africa in January 2018, the third-largest hospital in the world turned to Ohio State University’s Wexner Medical Center for help.
One reason: Wexner Medical Center has more infectious-disease doctors than in all of South Africa, according to Debbie Goff, an infectious-disease specialist and clinical pharmacist at the medical center.
Another is that Goff was, at the time, already leading a training program in South Africa in response to increasingly high rates of antibiotic resistance, so the hospital there asked whether Goff could put together a similar program for neonatal intensive-care units.
As part of the program, South African pharmacists Azraa Paruk and Sonya Kolman were in Columbus this month, from Aug. 4 to Thursday, for training at Wexner Medical Center and Nationwide Children’s Hospital. They received one-on-one mentoring and learned more about infectious diseases and the role of clinical pharmacists.
Paruk and Kolman are now tasked with teaching their colleagues in South Africa. Two other South African pharmacists were in Columbus for the program in June.
“With clinician pharmacy being very new in South Debbie Goff, an infectious-disease specialist and clinical pharmacist at Ohio State’s Wexner Medical Center, points out Ohio Stadium to Azraa Paruk, a pharmacist from South Africa. Africa, you still find a lot of barriers,” said Paruk, a pharmacist at Chris Hani Baragwanath Hospital, which is in Johannesburg. “This trip and all the learning, I’m more confident now because now I know how to overcome those barriers, and I know how much support I have.”
Resistance to antibiotics develops when germs are able to beat the drugs made to kill them, meaning that the germs keep growing, according to the federal Centers for Disease Control and Prevention in Atlanta. At least 2 million people get an antibiotic-resistant infection each year in the United
States, and at least 23,000 die, according to the CDC.
Antibiotic resistance “is a global health-care crisis,” Goff said. “It’s right here in Columbus, Ohio, and it’s right here in Ohio State. It’s not something that any hospital can escape. It’s in the community . ... It’s prevalent around the world, but in low-middle-income countries — because there’s fewer physicians, fewer pharmacists, fewer nurses, antibiotics over-the-counter in some countries — the problem of resistance is far greater than it is in the United States.”
To create the training program, Goff partnered South African pharmacist Sonya Kolman took part in the training in Columbus to learn more about resistance to antibiotics. She and fellow pharmacist, Paruk, left, are now tasked with teaching their colleagues in South Africa.
with Pavel Prusakov, a neonatal intensive-care unit pharmacist at Nationwide Children’s Hospital, and Dr. Pablo Sanchez, a neonatologist at Nationwide Children’s Hospital. They received a $100,000 grant to start the Osu-south Africa “Train-the-trainer” NICU Antibiotic Stewardship Pharmacist Mentoring Program.
In 2010, Goff began an Osu-south Africa “Trainthe-trainer” Antibiotic Stewardship Pharmacist Mentoring Program for adults, after receiving a $47,000 grant from OSU’S Outreach and Engagement.
“I anticipate (the NICU program) will be as successful and have as big of an impact as our antibiotic stewardship adult program,” Goff said. The adult model has decreased the use of antibiotics in 47 South African hospitals by 18%, she said.
The training doesn’t stop when the two weeks are up. In September, Goff, Prusakov, Sanchez and Dr. Julie Mangino, an infectiousdisease doctor at the Wexner Medical Center, will travel to South Africa to help make sure the pharmacists trained here are applying their new skills.
“I’ve seen many drugresistant infections around the world to know that they are coming to our country and they are already here,” Goff said. “So what can I do? I know how to train pharmacists, and they needed to be part of this health care team.”