Scientific letters

Establishing a pharmacist–prescriber partnership in publicly funded primary healthcare clinics to optimise antibiotic prescribing in the Western Cape: An exploratory study

Oliver van Hecke, Renier Coetzee
South African Family Practice | Vol 62, No 1 : Part 2| a5090 | DOI: | © 2020 Oliver van Hecke, Renier Coetzee | This work is licensed under CC Attribution 4.0
Submitted: 21 January 2020 | Published: 22 June 2020

About the author(s)

Oliver van Hecke, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
Renier Coetzee, School of Pharmacy, Faculty of Natural Science, University of the Western Cape, Cape Town, South Africa


Background: Promoting evidence-based antibiotic prescribing through successful antimicrobial stewardship (AMS) programmes is critical to preserving the effectiveness of antibiotics for common infections in primary care. This requires a coordinated multidisciplinary effort. Such pharmacist–prescriber partnerships have been effective in high-income countries (HICs). Yet, evidence generated in such countries is not always applicable because of different social determinants of health.

Methods: A multidisciplinary workshop was conducted with pharmacists and clinicians (doctors, nurses) on community-based antibiotic stewardship, the purpose of which was to explore how and where such partnerships might work in publicly funded primary care clinics in the greater Cape Metro region.

Results: Participants perceived that promoting effective AMS was a priority for South African primary healthcare. However, it was clear that there are many hurdles to overcome working in settings that are relatively resource-poor. Prescribing guidelines needed to be harmonised. Participants felt that staff training on the principles of AMS should be mandatory. Research was urgently needed to better understand their community’s understanding of antibiotic use and AMS, and to champion outreach projects in the community.

Conclusion: Important stakeholder perspectives in the community were highlighted to promote a multidisciplinary approach to AMS initiatives in primary care. These will need to be addressed to optimise antibiotic prescribing in the community.


Antimicrobial stewardship; AMS; primary care; pharmacy; antibiotics


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