The roles of pharmacists and the challenges they face in implementing antimicrobial stewardship in Nigeria: a narrative review

Abstract Background While antimicrobial resistance (AMR) is not a newly emerging phenomenon, it remains a credible threat to public health, especially in low- and middle-income countries (LMICs) like Nigeria. The main driver of AMR is the inappropriate use of antimicrobial agents, particularly antibiotics. Studies have shown that nearly half of all antibiotic use in Nigeria is inappropriate. AMR reduces the effectiveness of these lifesaving drugs and contributes to the death of hundreds of thousands of people every year. Main body This study explores AMR, antimicrobial stewardship (AMS), the roles pharmacists undertake, and the challenges they encounter in effectively implementing AMS in Nigeria while also outlining future directions to strengthen pharmacist-led stewardship efforts. Pharmacists, as stewards of antibiotic use and distribution, play a significant role in the fight against AMR. Their roles include patient education, collaboration with healthcare providers, supporting surveillance efforts, promoting infection prevention and control, implementing AMS programs while ensuring compliance with national and international guidelines. The alarming rise of drug-resistant infections in everyday clinical practice calls for the need for strategic interventions such as AMS. AMS involves efforts designed to promote the responsible utilisation of antimicrobial agents ensuring these drugs remain effective. Effectively addressing AMR requires a coordinated approach involving pharmacists, other healthcare providers, regulatory bodies, and relevant stakeholders to ensure the responsible use of antimicrobial agents and to safeguard the health of the public. Short conclusion As the escalating crisis of AMR poses a significant challenge to public health, mitigating its spread in Nigeria requires strengthening pharmacists’ education and involvement, enhancing public awareness campaigns, enforcing stronger regulatory frameworks and integrating technology for better surveillance.