The most urgent antimicrobial resistance problems identified by chapter members are:

  • Lack of regulation in agricultural use
  • Lack of surveillance of antibiotic use and resistance
  • Lack of continuing medical education on antibiotic use for prescribers

Antimicrobial resistance poses major challenges to treating infectious diseases. The infectious diseases of primary concern in South Africa are HIV/AIDS and tuberculosis.

Resistance to beta-lactam antibiotics, aminoglycosides, fluoroquinolones and macrolides is prioritized, as is resistance in Acinetobacter spp., Citrobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp., Proteus spp., Pseudomonas aeruginosa and Staphylococcus aureus.


APUA South Africa was founded in 2006. The chapter works under the auspices of the South African Society for Clinical Microbiology (ex-National Antibiotic Surveillance Forum), which undertakes surveillance and publishes reports on it in the public and private sectors to inform treatment guidelines.

Chapter Objectives and Priorities:

The chapter’s overarching objective is the optimization of antibiotic therapy in the face of escalating resistance within a health system that faces an ever-increasing incidence of infections and infectious diseases such as HIV/AIDS. The South African Chapter of APUA focuses on communicating the nature and extent of antimicrobial resistance in the country to all stakeholders, but particularly the general public, by highlighting evidence-based strategies for the prevention and containment of antibiotic resistance.

Mtubatuba, South Africa March 2005

Mtubatuba, South Africa March 2005


Chapter activities focus on investigating antibiotic use, assessing risk factors, evaluating infection control policies and procedures and ascertaining pharmaco-economics in the context of antibiotic resistance within the public and private healthcare sectors by:

  • Instituting disease-based, phenotypic and genotypic antibiotic resistance surveillance programmes
  • Formulating/amending treatment guidelines/algorithms for infections
  • Establishing the role of antibiotic use in the emergence of resistance
  • Determining the clinical significance of resistance in terms of less than optimal clinical response, morbidity and mortality
  • Evaluating risk factors associated with the acquisition of or colonization with antibiotic resistant pathogens using appropriate epidemiology
  • Establishing the role of infection control policies and procedures in the dissemination/containment of antibiotic resistant pathogens
  • Investigating the pharmaco-economic implications of resistance
  • Developing strategies for the prevention and containment of resistance based on the investigations above



Professor Sabiha Essack (B. Pharm., M. Pharm., PhD), President of APUA South Africa, is also Dean of the Faculty of Health Sciences at the University of KwaZulu-Natal and a Wellcome Trust Research Fellow. She has established the Antimicrobial Resistance Research Proto-Unit in the School of Pharmacy and Pharmacology and has secured several research grants for Essential National Health Research from the World Health Organization, the Wellcome Trust, the Medical Research Council and the National Research Foundation to investigate strategies for the prevention and containment of antibiotic resistance. She is also the co-founder and chair of the South African Committee of Health Sciences Deans.


Antibiotic Use and Resistance in Public Sector Hospitals in KwaZulu-Natal

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