Curriculum update for future pharmacy technicians to enhance rational use of antibiotics in Turkey

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
O Karadag Caman ◽  
S Uner ◽  
B Arica Yegin ◽  
H Ozcebe

Abstract Background Antimicrobial resistance (AMR) is one of the most important global public health issues and training of healthcare professionals and the public needs to be an integral part of all AMR efforts. In 2015, four out of six countries with the highest antibiotic consumption rate in the world were low and middle-income countries, where Turkey was reported as the country with the highest consumption. Methods This paper aims to present a new undergraduate course entitled “Rational use of antibiotics”, specifically designed for pharmacy technician students to increase their awareness on AMR and to equip them with knowledge and skills in promoting rational antibiotic use. The curriculum update was part of a larger international project, supported by the Erasmus+ KA2 Strategic Partnership Program (Project no: 2015-1-TR01-KA204-022393). Results Pharmacy technicians are among the most critical health professionals regarding rational antibiotic use because they can play a significant role in educating potential antibiotic users and have a multiplier effect in disseminating evidence-based knowledge. The 16-week long undergraduate course was designed by pharmacy and public health faculty with a multidisciplinary approach, focusing on topics such as epidemiology and control of communicable diseases, antibiotics, AMR and its public health consequences, legal regulations and medical practice regarding rational antibiotic use, as well as principles and methods of health promotion and health education. Conclusions Quantitative and qualitative evaluation of the newly introduced undergraduate course on the rational use of antibiotics showed promising results, which indicate that designing specific courses for health professions students to combat AMR can be more widely practiced in countries with high antibiotic consumption. Public health academics can take a leading role and responsibility in the design of such multidisciplinary courses for undergraduate programs in health care. Key messages Specific courses on rational use of antibiotics can be effective in changing knowledge, attitude, and behaviors of healthcare professionals, and consecutively the general public in combatting AMR. Public health academics can take a leading role and responsibility in design of such multidisciplinary courses for undergraduate programs in health care.

2019 ◽  
Vol 3 (1) ◽  
pp. 73-82
Author(s):  
Sherly Tandi Arrang ◽  
Fonny Cokro ◽  
Erlia Anggrainy Sianipar

Self-medication is defined as self treatment and self-diagnose for conditions such as cough, flu, fever, pain, stomach ulcers, worms, diarrhea, rash, and some other minor illnesses. Based on the data from Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI (2013), there were 103.860 of 294.959 households (35,2%) in Indonesia which store medicines for selfmedication (including 35,7% “Obat Keras” or “Gevaarlijk” and 27,8% antibiotics). DKI Jakarta (56,4%) is the highest province with respect to stored medicines. Some studies have found that 40-62% of antibiotics are not used properly. The inappropriate use of antibiotics can lead to antibiotic resistance risk and can be life-threatening for people in every part of the world. To address this problem, this community service was conducted to provide information about selfmedication of influenza and cough illness and to improve people’s knowledge in the proper use of antibiotics. Lecturing was chosen as the method for explaining the rational use of antibiotics and participants were requested to fill out a questionnaire. This activity was attended by 34 participants (and 32 participants filled out the questionnaire). About 13 participants (40,6%) provided correct answers to questions on the proper use of antibiotics. Twenty six participants (81,25%) said they had previously used antibiotics, 14 of them (53,85%) admitted to purchasing antibiotics without a prescription. Antibiotics are taken to treat symptoms such as runny nose, cough, sore throat, fever, and other conditions. A total of 7 participants (26,92%) admitted taking antibiotics with dosage modification and 8 participants (30,77%) switched one type of antibiotics with another type of antibiotics. Based on the results, we concluded that people did not have sufficient knowledge about the rational use of antibiotics. We suggested that counseling about the proper use of antibiotics should be improved.


Author(s):  
Inga Petruschke ◽  
◽  
Florian Salm ◽  
Michelle Kaufmann ◽  
Antje Freytag ◽  
...  

Abstract Background Increasing antimicrobial resistance is a serious societal challenge affecting outpatient, inpatient and veterinary care. The German One-Health project, RAI (Rational use of Antibiotics via Information and Communication) addresses all three sectors. In the outpatient sector, General Practitioners (GPs) are the main prescribers of antibiotics and were therefore, targeted for this study. A multimodal intervention focusing on Acute Respiratory Tract infections (ARI) was designed and implemented. The aim of this study was to evaluate acceptance, rating and the self-reported impact of the intervention among GPs. Methods The intervention offered six tools: a GP training on rational antibiotic use, an app for self-monitoring, a leaflet and a set of posters (both for use as information materials in waiting rooms) and both digital and printed information prescriptions (material for ‘prescribing’ information instead of an antibiotic to the patient). The tools could be used according to individual preferences. The intervention was conducted between August 2016 and July 2017. Following the intervention, a three pages anonymous questionnaire was sent to all 271 participants. Items covered socio-demographic and professional background, use and judgement of the intervention tools (6 point Likert scale), impact of the intervention tools (4 point Likert scale). Results The response rate was 39% (n = 107). On average, respondents used 3.1 of the six available tools, with printed information prescriptions used most frequently (79%). Digital information prescriptions were used more frequently by men than by women (OR 2.8; 95% CI 1.16–7.24; p = 0.02). Eighty-seven percent of respondents stated that information prescriptions supported doctor-patient communication. In a comparison of the overall impression of the different intervention tools the GP training on rational antibiotic use was rated best (1.67 on a 6 point scale with 1 = highest, 6 = lowest) and most often noted as having had a “strong” or “very strong” impact on personal antibiotic prescribing behavior. Conclusions The multimodal intervention addressing education and communication was well accepted among GPs and could help in fostering rational use of antibiotics in primary care.


Author(s):  
Jasper Littmann ◽  
Annette Rid ◽  
Alena Buyx

Abstract To reduce the effect of antimicrobial resistance and preserve antibiotic effectiveness, clinical practice guidelines and health policy documents call for the “rational use” of antibiotics that aims to avoid unnecessary or minimally effective antibiotic prescriptions. In this paper, we show that rational use programmes can lead to ethical conflicts because they place some patients at risk of harm – for example, a delayed switch to second-line antibiotics for community-acquired pneumonia is associated with increased fatality rates. Implementing the rational use of antibiotics can therefore lead to conflicts between promoting patients’ clinical interests and preserving antibiotic effectiveness for future use. The resulting ethical dilemma for clinicians, patients and policy makers has so far not been adequately addressed. We argue that existing guidance for acceptable risks in clinical research can help to define risk thresholds for the rational use of antibiotics. We develop an ethical framework that allows clinicians and policy-makers to evaluate policies for rational antibiotic use in six practical steps.


Author(s):  
Bhavika D. ◽  
A. Naga Teja Pavani ◽  
G. Meghavani ◽  
Aditya Jillella ◽  
Sameer Uz Zaman

Background: Antibiotic resistance has emerged as a serious global problem. Irrational prescribing of antibiotics is one of the key factors responsible for the development of antibiotic resistance. As today’s medical students will be the future prescribers their awareness regarding antibiotic resistance and rational prescribing of antibiotics is very much important. The main objective of the study was to evaluate the knowledge, attitude and practices of the medical students towards antibiotic use.Methods: A cross-sectional questionnaire-based study was conducted involving the medical students from all the semesters. A predesigned questionnaire was used to evaluate the knowledge, attitude and practices of the respondents. The response options were ‘yes’ or ‘no’ for some questions, and a 5 point Likert scale used to assess some questions. The data was analyzed using MS office Excel.Results: A total of 457 fully completed questionnaires from the respondents were evaluated. Majority of the respondents (70%) were females, and 91% of the respondents were aware of antibiotic resistance as a global problem. On analysis of score of questions assessing knowledge, 91% of respondents had attained a score in the range of 5-7. Majority (83%) of the respondents used antibiotics only on doctor’s prescription and 74% of the respondents had completed the prescribed course.Conclusions: The present study gives an insight on the knowledge, attitude and practices of medical students on antibiotic use, and can be used as a tool to plan educational strategies to improve the knowledge of the students regarding rational use of antibiotics.


Author(s):  
Faiz Ullah Khan ◽  
Farman Ullah Khan ◽  
Khezar Hayat ◽  
Tawseef Ahmad ◽  
Amjad Khan ◽  
...  

Antibiotic resistance (ABR) is an emerging global threat to public health. Substantial evidence has indicated that community pharmacists (CPs) can play a critical role in managing the ever-increasing threat of antibiotic resistance. The study aimed to determine the knowledge, attitude, and practices of CPs (n=180) towards antibiotics and antibiotic resistance as well as to improve the rational use of antibiotics. Two phases of mixed methods (quantitative and qualitative) online study were conducted in Pakistan from August 2019 to March 2020 by using validated questionnaires and semi-structured interview data. Different statistical methods were used to tabulate the quantitative data whereas inductive thematic analysis was conducted to categorize themes from the qualitative data and draw conclusions. Approximately 64.4% were male (mean: 29-33 years old). Overall, CPs had good knowledge of and were familiar with superbugs and their roles in ABR (65.6%, Median=1, IQR=1) although they were poor in differentiating some antibiotic groups with their respective ABR patterns (31.1%, Median=1, IQR=1). Most CPs have a positive attitude towards antibiotics with most (90.0%) having identified ABR as a critical issue in public health (Median=1, IQR=0). Overall, CPs' practices towards antibiotics were reasonable where they tend to educate patients about the rational use of antibiotics (52.8%, Median=1, IQR=1). Two main themes (antibiotics and counseling of patients) were related to self-medication with while educational interventions are the sub-theme. ABR is multifactorial where the subthemes related to budget, time constraints incompetent staff, the absence of CPs, the lack of training, enforcement of laws and regulations are the need of the hour in Pakistan. Effective antibiotic stewardship programs, patient education, and awareness campaigns about antibiotics and ABR along with training of the CPs are important factors that have to be addressed in a timely manner.


2013 ◽  
Vol 154 (24) ◽  
pp. 947-956 ◽  
Author(s):  
Mária Matuz ◽  
Ria Benkő ◽  
Edit Hajdú ◽  
Réka Viola ◽  
Gyöngyvér Soós

Introduction: Rational use of antibiotics is an important tool in combating antibiotic resistance. Aim: The aim of the authors was to evaluate the quality of ambulatory antibiotic use in Hungary. Method: Crude antibiotic sales data for the period between 1996 and 2010 were converted into DDD (Defined Daily Dose) per 1000 inhabitants and per year. The recently developed and validated drug-specific quality indicators were used to evaluate antibiotic use. Results: Beside constant quantity (18.0±1.8 DDD/1000 inhabitants/day), the authors detected major changes in the composition of antibiotic use. Ratios of the consumption of broad to narrow spectrum beta-lactams and macrolides increased eight-fold (1996: 2.2 vs. 2010: 15.8) and consumption of fluoroquinolones tripled. Out of the ten surveyed drug-specific quality indicators, Hungary belonged to the European elite in case of three, while considering the remaining seven, Hungary ranked among the weak or weakest European countries. Conclusion: In quantity Hungary an ambulatory antibiotic use resembles to Scandinavian countries while it mimics antibiotic consumption patterns of southern countries. Orv. Hetil., 2013, 154, 947–956.


Author(s):  
Okechukwu Chioma

Introduction: The burden of antibiotic resistance in the hospitals and communities is progressively worsening hence the critical need to put into practice all the key components of rational use of antibiotics in our daily patient interactions. This paper aims to highlight the problem of antibiotic resistance, the importance of rational use of antibiotics and to show an on the spot sketch of the antibiotic use pattern among in-patients in the children wards in a tertiary hospital. Methodology: A brief review of the existing literature on antibiotic resistance and the rational use of antibiotics was done. A one-day cross-sectional point prevalence study was conducted in the children wards in UPTH and all children receiving antibiotics on that day, identified. The prevalence of antibiotic use was determined by dividing the number of inpatients on antibiotics at the time of the survey by the total number of patients on admission. Data were presented in percentages using pie and bar charts. Results: There were a total of 40 children on admission in the paediatric wards with a Male: Female ratio of 1.2:1. 34 (85.0%) of the children on admission were receiving at least one antibiotic. The most common route of administration of the antibiotics was the intravenous route (94.1%). The five most commonly prescribed antibiotics in the children medical wards and the emergency ward were Ceftriaxone, Gentamycin, Cefuroxime, Metronidazole and Crystalline penicillin, while the five most common antibiotics prescribed in the special care baby unit were Gentamycin, Ceftazidime, Ceftriaxone, Metronidazole and Ofloxacin. Only 10 (29.4%) out of children receiving antibiotics had a microbiology culture result available, and 4 were receiving antibiotics in line with the culture sensitivity pattern. Two (5.9%) children had a multidrug-resistant infection. Conclusion: This study showed a high prevalence of antibiotic use among inpatients and low utilization of microbiology culture results in the choice of antibiotics in a tertiary hospital in South-south Nigeria. Antibiotic prescribing patterns among healthcare workers should be improved upon by training and retraining of personnel as well as strict adherence to antibiotic prescription guidelines.


Author(s):  
Dnyanesh Limaye ◽  
Patrick Ziesenis ◽  
Vaidehi Limaye ◽  
Mansoor Ahmad ◽  
Farah Saeed ◽  
...  

Background: Antimicrobial resistance has become a serious global problem. A potential post-antibiotic era is threatening present and future medical advances. In Pakistan, the usage of antibiotic is unnecessarily high and due to over exposure to these drugs, bacteria are developing resistance against these drugs. It is necessary to improve public awareness about the rational use of antibiotics in order to bring a change in consumer’s behaviour. Therefore, present study was undertaken to assess the existing knowledge, attitude and practices related to antibiotic usage among university students.Methods: A cross-sectional study was carried out among university students from Karachi, Pakistan during May-June 2018. 200 students were approached to participate in the study of which 159 agreed to participate (males: 70, females: 89). Pretested questionnaire was distributed to the study subjects and the collected data was analyzed using IBM SPSS version 23.Results: Substantial number of (33% and 50%) participants were unaware about the differences in antibiotic: anti-inflammatory drugs and antibiotic: antipyretics respectively. 29% of the participants thought it is right to stop antibiotics only based on symptomatic improvement. Thirty nine percent and eighty three percent participants believed that antibiotics should always be prescribed to treat flu like symptoms and pneumonia respectively.Conclusions: Participants demonstrated average knowledge about antibiotics. Similarly, their attitude and practice toward antibiotic use was associated with misconceptions. An educational intervention is necessary to make them aware about rational use of antibiotics.


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