Perception, Attitude and Knowledge of Antimicrobial Resistance, Appropriate Antimicrobial Use, and Infection Control Among the Sixth Year Medical Students in Three Medical Schools

A questionnaire-based study was conducted among final-year Thai medical students. The problem of antimicrobial resistance is well recognized, but their knowledge of antimicrobial resistance, appropriate antimicrobial use, and infection control was substantially limited. Only half of these students recognized existence of an antimicrobial stewardship program or infection control unit in their hospitals.Infect Control Hosp Epidemiol 2016;37:603–605

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Perception, Attitude, and Knowledge of Antimicrobial Resistance, Appropriate Antimicrobial Use, and Infection Control Among the First-year Residents and Fellows Across Medical Specialties

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.1149 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S451-S451

Author(s):

Pinyo Rattanaumpawan ◽

Nuttagarn Chuenchom ◽

Visanu Thamlikitkul

Keyword(s):

Antimicrobial Resistance ◽

Infection Control ◽

First Year ◽

Antimicrobial Use ◽

Medical Specialties ◽

Appropriate Antimicrobial Use

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Knowledge, attitude and perception on antimicrobial use and antimicrobial resistance among final year medical students in the College of Medicine, Malawi

Malawi Medical Journal ◽

10.4314/mmj.v32i3.3 ◽

2020 ◽

Vol 32 (3) ◽

pp. 120-123

Author(s):

Alfred Kamoto

Keyword(s):

Medical Students ◽

Antimicrobial Resistance ◽

Medical Curriculum ◽

Descriptive Analysis ◽

Cross Sectional Study ◽

Antimicrobial Use ◽

Cross Sectional ◽

Population Sampling ◽

Adequate Knowledge ◽

Attitudes And Perceptions

BackgroundMedical curricula need to provide adequate knowledge on antimicrobial medicine use and antimicrobial resistance (AMR). Such knowledge is critical in shaping correct attitudes and perceptions among future prescribers. However, the extent of preparation provided by medical curricula remains unknown.AimThe current study sought to determine knowledge, attitude and perception on antimicrobial use and AMR among final year medical students in Malawi.MethodsA descriptive cross-sectional study was undertaken among all final year medical students at the College of Medicine, University of Malawi in 2016. Total population sampling and self-administered questionnaires were used. Data were entered using Microsoft Excel and analysed with Epi info. Descriptive analysis for categorical data was done using frequencies and proportions, and for continuous data using measures of central tendency.ResultsThe response rate in this study was 95%. The mean and median aggregated scores were 7.2 and 7, respectively, for the 11 knowledge questions. Over 88% of the respondents answered more than half of the knowledge questions correctly. Respondents agreed that antimicrobials are overused both at national (50; 69%) and at hospital (52; 72%) levels.ConclusionThis study reports high aggregated knowledge scores on antimicrobial use and resistance with wide variations on correct knowledge scores per question. The study further shows varying level in attitudes and perceptions among medical students. Overall, there were gaps on antimicrobial use and knowledge of AMR which the medical curriculum should addresses.

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One Health—Its Importance in Helping to Better Control Antimicrobial Resistance

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed4010022 ◽

2019 ◽

Vol 4 (1) ◽

pp. 22 ◽

Cited By ~ 27

Author(s):

Peter Collignon ◽

Scott McEwen

Keyword(s):

Antimicrobial Resistance ◽

Infection Control ◽

One Health ◽

Growth Promotion ◽

Animal Husbandry ◽

Resistant Bacteria ◽

Antimicrobial Use ◽

Inappropriate Use ◽

International Agencies ◽

Better Regulation

Approaching any issue from a One Health perspective necessitates looking at the interactions of people, domestic animals, wildlife, plants, and our environment. For antimicrobial resistance this includes antimicrobial use (and abuse) in the human, animal and environmental sectors. More importantly, the spread of resistant bacteria and resistance determinants within and between these sectors and globally must be addressed. Better managing this problem includes taking steps to preserve the continued effectiveness of existing antimicrobials such as trying to eliminate their inappropriate use, particularly where they are used in high volumes. Examples are the mass medication of animals with critically important antimicrobials for humans, such as third generation cephalosporins and fluoroquinolones, and the long term, in-feed use of antimicrobials, such colistin, tetracyclines and macrolides, for growth promotion. In people it is essential to better prevent infections, reduce over-prescribing and over-use of antimicrobials and stop resistant bacteria from spreading by improving hygiene and infection control, drinking water and sanitation. Pollution from inadequate treatment of industrial, residential and farm waste is expanding the resistome in the environment. Numerous countries and several international agencies have now included a One Health Approach within their action plans to address antimicrobial resistance. Necessary actions include improvements in antimicrobial use, better regulation and policy, as well as improved surveillance, stewardship, infection control, sanitation, animal husbandry, and finding alternatives to antimicrobials.

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1306. Antimicrobial Resistance Knowledge, Attitudes, and Perceptions Among Medical Students in Southern India

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.1139 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S399-S399

Author(s):

Olivia Menden ◽

Sumathi Prabhu ◽

Veena Shetty ◽

Chaithra Pandith ◽

Shobha Giri ◽

...

Keyword(s):

Multivariate Analysis ◽

Medical Students ◽

Antimicrobial Resistance ◽

Infection Control ◽

Antimicrobial Stewardship ◽

World Health ◽

Attitude Score ◽

Major Public Health Problem ◽

Antimicrobial Prescribing ◽

The Mean

Abstract Background Antimicrobial resistance (AMR) is a major public health problem in India. The World Health Organization recognizes that the education of medical students on antimicrobial stewardship plays a critical role in the efforts to combat AMR, but data related to knowledge, attitudes and practices (KAP) regarding AMR is limited in India. Methods This cross-sectional study was conducted in July-August 2017. Medical students at K.S. Hegde Medical Academy in Mangalore, India were surveyed with an anonymous questionnaire using a convenience sampling method involving second year, third year, fourth year, and intern students (n = 347). Data about demographics, sources of information, and antimicrobial training were collected. In addition, AMR knowledge and attitude scores were calculated. A Mann–Whitney U test was used to determine factors that were associated with significant differences in knowledge scores and attitude scores. The primary outcome measure of this study was to determine positive predictors of increased confidence in prescribing antimicrobials in the future using multivariate analysis. Results A total of 347 surveys were analyzed (response rate of 98.9%). The mean total knowledge score was 11.47 out to 31 with a standard deviation (SD) of 3.39, and the mean attitude score was 5.99 out of 16 (SD = 4.207). While 13.2% of students were “very familiar” or “familiar” with the term “Antimicrobial Stewardship,” and 88.2% of students said they would like more antimicrobial education in medical school. On multivariate analysis, female gender (OR 2.51, 95% CI (1.51, 4.18)), clinical vignette antimicrobial knowledge scores (OR 1.26, 95% CI (1.05, 1.51)), positive attitude scores (OR 0.94, 95% CI (0.88, 0.995)), awareness of Infection Control Policy (OR 1.87, 95% CI (1.09, 3.22)), and > 3 years of antimicrobial prescribing clinical training (OR 2.48, 95% CI (1.29, 4.75)) were predictors of confidence in antimicrobial prescribing. Conclusion This study identifies several possible interventions for improving confidence such as increased clinical knowledge through clinical experience, increased awareness of infection control policies and antimicrobial guidelines, and empowering students to be antimicrobial stewards to combat AMR. Disclosures All authors: No reported disclosures.

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The Hospital Antimicrobial Use Process: From Beginning to End

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy098 ◽

2018 ◽

Vol 5 (6) ◽

Cited By ~ 2

Author(s):

William R Truong ◽

Jason Yamaki

Keyword(s):

Antimicrobial Resistance ◽

Patient Outcomes ◽

Adverse Drug Reactions ◽

Antimicrobial Stewardship ◽

Antimicrobial Use ◽

Drug Reactions ◽

Improve Patient ◽

Appropriate Antimicrobial Use

Abstract Hospital antimicrobial stewardship (AMS) programs are responsible for ensuring that all antimicrobials are utilized in the most appropriate and safe manner to improve patient outcomes, prevent adverse drug reactions, and prevent the development of antimicrobial resistance. This Perspectives article outlines the hospital antimicrobial use process (AUP), the foundational system that ensures that all antimicrobials are utilized in the most appropriate and safe manner. The AUP consists of the following steps: antimicrobial ordering, order verification, preparation and delivery, administration, monitoring, and discharge prescribing. AMS programs should determine how each step contributes to how an antimicrobial is used appropriately or inappropriately at their institution. Through this understanding, AMS programs can integrate stewardship activities at each step to ensure that every opportunity is taken to optimize antimicrobial use during a patient’s treatment course. Hence, approaching AMS through the framework of a hospital’s AUP is essential to improving appropriate antimicrobial use.

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Therapy-related issues: infections

10.1093/med/9780199603640.003.0020 ◽

2012 ◽

Author(s):

Philip Wiffen ◽

Marc Mitchell ◽

Melanie Snelling ◽

Nicola Stoner

Keyword(s):

Antimicrobial Resistance ◽

Infection Control ◽

Antimicrobial Prophylaxis ◽

Antimicrobial Use ◽

Antimicrobial Prescribing ◽

Modes Of Action ◽

Micro Organisms

Basic microbiology 412Modes of action of antibacterials 416Selection and use of antimicrobials 418Antimicrobial prophylaxis 428Optimizing antimicrobial use 430Antimicrobial prescribing guidelines 432Antimicrobial resistance 436Infection control 440Micro-organisms are classified in many ways. The most important classifications are as follows. ...

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920. Use of the Web by State and Territorial Health Departments to Promote the Dissemination of State Antimicrobial Resistance Surveillance Data, United States

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1108 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S494-S495

Author(s):

Xin Yin ◽

Keith W Hamilton ◽

Heather Tate ◽

Nkuchia M M’ikanatha

Keyword(s):

Public Health ◽

United States ◽

Antimicrobial Resistance ◽

Health Professionals ◽

One Health ◽

Antimicrobial Use ◽

Web Survey ◽

Related Information ◽

Appropriate Antimicrobial Use ◽

The Web

Abstract Background Antimicrobial resistant (AMR) bacteria pose a serious threat to public health. The national response to this threat includes calls for promoting judicious use of antibiotics in humans and animals and strengthening integrated One Health surveillance of AMR bacteria in humans, animals, and environment. However, the extent to which public health jurisdictions are disseminating surveillance findings to promote judicious use of antimicrobials is unclear. Methods We used a standardized web audit tool to manually review and document the presence of AMR-related information on the websites of all public health jurisdictions that participate in national notifiable disease surveillance in the United States. We also emailed a survey to representatives in the 54 jurisdictions that participate in the National Antimicrobial Resistance Monitoring System (NARMS) activities coordinated by the Centers for Disease Control and Prevention. The survey asked questions about AMR-related information on their public health department website. Results Of the 37 (68.5%) jurisdictions that responded to the email survey, 26 (70.3%) indicated that their websites have information on appropriate antibiotic use for health professionals, veterinarians and general public, compared to 89.3% from the web survey (Figure). Eleven (29.7%) indicated that they have data on antimicrobial susceptibility for pathogens, or antibiograms, on their websites, compared to 48.2% from the web survey. While 11 (29.7%) jurisdictions indicated that they have highlighted appropriate antimicrobial use on the homepage, the web survey found no reference on the homepage. Comparison of results from email and web survey on public health jurisdictions’ website, United States - 2020 Conclusion Public health jurisdictions have begun to use websites to increase awareness about the threat of antimicrobial resistance. However, the limited presence of information on appropriate antimicrobial use for the public, health professionals and veterinarians suggest the need for improvement. Gaps exist between the awareness of the epidemiologists and laboratorians and the information reported on public health jurisdictions’ websites. Websites can be expanded and better leveraged to increase visibility of AMR and appropriate antimicrobial prescribing across One Health domains. Disclosures All Authors: No reported disclosures

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Effects of the cefazolin shortage on the sales, cost, and appropriate use of other antimicrobials

BMC Health Services Research ◽

10.1186/s12913-021-07139-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ryuji Koizumi ◽

Yoshiki Kusama ◽

Yusuke Asai ◽

Gu Yoshiaki ◽

Yuichi Muraki ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Prediction Model ◽

Broad Spectrum ◽

Early Recognition ◽

Antimicrobial Use ◽

Appropriate Use ◽

Sales Data ◽

Defined Daily Doses ◽

Before And After ◽

Appropriate Antimicrobial Use

Abstract Background Shortages of antimicrobials lead to treatment failures, increase medical costs, and accelerate the development of antimicrobial resistance. We evaluated the effects of the serious cefazolin shortage in 2019 in Japan on the sales, costs, and appropriate use of other antimicrobials. Methods We evaluated monthly defined daily doses/1000 inhabitants/day (DID) values of antimicrobial sales from January 2016 to December 2019 using wholesaler’s sales databases. Using 2016–2018 sales data, we generated a prediction model of DID in 2019 under the assumption that the cefazolin shortage did not occur. We then compared the predicted DID and actual DID. Cefazolin, government-recommended alternatives, and government-not-recommended broad-spectrum alternatives were assessed. Antimicrobial groups according to the AWaRe classification were also assessed to evaluate the effect on appropriate antimicrobial use. In addition, we evaluated changes in costs between 9 months before and after the cefazolin shortage. Results DID values of total antimicrobials increased sharply 1 month before the decrease in cefazolin. Actual DIDs were higher than predicted DIDs for ceftriaxone, flomoxef, clindamycin, cefotiam, piperacillin/tazobactam, and meropenem. Actual DID values were higher than the predicted DID values in the Watch group. The costs of antimicrobials between pre- and post- cefazolin shortage were unchanged. Conclusion The cefazolin shortage brought confusion to the antimicrobial market and led to a setback in the appropriate use of antimicrobials. Early recognition and structures for prompt reactions to antimicrobial shortages are needed. Moreover, development of a system to secure the supply of essential antimicrobials is required.

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Knowledge, perception and attitude of under-graduate and post-graduate medical students about antimicrobial use, resistance and stewardship at a tertiary care teaching hospital in rural Telangana, India

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20190087 ◽

2019 ◽

Vol 8 (2) ◽

pp. 193

Author(s):

Jayaram Chundru ◽

Shailendra D. ◽

Rahul R. Tirumalareddy ◽

Harsha Kumari ◽

Vishal P. Kovilakonda

Keyword(s):

Medical Students ◽

Antimicrobial Resistance ◽

Antimicrobial Stewardship ◽

Antimicrobial Agents ◽

Tertiary Care ◽

Good Knowledge ◽

Fisher Exact Test ◽

Antimicrobial Use ◽

Online Questionnaire ◽

Cross Sectional

Background: Inappropriate antimicrobial use contributes to antimicrobial resistance. Assessing knowledge, perception and attitude regarding antimicrobial use serves as a prelude to design and implement educational modules to promote rational antimicrobial use.Methods: An online questionnaire based cross-sectional study involving 338 medical students; under-graduates, interns and post-graduates was conducted in a medical college in south India. Chi-square test or Fisher exact test were used to determine association between variables.Results: Fifty percent of the participants (170/338) responded to the questionnaire. The responses were similar across undergraduates, interns and post-graduates. Majority of the responders had good knowledge regarding use of antimicrobials. Most of the participants (92.35%) expressed that a broad-spectrum antimicrobial should be started to treat a serious infection while awaiting culture and sensitivity reports and 88.82% did not prefer to use antimicrobial agents for common cold. Similarly, most of the respondents (93.56%) were aware of the fact that antimicrobial resistance is a global problem. However, many of them (74.71%) were not aware of antimicrobial stewardship programme in their college.Conclusions: This study revealed that most of the students had good knowledge, fair perception and positive attitude regarding the use of, and resistance to antimicrobial agents but not about stewardship programmes. Proactive measures are required to sensitise medical students on antimicrobial stewardship programmes.

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