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

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 Sixth Year Medical Students in Three Medical Schools

Open Forum Infectious Diseases ◽

10.1093/ofid/ofv133.299 ◽

2015 ◽

Vol 2 (suppl_1) ◽

Cited By ~ 1

Author(s):

Nuttagarn Chuenchom ◽

Romanee Chaiwarith ◽

Rawisut Deoisares ◽

Visanu Thamlikitkul ◽

Pinyo Rattanaumpawan

Keyword(s):

Medical Students ◽

Antimicrobial Resistance ◽

Infection Control ◽

Medical Schools ◽

Antimicrobial Use ◽

Appropriate Antimicrobial Use

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

10.21203/rs.3.rs-667305/v1 ◽

2021 ◽

Author(s):

Ryuji KOIZUMI ◽

Yoshiki KUSAMA ◽

Yusuke ASAI ◽

Yoshiaki GU ◽

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/1,000 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 non-government-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, Attitude, and Practices on Antimicrobial Use and Antimicrobial Resistance among Poultry Drug and Feed Sellers in Bangladesh

Veterinary Sciences ◽

10.3390/vetsci8060111 ◽

2021 ◽

Vol 8 (6) ◽

pp. 111

Author(s):

Md. Abul Kalam ◽

Md. Abdul Alim ◽

Shahanaj Shano ◽

Md. Raihan Khan Nayem ◽

Md. Rahim Badsha ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Current Knowledge ◽

Rank Order ◽

Antimicrobial Use ◽

Poultry Production ◽

Attitudes And Practices ◽

12Th Grade ◽

Study Results ◽

Knowledge Attitudes And Practices ◽

Drug Sellers

Poultry production has boomed in Bangladesh in recent years. The poultry sector has contributed significantly to meet the increased demand for animal source proteins in the country. However, increased use of antimicrobials and antibiotics appeared to be a significant threat to food safety in the poultry sector. The poultry drug and feed sellers are at the frontline position involving selecting and delivering the antimicrobials to the poultry farmers. Studies assessing the poultry drug and feed sellers’ knowledge, attitudes, and practices (KAPs) are limited. The current study aimed to assess the community poultry drug and feed sellers’ KAPs of antimicrobial use (AMU) and antimicrobial resistance (AMR) in some selected areas of Bangladesh. We determined the respondents’ (drug and the feed sellers) KAPs of AMU and AMR using a tested and paper-based questionnaire. The study demonstrated that most respondents have insufficient knowledge, less positive attitudes, and inappropriate practices regarding AMU and AMR. The factor score analysis further showed that the type of respondents and their years of experience, level of education, and training on the drug were the significant factors impacting the current knowledge, attitudes, and practices of AMU and AMR. The adjusted logistic regression analysis revealed that the drug sellers who completed their education up to 12th grade and had training on the drug had adequate knowledge of AMU and AMR. The data also showed that the drug sellers belong to the age group 31–35 and 36–40 years and who completed 12th grade had good attitudes on the same. Likewise, the analysis further determined that drug sellers belonging the age category 18–25 and 26–30 years, and interestingly, the respondents who completed education up to 12th grade, had better practices. Spearman’s rank-order correlation revealed a positive association between each pair of the KAPs scores for the respondents. The correlation was fair between knowledge–attitudes, knowledge–practices, and attitudes–practices. Based on the current study results, we recommend educational interventions and appropriate training for the poultry drug and feed sellers to raise awareness and to upgrade their current knowledge on the appropriate use of antimicrobials. This will ultimately lead to reducing the chances of developing AMR in the poultry sectors of the country.

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Deferred Action for Childhood Arrivals (DACA) medical students – an examination of their journey and experiences as medical students in limbo

BMC Medical Education ◽

10.1186/s12909-021-02787-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Christina Gillezeau ◽

Wil Lieberman-Cribbin ◽

Kristin Bevilacqua ◽

Julio Ramos ◽

Naomi Alpert ◽

...

Keyword(s):

Medical Students ◽

Medical School ◽

First Year ◽

Convenience Sample ◽

Student Sample ◽

Medical Specialties ◽

Residency Programs ◽

Deferred Action ◽

The Status ◽

Depth Interviews

Abstract Background Although the value of DACA medical students has been hypothesized, no data are available on their contribution to US healthcare. While the exact number of DACA recipients in medical school is unknown, DACA medical students are projected to represent an increasing proportion of physicians in the future. The current literature on DACA students has not analyzed the experiences of these students. Methods A mixed-methods study on the career intentions and experiences of DACA medical students was performed utilizing survey data and in-depth interviews. The academic performance of a convenience sample of DACA medical students was compared to that of matriculated medical students from corresponding medical schools, national averages, and first-year residents according to specialty. Results Thirty-three DACA medical students completed the survey and five participated in a qualitative interview. The average undergraduate GPA (SD) of the DACA medical student sample was 3.7 (0.3), the same as the national GPA of 2017–2018 matriculated medical students. The most common intended residency programs were Internal Medicine (27.2%), Emergency Medicine (15.2%), and Family Medicine (9.1%). In interviews, DACA students discussed their motivation for pursuing medicine, barriers and facilitators that they faced in attending medical school, their experiences as medical students, and their future plans. Conclusions The intent of this sample to pursue medical specialties in which there is a growing need further exemplifies the unique value of these students. It is vital to protect the status of DACA recipients and realize the contributions that DACA physicians provide to US healthcare.

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