scholarly journals Antimicrobial stewardship: Assessment of knowledge, awareness of antimicrobial resistance and appropriate antibiotic use among healthcare students in a Nigerian University

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wuraola Akande-Sholabi ◽  
Amen T. Ajamu
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Healthcare Professionals ◽  
Antibiotic Use ◽  
The Body ◽  
Healthcare Students ◽  
Inappropriate Use ◽  
The Past ◽  
Inadequate Knowledge ◽  
Nigerian University

Abstract Background Inappropriate use of antibiotics is a major cause of antimicrobial resistance (AMR). Inadequate knowledge about AMR among healthcare students could affect their practice of antimicrobial stewardship as future healthcare professionals. This study aims to assess the use of antibiotics and knowledge of AMR among future healthcare professionals of a Nigerian University. Methods Respondents’ knowledge of antimicrobial resistance, use of antibiotics, and source of antibiotics in the past 12 months was explored using a self-administered questionnaire. Multivariate analyses were used to evaluate the relationship between specific variables and respondents’ knowledge. Results Of the 939 questionnaires administered to the students, 866 were filled given a response rate of 92.2 %. A total of (765; 88.3 %) of the respondents were aware that antimicrobial resistance makes it harder to eliminate the infection from the body as existing drugs become less effective. In all 824, (95.2 %) of the respondents had use antibiotics in the past 12 months. The use of antibiotics to treat malaria was self-reported by (175; 21.2 %). About half (432; 52.4 %) purchased the antibiotics from community pharmacies, while others obtained their antibiotics from the hospitals (192; 23.3 %), patent medicine stores (150; 18.2 %), and friends and family (50; 6.1 %) in the last 12 months. In all 506, (58.4 %) had good knowledge of antimicrobial resistance. Logistic regression shows that students in 3rd to 6th year 9.29 [AOR = 9.29, 95 % CI: (3.7–22.96)], had greater knowledge of antimicrobial resistance. Conclusions The healthcare students demonstrated a moderate knowledge of AMR. This underscores the need to adopt several educational tactics to introduce the concepts of AMR to the students and ensure there are strict policies to regulate the flow of antibiotics.

scholarly journals A survey of the knowledge and attitudes of Egyptian healthcare professionals towards the application of Health Information Technology to optimize antibiotic therapy

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i28-i28
Author(s):  
N Hassan ◽  
R Slight ◽  
S P Slight
Keyword(s):  
Information Technology ◽  
Developing Countries ◽  
Antimicrobial Resistance ◽  
Health Information Technology ◽  
Health Information ◽  
Antimicrobial Stewardship ◽  
Healthcare Professionals ◽  
Response Rate ◽  
Public Healthcare ◽  
P Value

Abstract Introduction Antimicrobial resistance is a global health problem, especially in developing countries. Antimicrobial Stewardship Programmes (AMS) have been shown to be effective at reducing antimicrobial resistance and hospital patient stays. Health information technology (HIT) can support Outpatient Parenteral Antimicrobial Therapy (OPAT) through more accurate diagnosis and management of infectious diseases. Aim To evaluate the knowledge and attitude of Egyptian healthcare professionals towards the application of HIT to optimize OPAT. Methods Healthcare professionals who worked in either private or public sectors of Egyptian healthcare system were emailed and asked if they would be willing to complete an electronic questionnaire (using google forms). One reminder was sent by email each week for two weeks (two in total) from the first invitation. The survey was laid out in four sections. The first section included specific details about the healthcare professional’s current employment and role, the second related to HIT services available in their organisations, the third covered their training in HIT and antimicrobial stewardship programmes, and the fourth included their use of HIT to optimize OPAT. Ethical approval was obtained from National Heart Institute, Egypt. Descriptive analysis was carried out for all the variables. One-way ANOVA testing at level of significance P-value <0.05, was used to compare numerical variables. SPSS version 26 was used for statistical analysis. Results Three hundred and eighty-five healthcare professionals were invited to respond to the questionnaire. (The response rate was 75.34% (290)). Of these, 152 (52.6%) were pharmacists, 134 (46.4%) physicians, and 3 (1%) nurses, and many participants (30.8%) had between 6 to 10 years of experience working in either outpatient or in-patient units. Only 15.2% of respondents mentioned that they have access to OPAT in their organizations, 51.2% did not have the service, while 33.6% responded that they did not know if the service was available. However, 27.3% had a training on ASP and 18.3% had a training on HIT. Mean scores for both knowledge (14.31±5.49) and attitude (14.67±2.53) were significantly higher in professionals who had received training in HIT (p = 0.003 & 0.006 respectively). However, scores for attitude were better than scores for knowledge. Conclusions In developing countries, HIT applications in OPAT are still in their infancy with only a few organisations adopting them. Egyptian healthcare professionals showed positive attitudes towards HIT use, especially when their knowledge was improved through training. Two strengths of this study include our high response rate and the wide breadth of different healthcare professionals who responded from both private and public healthcare settings. However, being a questionnaire, some questions were left unanswered and some respondents may not have been aware of their reasons for a particular answer. That said, this study has important implications for practice, with more awareness amongst healthcare professionals required on the availability of HIT services in their hospitals and how further training may be needed on the applications of HIT in optimizing OPAT.

scholarly journals Assessing Knowledge and Perception Regarding Antimicrobial Stewardship and Antimicrobial Resistance in University Students of Pakistan: Findings and Implications

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 866
Author(s):  
Iltaf Hussain ◽  
Nisa Yousaf ◽  
Sana Haider ◽  
Pervisha Jalil ◽  
Muhammad Usman Saleem ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
University Students ◽  
Antimicrobial Stewardship ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Dosing Regimen ◽  
Student Knowledge ◽  
Chi Square ◽  
Cross Sectional ◽  
Self Administered Questionnaire

The irrational use of antimicrobials has enormously contributed to antimicrobial resistance (AMR) globally and especially in the developing world. To assess the knowledge and perception regarding AMR and antimicrobial stewardship (AMS), a descriptive cross-sectional study was carried out in university students enrolled in pharmacy, veterinary, and biology programs by using an online self-administered questionnaire. The Chi-square and Fisher exact tests (where applicable) were performed to assess the association of the demographics with the students’ knowledge and perception regarding AMR and AMS. A total of 496 students completed the questionnaire, among which, 85.7% of the participants were familiar with the term AMR and 79.4% of the participants correctly identified a poorly designed dosing regimen as a contributing factor towards AMR. The majority of participants (57.9%) were familiar with the term AMS and 86.5% were aware of the aim of AMS. The participants showed good knowledge regarding AMR and AMS, but to further improve student knowledge and perception of AMS and AMR, it is suggested that dedicated modules on antibiotic use and AMS should be incorporated into the curricula of these undergraduate and postgraduate programs.

scholarly journals Where to from here? Identifying and prioritising future directions for addressing drug-resistant infection in Australia

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gregory Merlo ◽  
Minyon Avent ◽  
Trent Yarwood ◽  
Bonnie Smith ◽  
Mieke van Driel ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Infection Prevention ◽  
Implementation Strategies ◽  
Antibiotic Use ◽  
Future Directions ◽  
World Cafe ◽  
Resistant Infection ◽  
Using Data ◽  
Patient Stories

Abstract Background The Australian National Antimicrobial Resistance Strategy calls for a collaborative effort to change practices that have contributed to the development of drug-resistance and for implementation of new initiatives to reduce antibiotic use. Methods A facilitated workshop was undertaken at the 2019 National Australian Antimicrobial Resistance Forum to explore the complexity of antimicrobial stewardship (AMS) implementation in Australia and prioritise future action. Participants engaged in rotating rounds of discussion using a world café format addressing six topics relating to AMS implementation. Once all tables had discussed all themes the discussion concluded and notes were summarised. The documents were independently openly coded by two researchers to identify elements relating to the implementation of antimicrobial stewardship. Results There were 39 participants in the facilitated discussions, including pharmacists, infectious disease physicians, infection prevention nurses, and others. Participants discussed strategies they had found successful, including having a regular presence in clinical areas, adapting messaging and implementation strategies for different disciplines, maintaining positivity, and being patient-focused. Many of the recommendations for the next step involved being patient focussed and outcomesdriven. This involves linking data to practice, using patient stories, using data to celebrate wins and creating incentives. Discussion Recommendations from the workshop should be included in priority setting for the implementation of AMS initiatives across Australia.

scholarly journals PROBLEM OF ANTIBIOTIC USE AND ANTIMICROBIAL RESISTANCE IN INDONESIA: ARE WE REALLY MAKING PROGRESS?

2013 ◽  
Vol 4 (4) ◽  
pp. 5 ◽  
Author(s):  
Usman Hadi ◽  
Kuntaman Kuntaman ◽  
Mariyatul Qiptiyah ◽  
Hari Paraton
Keyword(s):  
Antimicrobial Resistance ◽  
Antibiotic Use ◽  
Teaching Hospitals ◽  
Resistant Bacteria ◽  
Prevention Study ◽  
Antibiotic Resistant ◽  
Inappropriate Use ◽  
Government Hospitals ◽  
Inappropriate Antibiotics ◽  
Very High

Background: Based on the results Antimicrobial Resistance in Indonesia: prevalence and prevention-study (AMRIN-study), the Ministry of Health of Indonesia in 2005 began a program antibiotic resistance control (PPRA) in some government hospitals, and is currently developing to all government teaching hospitals in Indonesia. Aim: The core activities of the PPRA are to implement standardized surveillance emergence of antibiotic resistant bacteria, and the surveillance of antibiotic use in terms of quantity and quality. Method: Our research in the years 2003 showed the proportion of antibiotic use 84% of patients in a hospital. The use of inappropriate antibiotics was very high, 42% no indication. Result: In 2012 the results of surveillance showed decline of inappropriate use of antibiotic, but prevalence extended-spectrum b-lactamase (ESBL)-producing K.pneumoniae (58%), and E.coli (52%) andmethicillin-resistant S.aures (MRSA) (24%) were increasing. Conclusion: It was needed to implement the most appropriate programs to prevent the growth and development of bacteria resistant to antibiotics.

scholarly journals Exploring gender differences in knowledge and practices related to antibiotic use in Southeast Asia: A scoping review

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0259069
Author(s):  
Phuc Pham-Duc ◽  
Kavitha Sriparamananthan
Keyword(s):  
Gender Differences ◽  
Antimicrobial Resistance ◽  
Southeast Asia ◽  
Scoping Review ◽  
Antibiotic Use ◽  
Educational Interventions ◽  
Sociodemographic Factors ◽  
Targeted Interventions ◽  
Inappropriate Use ◽  
Males And Females

Inappropriate use of antibiotics has been one of the main contributors to antimicrobial resistance, particularly in Southeast Asia. Different genders are prone to different antibiotic use practices. The objective of this scoping review is to understand the extent and type of evidence available on gender differences in antibiotic use across Southeast Asia. The search strategy for this scoping review involved PubMed, Semantic Scholar, BioMed Central and ProQuest. Two-level screening was applied to identify the final sample of relevant sources. Thematic content analysis was then conducted on the selected final sources to identify recurring themes related to gender differences in antibiotic use and a narrative account was developed based on the themes. Recommendations for next steps regarding reducing inappropriate antibiotic use and gender considerations that need to be made when developing future interventions were also identified. Research on gender and antibiotic use remains scarce. Studies that discuss gender within the context of antibiotic use often mention differences between males and females in knowledge, attitudes and/or behaviour, however, do not explore reasons for these differences. Gender differences in antibiotic use were generally examined in terms of: (i) knowledge of antibiotic use and antimicrobial resistance and (ii) practices related to antibiotic use. Evidence indicated that differences between males and females in knowledge and practices of antibiotic use varied greatly based on setting. This indicates that gender differences in antibiotic use are greatly contextual and intersect with other sociodemographic factors, particularly education and socioeconomic status. Educational interventions that are targeted to meet the specific needs of males and females and delivered through pharmacists and healthcare professionals were the most common recommendations for reducing inappropriate use of antibiotics in the community. Such targeted interventions require further qualitative research on factors influencing differences in knowledge and practices related to antibiotic use among males and females. In addition, there is also a need to strengthen monitoring and regulation practices to ensure accessibility to affordable, quality antibiotics through trusted sources.

scholarly journals Overuse of antibiotics in maternity and neonatal wards, a descriptive report from public hospitals in Dar es Salaam, Tanzania

2021 ◽  
Author(s):  
Mwaka Athuman Kakolwa ◽  
Susannah L. Woodd ◽  
Alexander M. Aiken ◽  
Fatuma Manzi ◽  
Giorgia Gon ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Antimicrobial Resistance ◽  
Antibiotic Use ◽  
Dar Es Salaam ◽  
Prophylactic Antibiotics ◽  
Public Hospitals ◽  
Descriptive Data ◽  
Inappropriate Use ◽  
Control Drug ◽  
Postnatal Women

Abstract Background: Overuse of antibiotics is a major challenge and undermines measures to control drug resistance worldwide. Postnatal women and newborns are at risk of infections and are often prescribed prophylactic antibiotics, although there is no evidence to support their universal use in either group. Methods: We performed point prevalence surveys in three hospitals in Dar es Salaam, Tanzania, in 2018 to collect descriptive data on antibiotic use and infections in maternity and neonatal wards. Results: Prescribing of antibiotics was high in all three hospitals ranging from 90% (43/48) to 100% (34/34) in women after cesarean section, from 1.4% (1/73) to 63%(30/48) in women after vaginal delivery, and from 89%(76/85) to 100%(77/77) in neonates. The most common reason for prescribing antibiotics was medical prophylaxis in both maternity and neonatal wards.Conclusion: We observed substantial overuse of antibiotics in postnatal women and newborns.This calls for urgent antibiotic stewardship programs in Tanzanian hospitals to curb the inappropriate use and limit the spread of antimicrobial resistance.

scholarly journals Extent of misuse and dependence of codeine-containing products among medical and pharmacy students in a Nigerian University

2019 ◽  
Author(s):  
Wuraola Akande-Sholabi ◽  
Rasaq Adisa ◽  
Olayinka S Ilesanmi ◽  
Ayomide Esther Bello
Keyword(s):  
Peer Influence ◽  
Pharmacy Students ◽  
Cross Sectional Survey ◽  
Preventive Program ◽  
Cross Sectional ◽  
Medication Misuse ◽  
Healthcare Students ◽  
Inappropriate Use ◽  
Nigerian University ◽  
Cough Syrup

Abstract Background Misuse and dependency of opioids especially codeine-containing products is of increasing global concern. Inappropriate use of opioids among healthcare students could affect quality of service and ethical conducts of these future professionals, thereby putting the society at risk. Objectives To evaluate knowledge and perception of medical and pharmacy students in a Nigerian tertiary University on use of opioids with focus on codeine-containing products. Methods A cross-sectional survey among 335-medical and 185-pharmacy students from University of Ibadan, Nigeria, between September and December 2018, using a semi-structured questionnaire. Results Codeine-containing cough syrup was the most commonly used opioid-products (163;31.3%) among the students. Majority (469;90.2%) had good perception about codeine-containing products, while 319(61.3%) had poor knowledge of opioids usage. Logistic-regression shows that students who experienced some side-effects they would like to experience again, 36.31[AOR=36.31, 95% CI: (10.89-121.12)] and those pressured into using codeine-containing products, 11.77[AOR=11.77, CI=95% (2.50-55.38)] had more tendency of misuse. Conclusion Misuse of codeine-containing products among medical and pharmacy students is obvious. Peer-influence and experience of some effects are significant predictors of misuse among the students. Thus, healthcare curriculum should incorporate preventive program on medication misuse, while policy that favours peer-support program on medication misuse is advocated for healthcare students.

scholarly journals Knowledge and Expectations on Antibiotic Use among Older Adults in Malaysia: A Cross-Sectional Survey

Geriatrics ◽  
2019 ◽  
Vol 4 (4) ◽  
pp. 61 ◽  
Author(s):  
Lai San Kong ◽  
Farida Islahudin ◽  
Leelavathi Muthupalaniappen ◽  
Wei Wen Chong
Keyword(s):  
Older Adults ◽  
Viral Infections ◽  
Antibiotic Use ◽  
The Body ◽  
Limited Information ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Inappropriate Use ◽  
Validated Questionnaire

Antibiotics are commonly prescribed among older adults, and inappropriate use of antibiotics has been noted. However, there is limited information about their knowledge and expectations for antibiotics. This study aimed to assess older adults’ knowledge of antibiotic use and resistance, their expectations for antibiotics and the relationship between knowledge, expectation and inappropriate practices related to antibiotic use. A cross-sectional survey involving respondents aged 60 years and above was conducted, using a validated questionnaire. A lack of knowledge about the role of antibiotics was observed, whereby more than half of the respondents incorrectly believed that antibiotics can treat viral infections (53.5%) and colds and coughs (53.7%). Also, 67.9% of respondents incorrectly believed that antibiotic resistance occurs when the body becomes resistant to antibiotics. Almost half of the respondents would expect antibiotics for symptoms of self-limiting viral infections. Respondents who answered correctly for the role of antibiotics in viral infections were more likely not to expect antibiotics for cold, flu and cough (p < 0.001). Respondents who answered correctly regarding the need to adhere to antibiotics were more likely to have completed their antibiotic course (p < 0.001). Future educational initiatives should provide key information on the role of antibiotics and the importance of complying with antibiotics in this population.

scholarly journals Knowledge, Attitudes and Practices of Veterinarians Towards Antimicrobial Resistance and Stewardship in Nigeria

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 453
Author(s):  
Usman O. Adekanye ◽  
Abel B. Ekiri ◽  
Erika Galipó ◽  
Abubakar Bala Muhammad ◽  
Ana Mateus ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
Online Survey ◽  
Action Plan ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Health Concern ◽  
Attitudes And Practices ◽  
Laboratory Services ◽  
Knowledge Attitudes And Practices

Antimicrobial resistance (AMR) is a global health concern and the inappropriate use of antibiotics in animals and humans is considered a contributing factor. A cross-sectional survey to assess the knowledge, attitudes and practices of veterinarians regarding AMR and antimicrobial stewardship was conducted in Nigeria. A total of 241 respondents completed an online survey. Only 21% of respondents correctly defined the term antimicrobial stewardship and 59.8% were unaware of the guidelines provided by the Nigeria AMR National Action Plan. Over half (51%) of the respondents indicated that prophylactic antibiotic use was appropriate when farm biosecurity was poor. Only 20% of the respondents conducted antimicrobial susceptibility testing (AST) frequently, and the unavailability of veterinary laboratory services (82%) and the owner’s inability to pay (72%) were reported as key barriers to conducting AST. The study findings suggest strategies focusing on the following areas may be useful in improving appropriate antibiotic use and antimicrobial stewardship among veterinarians in Nigeria: increased awareness of responsible antimicrobial use among practicing and newly graduated veterinarians, increased dissemination of regularly updated antibiotic use guidelines, increased understanding of the role of good biosecurity and vaccination practices in disease prevention, and increased provision of laboratory services and AST at affordable costs.

scholarly journals 1034. Automating Assessments of Vancomycin Appropriateness

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S364-S364
Author(s):  
Haley K Holmer ◽  
Caitlin M McCracken ◽  
Gregory B Tallman ◽  
Sara J Gore ◽  
Timothy Shan ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Antibiotic Use ◽  
Empiric Therapy ◽  
Automated Classification ◽  
Electronic Health Record Data ◽  
Inappropriate Use ◽  
Days Of Therapy ◽  
Hospital Patients ◽  
Icd 10 ◽  
Procedure Codes

Abstract Background Assessing appropriateness of hospital antibiotic use is typically a labor-intensive task for antimicrobial stewardship teams and relies heavily on clinician judgement rather than a systematic process. Vancomycin is a frequently used agent that is a common stewardship target. We developed an algorithm to automatically classify the appropriateness of vancomycin days of therapy (DOTs) based upon electronic health record data. Methods We constructed a retrospective cohort of Oregon Health and Science University (OHSU) Hospital and Doernbecher Children’s Hospital patients admitted August 1, 2017 to July 31, 2018 receiving vancomycin. Data were collected on demographic, encounter, pharmacy, microbiology, and surgery data. An electronic algorithm was applied to classify vancomycin DOTs as appropriate, inappropriate, or indeterminate. Inappropriate use was defined as any case in which there was an opportunity for de-escalation as identified using microbiology data, ICD-10 codes, and procedure codes. Results We included 4,231 encounters; 493 (12%) were pediatric patients. Our algorithm automatically classified 59%, 3%, and 38% of encounters as having either appropriate, inappropriate, or indeterminate DOTs, respectively. Forty-four percent of all encounters received no more than a 24-hour course of vancomycin and were considered appropriate empiric therapy; half of these were attributed to surgical prophylaxis. Nine percent of all encounters had vancomycin administered within 3 days of a blood, sputum or tissue culture in which either a methicillin-resistant Staphylococcus species or an ampicillin-resistant, vancomycin-susceptible Enterococcus species was isolated and were classified as appropriate. Six percent of all encounters had cultures in which only Gram-negatives, fungi, or yeast were isolated and were therefore considered appropriate in the empiric period (≤48 hours) but inappropriate thereafter. Conclusion Automated assessments of antibiotic appropriateness could facilitate more informed antimicrobial stewardship initiatives and serve as a valuable stewardship metric. Characterization of indeterminate vancomycin use may inform increased automated classification. Further effort is needed to validate these assessments. Disclosures All authors: No reported disclosures.

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