Knowledge and Awareness of Physicians About Rational Antibiotic Use and Antimicrobial Resistance Before and After Graduation: A Cross-Sectional Study Conducted in Malatya Province in Turkey

Abstract Background Irrational antibiotic use can adversely affect treatment outcomes or even lead to increased antimicrobial resistance. We aimed to determine antimicrobial prescribing habits and to evaluate the level of theoretical knowledge of rational antibiotic use and awareness about antimicrobial resistance among the senior students of medical faculty and the family physicians in Malatya province in Turkey. Methods This study was cross-sectional research and was carried out between dates of 01 February-30 April 2019, in Malatya province. Power analysis was calculated as minimum 240 participants when considering a proportion difference of 0.18 between the groups, a type I error of 0.05 and a type II error of 0.20. A total 225 senior students in Inonu University Medical Faculty (Group 1) and 230 actively-working family physicians in Malatya primary healthcare services who were found eligible (Group 2) were included in to this study. A questionnaire form was prepared including seven sections and thirty questions. All of the participants were interviewed face to face. Before the questions, the purpose of the study and the contents of the questions were explained to participants. Qualitative data were analyzed by Pearson chi-square test. A p<0.05 value was considered to be statistically significant. Results The group 1 had a tendency to apply to specialist physician when starting to themselves antibiotic treatment, they were more cautious when making antibiotic decision, and their theoretical knowledge level was better. They argued that penal sanctions could be more effective by developing strict use policies to raise awareness of resistance to antibiotics. The group 2 had higher self-confidence and it was also concluded that forgot their theoretical antibiotic knowledge over time and could not follow the novel information because of the intensity of working life. Both groups stated that post-graduation trainings could be used effectively for reducing the antibiotic resistance. Conclusion This study highlighted the need for immediate action of training and corrective actions and might create awareness to determine the difference in theoretical knowledge levels and behavior models of physicians before and after graduation and to reduce higher use rates to lower levels. Key words: Antimicrobial resistance, antibiotic, awareness, rational use

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Knowledge levels and awareness about rational antibiotic use and antimicrobial resistance before and after graduation: A cross-sectional study conducted in Malatya province, Turkey

10.21203/rs.3.rs-365360/v1 ◽

2021 ◽

Author(s):

Adem Kose ◽

Cemil Colak

Keyword(s):

Antimicrobial Resistance ◽

Family Physicians ◽

Antibiotic Use ◽

Theoretical Knowledge ◽

Cross Sectional ◽

Before And After ◽

Knowledge Levels ◽

Group 2 ◽

Senior Students ◽

Rational Antibiotic Use

Abstract Background Irrational use of antibiotics may adversely affect the treatment outcomes or even lead to increased antimicrobial resistance. We aimed to evaluate the level of theoretical knowledge of rational antibiotic use and awareness about antimicrobial resistance among the senior students at a medical school and the family physicians.Methods This study was cross-sectional research and was carried out between 01 February-30 April 2019 in Malatya province. Two-hundred twenty-five senior students in the Inonu University Medical School (Group 1) and 230 actively-working family physicians in Malatya primary healthcare services who were found eligible (Group 2). Power analysis was calculated as the minimum of 240 participants when considering a proportion difference of 0.18 between the groups, a type I error of 0.05 and a type II error of 0.20. A p<0.05 value was considered to be statistically significant.Results Researchers argued that penal sanctions can be more effective by developing strict use policies to raise awareness of resistance to antimicrobials. Group 2 had higher self-confidence, and it was also concluded that they forgot their theoretical antibiotic knowledge over time, and they could not follow the current information because of the intensity of their working life. Both groups stated that post-graduation training could be used effectively for reducing antimicrobial resistance.Conclusions This study attempted to increase awareness to determine the difference in theoretical knowledge levels and behavior models of physicians before and after graduation. Sustainable antibiotic training for doctors after graduation will contribute positive effects to antimicrobial resistance and rational use of antibiotics.

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Antibiotic Use: A Cross-Sectional Study Evaluating the Understanding, Usage and Perspectives of Medical Students and Pathfinders of a Public Defence University in Malaysia

Antibiotics ◽

10.3390/antibiotics8030154 ◽

2019 ◽

Vol 8 (3) ◽

pp. 154 ◽

Cited By ~ 2

Author(s):

Mainul Haque ◽

Nor Azlina A. Rahman ◽

Judy McKimm ◽

Massimo Sartelli ◽

Golam Mohammad Kibria ◽

...

Keyword(s):

Medical Students ◽

Antimicrobial Resistance ◽

Antibiotic Use ◽

Cross Sectional Study ◽

Health Concern ◽

Small Data ◽

Sectional Study ◽

Cross Sectional ◽

Study Population ◽

National Defence

Background: Antimicrobial prescribing behaviors are often influenced by the local culture and prescribing appropriateness of medical doctors and other health care professionals. Globally, antimicrobial utilization practices have a profound impact on antimicrobial resistance and are a tremendous public health concern. The aim of this survey was to explore the knowledge and attitudes of medical students from the National Defence University of Malaysia regarding antimicrobial usage and antimicrobial resistance. Research design and methods: This was a cross-sectional study. The study population consisted of undergraduate medical students in each year group from the National Defence University of Malaysia. Students receive limited formal training on the use of antibiotics in their curriculum, and most of this learning is opportunistic whilst on clinical placement. Universal sampling was used as the study population was small. Data were collected utilizing a previously validated instrument regarding antibiotic use. Simple descriptive statistics were used to generate frequencies and percentages with SPSS V21. This research was approved by the Centre for Research and Innovation Management, National Defence University of Malaysia. Results: 206 questionnaires were distributed with a response rate of 99.03%, 54% (110) male, and 46% (94) female. Out of the respondents, 65% (132) had used antibiotics in the last year. Respondents displayed a moderate level of knowledge about antibiotics. Conclusions: This study revealed that the older the student was, or when the year of study and total knowledge score was higher, the students were less likely to stop antimicrobials when they felt better or use leftover antibiotics without consulting a doctor. Therefore, the nearer the students were to graduation, the better their knowledge and skills were, and this translated into their own behaviors regarding use of antimicrobials. This finding has clear implications for curriculum design and the inclusion of formal teaching throughout the medical program on antimicrobial use and antimicrobial resistance (AMR). However, more research is needed on this topic, including the prescribing habits and antibiotic use of practicing doctors.

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Is health literacy associated with antibiotic use, knowledge and awareness of antimicrobial resistance among non-medical university students in Egypt? A cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-046453 ◽

2021 ◽

Vol 11 (3) ◽

pp. e046453

Author(s):

Aya Mostafa ◽

Abdurrahman Abdelzaher ◽

Salma Rashed ◽

Salma I AlKhawaga ◽

Shadwa K Afifi ◽

...

Keyword(s):

Antibiotic Resistance ◽

Health Literacy ◽

Antimicrobial Resistance ◽

University Students ◽

Antibiotic Use ◽

Cross Sectional Study ◽

Health Concern ◽

Sectional Study ◽

Cross Sectional ◽

Medical University

ObjectivesAntibiotic resistance is a global public health concern, especially in developing countries, where antibiotic misuse is widespread. However, studies investigating relevant factors, particularly in youth, are limited. This study examined the levels of health literacy (HL) and their association with antibiotic use, knowledge of antibiotics and awareness of antibiotic resistance among university students in Egypt.DesignA cross-sectional study was conducted using self-administered questionnaires during 2018. The Health Literacy Survey (HLS-EU-Q16) and the WHO Antibiotic resistance: Multi-Country Public Awareness Survey were used. Bivariate and multivariable analyses were used to compare responses on use and knowledge of antibiotics, and awareness of antibiotic resistance between the three levels of students’ HL.SettingUniversity, Cairo, Egypt.Participants508 non-medical university students.OutcomesStudents’ HL scores were categorised into sufficient, problematic and inadequate. Students’ knowledge of antibiotics was categorised into good and poor. Students’ awareness of antibiotic resistance was categorised into high, average and poor.Results35.1% of students had sufficient HL. 79.7% of students had poor knowledge of antibiotics. 39.9% of students reported having used antibiotics in the past month without a prescription. 92.2% had limited awareness of antibiotic resistance and 30.6% of students heard about the term ‘antimicrobial resistance’. Background characteristics did not significantly differ by HL levels or knowledge scores, except for students’ year of study. Sufficient HL was independently associated with students’ high awareness of antibiotic resistance (adjusted OR=2.8; 95% CI: 1.3 to 5.9).ConclusionsHL was insufficient in this sample of non-medical Egyptian university students. Across all levels of HL, knowledge of antibiotics and awareness of antibiotic resistance were limited, reflecting deficiency in relevant education programmes. Findings suggest that sufficient HL supports high awareness of antibiotic resistance. Incorporating HL and rational antibiotic use awareness raising programmes in university curricula is an urgent necessity to curb antibiotic resistance.

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Public Health Literacy, Knowledge, and Awareness Regarding Antibiotic Use and Antimicrobial Resistance during the COVID-19 Pandemic: A Cross-Sectional Study

Antibiotics ◽

10.3390/antibiotics10091107 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1107

Author(s):

Suhaib M. Muflih ◽

Sayer Al-Azzam ◽

Reema A. Karasneh ◽

Barbara R. Conway ◽

Mamoon A. Aldeyab

Keyword(s):

Antibiotic Resistance ◽

Health Literacy ◽

Antimicrobial Resistance ◽

Online Survey ◽

Public Awareness ◽

Antibiotic Use ◽

Cross Sectional Study ◽

Modern Medicine ◽

Sectional Study ◽

Cross Sectional

Multi-drug-resistant (MDR) organisms pose a global threat to modern medicine, which has grown as a result of irrational antibiotic use and misuse. This study aimed to assess general public knowledge in Jordan and awareness of antibiotics and antibiotic resistance during the COVID-19 pandemic. A cross-sectional study was carried out utilizing the WHO multicountry public awareness survey. The study population was composed mainly of social media users, and a total of 1213 participants completed the online survey. According to the findings, more than half of the participants were well versed in antibiotic use and resistance. Those with adequate health literacy were found to better understand antibiotics (OR = 1.37, p = 0.017) and antibiotic resistance (OR = 1.46, p = 0.003). The vast majority (88.5%) recognized at least one antibiotic resistance term; however, 53.2% believed that antibiotic resistance is a problem in other nations. The participants in this study reported using antibiotics incorrectly, believing that they were treating sore throats, colds, and flu. The participants were well aware of antibiotic resistance solutions and their consequences on health. Age, education, health literacy, and antibiotic knowledge were found to be substantially (p < 0.05) associated with greater awareness of antibiotic resistance. The findings highlight the need for antimicrobial resistance education campaigns, health literacy, and antibiotic stewardship initiatives.

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

Antibiotics ◽

10.3390/antibiotics10070866 ◽

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.

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732. Evaulation of Micafungin Treatment at Pediatric Patients: A cross-sectional Study from Tertiary Pediatric Centre

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.924 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S416-S417

Author(s):

Kamile Arıkan ◽

Nuri Bayram ◽

İlker devrim ◽

Ayküke Akaslan-Kara

Keyword(s):

Amphotericin B ◽

Liver Function Tests ◽

Cross Sectional Study ◽

Resistance Rate ◽

Sectional Study ◽

Candida Spp ◽

Cross Sectional ◽

Median Serum ◽

Before And After ◽

Resistance Patterns

Abstract Background Micafungin is one of three currently available echinocandin for treatment of candidiasis and candidemia. Methods Children who were treated for micafungin for possible or proven invasive Candidia infection between May 2017 and October 2019 were included. Results In this cross-sectional study, totally 78 children with a median age of 3 months (8 days -17 years), 50 (64.1%, F/M: 0.56) male were included. Thirty four (43.6%) patients were neonate, 26 (76 %) of them were premature. Thirty seven patients (47.4%) received micafungin for candidemia and 41 (52.6%) patients received micafungin empirically for IC. Twelve (32.4%) Candida spp cultured were C. albicans, the rest twenty five (67.6%) Candida spp were non-albicans Candida spp. The most commonly cultured Candida spp was Candida parapsilosis (C. parapsilosis) (n=13) followed by C. albicans (n=12), C. glabrata (n=3), C. tropicalis (n=3), C. guilliermondii (n=3), C. krusei (n=2) respectively. Resistance rate of C. parapsilosis (n=13) isolates to fluconazole, voriconazole, amphotericin B, caspofungin, micafungin were as follows respectively; 66.7%, 100%, 69.2%, 90.9%, 37.5% respectively. Resistance rate of C. albicans (n=11) isolates to fluconazole, voriconazole, amphotericin B, caspofungin, micafungin were as follows respectively; 50%, 50%, 12.5%, 42.9%, 0% respectively. None of the C. tropicalis, C. guilliermondii and C. krusei isolates were resistant to micafungin. Culture negativity could not be achieved at the end of 14th day of micafungin treatment in the 15 (16.9%) candidemia episodes. The most commonly isolated Candida spp in patients with treatment failure was C. parapsilosis (n=7), the other species were; C. albicans (n=5), C. guilliermondii (n=1), C. tropicalis (n=1) and C. tropicalis and C. guilliermondii coinfection (n=1) respectively. Median serum AST, ALT and creatinin levels didn’t increase during and at the end of micafungin therapy. None of these patients had experienced an anormal kidney or liver function tests due to micafungin usage. Characteristics of patients who received micafungin.and cultured Candida spp Antifungal resistance patterns of Candida spp. Laboratory change before and after micafungin treatment Conclusion Increase in fluconazole resistant Candida spp makes micafungin a reasonable and effective choice for suspected or proven invasive candidiasis Disclosures All Authors: No reported disclosures

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Perspectives of Healthcare Professionals Regarding Factors Associated with Antimicrobial Resistance (AMR) and Their Consequences: A Cross Sectional Study in Eastern Province of Saudi Arabia

Antibiotics ◽

10.3390/antibiotics10070878 ◽

2021 ◽

Vol 10 (7) ◽

pp. 878

Author(s):

Mohamed A. Baraka ◽

Amany Alboghdadly ◽

Samar Alshawwa ◽

Asim Ahmed Elnour ◽

Hassan Alsultan ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Inappropriate Prescribing ◽

Healthcare Providers ◽

Cross Sectional Study ◽

Sectional Study ◽

Key Factors ◽

Eastern Province ◽

Cross Sectional ◽

Factors Associated ◽

Factors Influencing

Factors reported in the literature associated with inappropriate prescribing of antimicrobials include physicians with less experience, uncertain diagnosis, and patient caregiver influences on physicians’ decisions. Monitoring antimicrobial resistance is critical for identifying emerging resistance patterns, developing, and assessing the effectiveness of mitigation strategies. Improvement in prescribing antimicrobials would minimize the risk of resistance and, consequently, improve patients’ clinical and health outcomes. The purpose of the study is to delineate factors associated with antimicrobial resistance, describe the factors influencing prescriber’s choice during prescribing of antimicrobial, and examine factors related to consequences of inappropriate prescribing of antimicrobial. A cross-sectional study was conducted among healthcare providers (190) in six tertiary hospitals in the Eastern province of Saudi Arabia. The research panel has developed, validated, and piloted survey specific with closed-ended questions. A value of p < 0.05 was considered to be statistically significant. All data analysis was performed using the Statistical Package for Social Sciences (IBM SPSS version 23.0). 72.7% of the respondents have agreed that poor skills and knowledge are key factors that contribute to the inappropriate prescribing of antimicrobials. All of the respondents acknowledged effectiveness, previous experience with the antimicrobial, and reading scientific materials (such as books, articles, and the internet) as being key factors influencing physicians’ choice during antimicrobial prescribing. The current study has identified comprehensive education and training needs for healthcare providers about antimicrobial resistance. Using antimicrobials unnecessarily, insufficient duration of antimicrobial use, and using broad spectrum antimicrobials were reported to be common practices. Furthermore, poor skills and knowledge were a key factor that contributed to the inappropriate use and overuse of antimicrobials, and the use of antimicrobials without a physician’s prescription (i.e., self-medication) represent key factors which contribute to AMR from participants’ perspectives. Furthermore, internal policy and guidelines are needed to ensure that the antimicrobials are prescribed in accordance with standard protocols and clinical guidelines.

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Dietary Factors of blaNDM Carriage in Health Community Population: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115959 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5959

Author(s):

Shuangfang Hu ◽

Ziquan Lv ◽

Qiumei Xiang ◽

Yang Wang ◽

Jianzhong Shen ◽

...

Keyword(s):

Risk Factors ◽

Antimicrobial Resistance ◽

Cross Sectional Study ◽

Dietary Factors ◽

Coarse Grain ◽

Sectional Study ◽

Cross Sectional ◽

Health Community ◽

Health Communities ◽

Tuber Crops

Aim: There is an ongoing debate as to what extent antimicrobial resistance (AMR) can be transmitted from dietary to humans via the consumption of food products. We investigated this association between dietary and global spreading carbapenem-resistant gene blaNDM Methods: We did a cross-sectional study to assess the risk factors for carrier of blaNDM in health community. Healthy adults were recruited from the residents attending Community Healthcare Service in Shenzhen City (Guangdong Province, China), through 1February 2018 to 31December 2019, and 718 pre-participants were included in this study. Questionnaire were obtained and the qualitative food frequency questionnaire (Q-FFQ) were used to assess dietary intake. qPCR was applied to confirm the carrier of blaNDM in participants’fecal samples. Multivariable logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of each outcome according to each dietary factor before and after prosperity score matching (PSM). Results: we showed that a high intake of coarse grain (OR 1.003; 95% CI 1.001–1.005, p < 0.01) and root and tuber crops (OR 1.003; 95% CI 1.001–1.004, p < 0.05) were independent risk factor for blaNDM carrier in health communities, suggesting a possible transfer of AMRbetweendietary andhumans. Surprisingly, we also showed an association between a higher intake of poultry as a protective, which may be explained by the beneficial effects on the gut microbiota. Conclusion: Dietary factors such as intake of coarse grain, root and tuber crops and poultry were associated with blaNDM carrier in health communities. The influence of dietary factorson blaNDM carrier in the present study provides insights for the tangible dietary advice with guidelines to the routine of people with the risk of blaNDM carrier. This demonstrates the role of dietary intake in the prevention of blaNDM carrier, since prevention is the best way to control modifiable risk factors. A lower carrier rate of blaNDM is helpful to reduce the possibility of transmission and pathogenicity. Further studies on food, microbiota and antimicrobial resistance are necessary to confirm this possible association and unravel underlying mechanisms.

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The Impact of Bariatric Surgery on Menstrual Abnormalities—a Cross-Sectional Study

Obesity Surgery ◽

10.1007/s11695-020-04840-6 ◽

2020 ◽

Vol 30 (11) ◽

pp. 4505-4509

Author(s):

Anna Różańska-Walędziak ◽

Paweł Bartnik ◽

Joanna Kacperczyk-Bartnik ◽

Krzysztof Czajkowski ◽

Maciej Walędziak

Keyword(s):

Bariatric Surgery ◽

Menstrual Cycle ◽

Cross Sectional Study ◽

Reproductive Age ◽

Obese Women ◽

Sectional Study ◽

Cross Sectional ◽

Contraception Use ◽

Before And After ◽

The Impact

Abstract Introduction Obesity is associated with hyperestrogenism along with other hormonal abnormalities affecting the menstrual cycle. The most effective and decisive method of obesity treatment is bariatric surgery. The aim of this study was to analyze the impact of bariatric surgery on menstrual cycle, the incidence of menstrual abnormalities, hyperandrogenism manifestation, and contraception use. Materials and Methods It was a cross-sectional study of 515 pre-menopausal women who had undergone bariatric surgery between 1999 and 2017 in a bariatric center. Data was collected via anonymous questionnaire, and the questions covered a 1-year period before the surgery and the last year before questionnaire completion. Results Before the surgery, 38.6% of the patients reported irregular menstruations in comparison with 25.0% after bariatric surgery (RR = 0.65; 95%CI 0.53–0.79). The mean number of menstruations per year did not differ before and after surgery (10.2 ± 3.9 vs 10.4 ± 3.3; p < .45). There were no statistically significant differences in terms of prolonged menstruations, acne, and hirsutism prevalence. A total of 14.4% of patients before surgery reported estrogen-based contraception use in comparison with 15.0% after the surgery (p < .95). There were no significant differences in the frequency of OC use (11.0% before surgery vs 13.6% 12 months after the surgery vs 11.5% at the moment of survey administration; p < 0.46). Conclusion Bariatric surgery improves the regularity of the menstrual cycle in obese women in reproductive age. The lack of any changes in the combined hormonal contraception (CHC) use, especially OC, before and after bariatric surgery may be a result of a possibly low level of contraception counseling.

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