EVALUATION OF CONCEPT OF ANTIMICROBIAL STEWARDSHIP AMONG UG MEDICAL STUDENTS FOR BETTER UNDERSTANDING OF USE OF ANTIMICROBIAL AGENTS AND MINIMIZING ANTIMICROBIAL RESISTANCE
DOI:
https://doi.org/10.22159/ajpcr.2024v17i8.51536Keywords:
Medical interns, Antimicrobial resistance, Antibiotic stewardship, Perception, KnowledgeAbstract
Objectives: The objective of this study is to assess interns perception and knowledge about antibiotic stewardship and their preparedness for appropriate use of antimicrobials and to prescribe antimicrobials.
Methods: The 164 medical interns of BLDE (DU)’s Shri B.M. Patil Medical College who provided consent to participate in the study were included in this cross-sectional web-based online survey. The study was carried out using a validated questionnaire. The data were analyzed using the statistical tool for the social sciences (Version 20).
Results: Out of the 164 interns, 133 (83.1%) completed the entire survey. The term “antimicrobial stewardship” was familiar to 51% (n=68). 50% (n=66) agreed that antibiotics are inappropriately used at the hospital. Approximately 88% (n=104) and 85% (n=113) of the interns thought that insufficient infection control practices and the use of wide spectrum antibiotics were the main causes of resistance development, respectively. About 90% (n=119) thought that lecture series and grand round discussions on the responsible use of antibiotics were good educational tools. About 37% (n=49), 41% (n=54), and 24% (n=32) of the interns understood the proper antibiotic selection for treating simple cases of urinary tract infections, could de-escalate antibiotic therapy, understand an anti-biogram, and could match a different combination of antimicrobials and microorganisms, respectively.
Conclusion: The major findings of our study were, despite students having good perception, the knowledge component was inadequate, that is, they lacked their preparedness and confidence to prescribe antibiotics which emphasizes that the students are aware of the antimicrobial stewardship but their knowledge domain needs to be improved for better application in their clinical practice.
Downloads
References
Khan AK, Banu G, Reshma KK. Antibiotic resistance and usage-a survey on the knowledge, attitude, perceptions and practices among the medical students of a southern Indian teaching hospital. J Clin Diagn Res. 2013;7:1613-6. 2. Bai Y, Wang S, Bai J, Gong Y, Lu Z. Factors associated with doctors’ knowledge on antibiotic use in China. Sci Rep. 2016;6:23429. doi: 10.1038/srep23429
Sannathimmappa MB, Nambiar V, Aravindakshan R. A cross-sectional study to evaluate the knowledge and attitude of medical students concerning antibiotic usage and antimicrobial resistance. Int J Acad Med. 2021;7:113-9. doi: 10.4103/jehp.jehp_557_21
Reena AP, Ittyachen AM. Awareness of antibiotic resistance among medical students in Kerala State, India: A cross-sectional study. Curr Med Issues. 2022;20:245-52. doi: 10.4103/cmi.cmi_69_22
Archer A, Blom M, De Lange R, van Vuuren ES, Kellerman TE, Potgieter S, et al. The knowledge and perceptions regarding antibiotic stewardship of the interns rotating at the Bloemfontein Academic Complex. S Afr Fam Pract (2004). 2021;63:e1-6. doi: 10.4102/safp.v63i1.5336
Wasserman S, Potgieter S, Shoul E, Constant D, Stewart A, Mendelson M, et al. South African medical students’ perceptions and knowledge about antibiotic resistance and appropriate prescribing: Are we providing adequate training to future prescribers? S Afr Med J. 2017;25:405-10. doi: 10.7196/SAMJ.2017.v107i5.12370
Arnold SR, Straus SE. Interventions to improve antibiotic prescribing practices in ambulatory care. Cochrane Database Syst Rev. 2005;2005:CD003539. doi: 10.1002/14651858.CD003539.pub2
Founou RC, Founou LL, Essack SY. Clinical and economic impact of antibiotic resistance in developing countries: A systematic review and meta-analysis. PLoS One. 2017;12:e0189621
Pollack LA, Srinivasan A. Core elements of hospital antibiotic stewardship programs from the centers for disease control and prevention. Clin Infect Dis. 2014;59 Suppl 3:S97-100. doi: 10.1093/ cid/ciu542
Chokshi A, Sifri Z, Horng H. Global contributors to antibiotic resistance. J Glob Infect Dis. 2019;11:36-42. doi: 10.4103/jgid.jgid_110_18
Majumder MA, Singh K, Hilaire MG, Rahman S, Sa B, Haque M. Tackling antimicrobial resistance by promoting antimicrobial stewardship in medical and allied health professional curricula. Expert Rev Anti Infect Ther. 2020;18:1245-58. doi: 10.1080/14787210.2020.1796638
Venugopalan V, Trustman N, Manning N, Hashem N, Berkowitz L, Hidayat L. Administration of a survey to evaluate the attitudes of house staff physicians towards antimicrobial resistance and the antimicrobial stewardship program at a community teaching hospital. J Glob Antimicrob Resist. 2016;4:21-7. doi: 10.1016/j.jgar.2016.01.004
Vazquez-Lago JM, Lopez-Vazquez P, Lopez-Duran A, Taracido-Trunk M, Figueiras A. Attitudes of primary care physicians to the prescribing of antibiotics and antimicrobial resistance: A qualitative study from Spain. Fam Pract. 2012;29:352-60. doi: 10.1093/fampra/cmr084
Dyar OJ, Pulcini C, Howard P, Nathwani D, ESGAP (ESCMID Study Group for Antibiotic Policies). European medical students: A first multicenter study of knowledge, attitudes, and perceptions of antibiotic prescribing and antibiotic resistance. J Antimicrob Chemother. 2014;69:842-6. doi: 10.1093/jac/dkt440
Abbo LM, Cosgrove SE, Pottinger PS, Pereyra M, Sinkowitz-Cochran R, Srinivasan A, et al. Medical students’ perceptions and knowledge about antimicrobial stewardship: How are we educating our future prescribers? Clin Infect Dis. 2013;57:631-8. doi: 10.1093/cid/cit370
Eyal L, Cohen R. Preparation for clinical practice: A survey of medical students’ and graduates’ perceptions of the effectiveness of their medical school curriculum. Med Teach. 2006;28:162-70. doi: 10.1080/01421590600776578
Scaioli G, Gualano MR, Gili R, Masucci S, Bert F, Siliquini R. Antibiotic use: A cross-sectional survey assessing the knowledge, attitudes and practices amongst students of a school of medicine in Italy. PLoS One. 2015;1:0122476. doi: 10.1371/journal.pone.0122476
Hayat K, Fatima N, Umer MF, Khan FU, Khan FU, Najeeb ZU, et al. Findings and implications regarding future prescribers’ knowledge of antimicrobial resistance and readiness for antimicrobial stewardship initiatives in Pakistan. Front Pharmacol. 2022;8:771083. doi: 10.3389/ fphar.2022.771083
Sharma AK, Goyal V, Sankhla S. Knowledge, attitude and practice towards antibiotic use and antibiotic resistance among medical students: A cross sectional study. Int J Pharm Sci Res. 2022;13:4166-72. doi: 10.13040/IJPSR.0975-8232.13(10).4166-72
Ritchie O, Shetty V, Prabhu S, Shetty AK. Confidence in antibiotic prescribing intentions among senior medical students in India. Ame J Trop Med Hyg. 2020;103:2561. doi: 10.4269/ajtmh.20-0193
Higuita-Gutiérrez LF, Roncancio Villamil GE, Jiménez Quiceno JN. Knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Colombia: A cross-sectional descriptive study. BMC Public Health. 2020;20:1861. doi: 10.1186/ s12889-020-09971-0
Published
How to Cite
Issue
Section
Copyright (c) 2024 Jyoti Patil, Priya P Vishwakarma, Rashmi M Karigoudar, Anand M Ingale
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.