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El-Sokkary RH, Badran SG, El Seifi OS, El-Fakharany YM, Tash RME. "Antibiotic prescribing etiquette" an elective course for medical students: could we recruit potential physicians to fight resistance? BMC MEDICAL EDUCATION 2023; 23:8. [PMID: 36604698 PMCID: PMC9815679 DOI: 10.1186/s12909-022-03949-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND A better understanding of medical students' competencies about antimicrobial resistance and their use could facilitate a more effective education for them as future prescribers. The aim is to explore the educational impact of an elective course on medical students' knowledge, perception, and attitude toward antibiotic resistance and use. METHODS Between December 2021 and January 2022, when a 2-credit hours elective course was designed and implemented, this interventional study was conducted. The primary outcome measure was the change in medical students' knowledge, perception, and attitude about antibiotic resistance and use. Using a pre-post course questionnaire, this outcome was assessed. The secondary measure included students' perception of the course; assessed by a post-course online survey. RESULTS Among the 50 enrolled students, the total knowledge score had significantly increased after the course with 95% CI After the course, with medium effect size ( Cohen's d= -0.7 ) the participants' mean ± SD total perception and attitude scores had significantly increased (52.38 ± 5.53 vs. 56.84 ± 5.86) respectively, (p = 0.000) with large effect size (( Cohen's d= -0.8) There was a significant positive correlation between the total knowledge, attitude, and perception after the course (r = 0.542, p < 0.01). The mean ± SD of the overall course satisfaction was 4.20 ± 0.94. out of 5. CONCLUSION Medical students' knowledge, perceptions, and attitudes towards antimicrobial prescription have been improved after the elective antibiotic prescribing etiquette course. Elective courses could offer a great opportunity to enable the students to understand the extent of the problem, stand on the facts, and take responsibility for the antibiotic resistance crisis. TRIAL REGISTRATION NA.
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Affiliation(s)
- Rehab H El-Sokkary
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig , Egypt.
| | - Shahenda G Badran
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig , Egypt
| | - Omnia S El Seifi
- Department of Family and Community Medicine, faculty of medicine, University of Tabuk, Tabuk, Kingdom of Saudi Arabia
- Community, Occupational and Environmental Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Yara M El-Fakharany
- Forensic Medicine and Clinical Toxicology Department, faculty of medicine, Zagazig University, Zagazig , Egypt
| | - Rehab M Elsaid Tash
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig , Egypt
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Kusuma IY, Pratiwi H, Pitaloka DAE. Role of Pharmacists in Antimicrobial Stewardship During COVID-19 Outbreak: A Scoping Review. J Multidiscip Healthc 2022; 15:2605-2614. [PMID: 36388623 PMCID: PMC9656343 DOI: 10.2147/jmdh.s385170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/25/2022] [Indexed: 08/11/2023] Open
Abstract
Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, pharmacists have been on the front lines of health care, offering vital services. Consequently, the need for pharmacists to support an effective antibiotic stewardship (AMS) program during the COVID-19 outbreak has become increasingly evident. This scoping review was performed to examine related articles in 2020-2022 published in the Scopus, SAGE, and Cochrane databases with the keywords "Pharmacist" and "Antibiotic Stewardship" and "COVID-19". The inclusion criteria were full-text articles written in English. A total of 15 articles were included in this review to describe the role of pharmacists in AMS during the COVID-19 outbreak. In general, pharmacists are responsible for identifying and treating patients during pandemics, ensuring the continued supply and accessibility of medications, promoting health policies, and monitoring antibiotic use for COVID-19 cases and co-infections. At the hospital, as the most significant element for pharmacists on the AMS team, the apparent change is demonstrated in educating patients on telehealth services, clarifying misconceptions about treatments and antibiotic consumption, as well as taking a leadership position to establish local guidelines for the COVID-19 treatment protocol. Pharmacists have an important role in the AMS program, and the COVID-19 pandemic was perceived as a highlight their importance. Therefore, their work with the AMS program needs to be improved as they learn to extend their role in telehealth services, educate and clarify the misconceptions about COVID-19 treatments and other antibiotic consumption in the community, inventory control the COVID-19 drug, antibiotics, and vaccine, as well as take the lead in establishing local guidelines on antibiotic consumption during the pandemic outbreak.
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Affiliation(s)
- Ikhwan Yuda Kusuma
- Institution of Clinical Pharmacy, Faculty of Pharmacy, University of Szeged, Szeged, 6725, Hungary
- Pharmacy Study Program, Faculty of Health, Universitas Harapan Bangsa, Purwokerto, 53182, Indonesia
| | - Hening Pratiwi
- Department of Pharmacy, Faculty of Health Sciences, Jenderal Soedirman University, Purwokerto, 53122, Indonesia
| | - Dian Ayu Eka Pitaloka
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, 45363, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, 45363, Indonesia
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SHEA statement on antibiotic stewardship in hospitals during public health emergencies. Infect Control Hosp Epidemiol 2022; 43:1541-1552. [PMID: 36102000 PMCID: PMC9672827 DOI: 10.1017/ice.2022.194] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Wimmer MR, Schulz LT, Hamel AG, Schwei RJ, Fong K, Burgess DR, Brett M, Hale CM, Holubar M, Jain R, Larry R, Spivak ES, Newland H, Njoku J, Postelnick M, Walraven C, Pulia MS. The impact of coronavirus disease 2019 (COVID-19) on the antimicrobial stewardship pharmacist workforce: A multicenter survey. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e56. [PMID: 36483364 PMCID: PMC9726570 DOI: 10.1017/ash.2022.37] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has required healthcare systems and hospitals to rapidly modify standard practice, including antimicrobial stewardship services. Our study examines the impact of COVID-19 on the antimicrobial stewardship pharmacist. DESIGN A survey was distributed nationally to all healthcare improvement company members. PARTICIPANTS Pharmacist participants were mostly leaders of antimicrobial stewardship programs distributed evenly across the United States and representing urban, suburban, and rural health-system practice sites. RESULTS Participants reported relative increases in time spent completing tasks related to medication access and preauthorization (300%; P = .018) and administrative meeting time (34%; P = .067) during the COVID-19 pandemic compared to before the pandemic. Time spent rounding, making interventions, performing pharmacokinetic services, and medication reconciliation decreased. CONCLUSION A shift away from clinical activities may negatively affect the utilization of antimicrobials.
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Affiliation(s)
- Megan R. Wimmer
- Department of Pharmacy, University of Wisconsin Health, Madison, Wisconsin
| | - Lucas T. Schulz
- Department of Pharmacy, University of Wisconsin Health, Madison, Wisconsin
| | - Ashlee G. Hamel
- Department of Pharmacy, Sentara Healthcare, Norfolk, Virginia
| | - Rebecca J. Schwei
- Department of Emergency Medicine, University of Wisconsin Madison, Madison, Wisconsin
| | - Karen Fong
- Department of Pharmacy, University of Utah Health, Salt Lake City, Utah
| | | | - Meghan Brett
- University of New Mexico Hospital, Albuquerque, New Mexico
| | - Cory M. Hale
- Department of Pharmacy, Penn State Health Milton S. Hershey Medical Center, HersheyPennsylvania
| | - Marisa Holubar
- Stanford University School of Medicine, Stanford, California
| | - Rupali Jain
- University of Washington, Seattle, Washington
| | - Rachel Larry
- Department of Pharmacy, Northwestern Memorial Hospital, Chicago, Illinois
| | | | | | | | - Michael Postelnick
- Department of Pharmacy, Northwestern Memorial Hospital, Chicago, Illinois
| | - Carla Walraven
- University of New Mexico Hospital, Albuquerque, New Mexico
| | - Michael S. Pulia
- Department of Emergency Medicine, University of Wisconsin Madison, Madison, Wisconsin
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Educational Activities for Students and Citizens Supporting the One-Health Approach on Antimicrobial Resistance. Antibiotics (Basel) 2021; 10:antibiotics10121519. [PMID: 34943732 PMCID: PMC8698298 DOI: 10.3390/antibiotics10121519] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/29/2021] [Accepted: 12/03/2021] [Indexed: 11/16/2022] Open
Abstract
Antibiotic resistance is one of the biggest threats to global health, food security and development. Urgent action is needed at all levels of society to reduce the impact and spread of antibiotic resistance. For a more sustaining approach, education in children, college students, citizens and caregivers are essential. The One-Heath approach is a collaborative, multisectoral and transdisciplinary strategy in which, no single organizations or sector can address the issue of antimicrobial resistance at the human-environment interface alone. Within this strategy, education plays a central role. In this scoping review, we highlighted a range of learning activities on antibiotic resistance as part of the One-Health approach. In particular, those applications that can be introduced to a wide audience to help arrest the current crisis for the next generation. The review identifies a high number of teaching opportunities: board and role-play games, round tables, musicals, e-learning and environmental experiments to couple with more curricula and formal education to inform a diverse group of audiences.
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Bendala Estrada AD, Calderón Parra J, Fernández Carracedo E, Muiño Míguez A, Ramos Martínez A, Muñez Rubio E, Rubio-Rivas M, Agudo P, Arnalich Fernández F, Estrada Perez V, Taboada Martínez ML, Crestelo Vieitez A, Pesqueira Fontan PM, Bustamante M, Freire SJ, Oriol-Bermúdez I, Artero A, Olalla Sierra J, Areses Manrique M, Carrasco-Sánchez HFJ, Vento VC, García García GM, Cubero-Morais P, Casas-Rojo JM, Núñez-Cortés JM. Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy. BMC Infect Dis 2021; 21:1144. [PMID: 34749645 PMCID: PMC8575150 DOI: 10.1186/s12879-021-06821-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 10/19/2021] [Indexed: 01/08/2023] Open
Abstract
Background Since December 2019, the COVID-19 pandemic has changed the concept of medicine. This work aims to analyze the use of antibiotics in patients admitted to the hospital due to SARS-CoV-2 infection.
Methods This work analyzes the use and effectiveness of antibiotics in hospitalized patients with COVID-19 based on data from the SEMI-COVID-19 registry, an initiative to generate knowledge about this disease using data from electronic medical records. Our primary endpoint was all-cause in-hospital mortality according to antibiotic use. The secondary endpoint was the effect of macrolides on mortality.
Results Of 13,932 patients, antibiotics were used in 12,238. The overall death rate was 20.7% and higher among those taking antibiotics (87.8%). Higher mortality was observed with use of all antibiotics (OR 1.40, 95% CI 1.21–1.62; p < .001) except macrolides, which had a higher survival rate (OR 0.70, 95% CI 0.64–0.76; p < .001). The decision to start antibiotics was influenced by presence of increased inflammatory markers and any kind of infiltrate on an x-ray. Patients receiving antibiotics required respiratory support and were transferred to intensive care units more often. Conclusions Bacterial co-infection was uncommon among COVID-19 patients, yet use of antibiotics was high. There is insufficient evidence to support widespread use of empiric antibiotics in these patients. Most may not require empiric treatment and if they do, there is promising evidence regarding azithromycin as a potential COVID-19 treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06821-1.
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Affiliation(s)
| | - Jorge Calderón Parra
- Internal Medicine Department, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain
| | | | - Antonio Muiño Míguez
- Internal Medicine Department, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Antonio Ramos Martínez
- Internal Medicine Department, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain
| | - Elena Muñez Rubio
- Internal Medicine Department, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain
| | - Manuel Rubio-Rivas
- Internal Medicine Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Paloma Agudo
- Internal Medicine Department, 12 de Octubre University Hospital, Madrid, Spain
| | | | | | | | | | | | - Marta Bustamante
- Internal Medicine Department, La Princesa University Hospital, Madrid, Spain
| | - Santiago J Freire
- Internal Medicine Department, A Coruña University Hospital, A Coruña, Spain
| | - Isabel Oriol-Bermúdez
- Infectious Diseases, Internal Medicine Department, Moisès Broggi Hospital, Sant Joan Despí, Barcelona, Spain
| | - Arturo Artero
- Internal Medicine Department, Dr. Peset University Hospital, Valencia, Spain
| | | | | | | | | | | | - Pablo Cubero-Morais
- Internal Medicine Department, Río Hortega University Hospital, Regional Health Management of Castilla y Leon (SACYL), Valladolid, Spain
| | - José-Manuel Casas-Rojo
- Internal Medicine Department, Infanta Cristina University Hospital, Parla, Madrid, Spain
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Affiliation(s)
- Chih-Cheng Lai
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan
| | - Wen-Liang Yu
- Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan.,Department of Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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