Knowledge and perceptions of antimicrobial stewardship program among health-care students in Saudi Arabia

Awareness and perception of antimicrobial stewardship program among healthcare professionals in the hospitals of ministry of health and population, Egypt: antimicrobial stewardship toolkit survey

BACKGROUND

Antimicrobial resistance (AMR) has been recognized by international policymakers as a serious threat due to its current and projected influence on global population health, healthcare expenditures and gross domestic product (GDP). The present work aimed to assess the awareness, perceptions, and practices of healthcare professionals regarding the implementation of the Antimicrobial Stewardship program (ASP).

METHODS

A cross-sectional study was conducted among 310 health care professionals. A self-administered questionnaire based on Antimicrobial Stewardship Toolkit for Acute and Long-Term Care Facilities; Greater New York Hospital Association (GNYAHA) was used to assess perceptions and knowledge about AMR and automatic selective perception.

RESULTS

A total of 310 healthcare professionals participated in the study, of which 60.6% were females, with a mean age of 37.32 ± 8.71, mean years of working of 6.0 ± 5.95 and mean years of experience of 7.97 ± 7.14. The mean scores for AMR awareness, antibiotic (AB) prescribing practices, ASP perception, and intervention beliefs were 73.05 ± 11.21, 32.97 ± 8.22, 52.85 ± 13.99, and 18.24 ± 2.71, respectively. Bivariate analysis showed that profession, primary work unit, staff position significantly affect the AMR awareness and ASP perception, while only staff position affect intervention beliefs. The Multivariate linear regression showed that working in pharmacy, ABs prescribing practice and ASP perception were independent predictors of AMR awareness. Years of work in hospital, AMR awareness and ASP perception were the independent predictors of ABs prescribing practice. AMR awareness, ABs prescribing practice and intervention beliefs were independent predictors of ASP perception while ASP perception was the only independent predictors of intervention beliefs.

CONCLUSIONS

The study found a high level of awareness and practice regarding AMR and ASP among healthcare professionals. Pharmacists had higher levels of AMR awareness and ASP perception than physician in different specialities. Levels of AMR awareness, ABs prescribing practice, ASP perception and intervention beliefs affect each other in different ways. Linear regression supported our findings that pharmacists had a higher level of AMR awareness, while years of work in hospital had a significant effect on ABs prescribing practice.

Knowledge, Awareness, and Perceptions Towards Antibiotic Use, Resistance, and Antimicrobial Stewardship Among Final-Year Medical and Pharmacy Students in Saudi Arabia

Background/Objectives: Antibiotic resistance (ABR) is a global crisis leading to increased mortality and economic burden. Antimicrobial stewardship (AMS) promotes responsible antibiotic use and prescribing practices to combat ABR. This study assessed the knowledge, awareness, and perceptions of final-year medical and pharmacy students in Saudi Arabia regarding antibiotic use, ABR, and AMS. Methods: A national cross-sectional survey was conducted from January to April 2024 using a 49-item questionnaire. The survey assessed knowledge of antibiotic use, ABR, and AMS using predefined scoring, while perceptions were evaluated with a 5-point Likert scale. Data were analyzed using descriptive statistics and Chi-square tests to explore associations between independent variables and outcomes. A logistic regression analysis identified factors associated with good knowledge, and results were reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: Among 197 participants from 26 Saudi universities, pharmacy students comprised 73.1% of the sample. Good knowledge was observed in 44.7% for antibiotic use, 47.7% for ABR, and 52.8% for AMS. However, 28.4% lacked awareness of AMS, and 5.6% were unaware of ABR. Pharmacy students demonstrated significantly higher knowledge and confidence in AMS and antibiotic handling compared to medical students (p < 0.001). Higher knowledge was also associated with the university's region and prior education on resistance or AMS during college. Conclusions: This study highlights significant gaps in knowledge and awareness of antibiotic use, ABR, and AMS among final-year medical and pharmacy students in Saudi Arabia. The findings emphasize the need for targeted educational strategies, standardized curricula, and enhanced AMS training to better prepare future healthcare professionals to combat ABR effectively.

Knowledge of Antibiotic Use and Resistance Among Medical Students in Saudi Arabia

Introduction

The World Health Organization (WHO) has placed great importance on providing thorough, hands-on training to medical students regarding responsible and appropriate antibiotic prescription. Accordingly, this study aims to gain a better perspective on the knowledge of antibiotic use and resistance among medical students in Jeddah, Saudi Arabia.

Methods

A questionnaire-based cross-sectional study was conducted among medical students in Jeddah, Saudi Arabia, from 1 September to 30 November 2023. The categorical variables are presented as frequencies and percentages. Mann-Whitney and Kruskal-Wallis tests were used to compare the outcomes, and generalised linear regression models were constructed to predict the students' knowledge of antibiotics and antibiotic resistance. A p-value of < 0.05 was taken to indicate statistical significance.

Results

The study included a total of 353 medical students. First-year medical students represented 28.60% of the participants, while females represented 76.80%. Most participants (92.40%) agreed that antibiotics are effective against bacteria, whereas only 25.20% agreed about antibiotics' effectiveness against viruses. More than half of the participants (53.80%) believed that bacterial infections can be resolved without antibiotics. A significant majority (78.20%) agreed that the unnecessary use of antibiotics makes them less effective. More than half of the participants (56.90%) acknowledged that infections caused by resistant bacteria are increasing in Saudi Arabia, and two-thirds (75.10%) believed that healthcare workers could effectively reduce antibiotic resistance in Saudi Arabia. Male students had low knowledge about antibiotics [Beta = -1.429, 95% CI (-2.618, -0.241), P value = 0.019].

Conclusion

Improving the curriculum by incorporating topics like resistance mechanisms and responsible antibiotic usage can address the knowledge gap among male students. This comprehensive training, utilizing various educational methods, is essential for fostering responsible antibiotic practices among future healthcare professionals.

Knowledge, Perception, and Self-Confidence of Antibiotic Resistance, Appropriate Antibiotic Therapy, and Antibiotic Stewardship Among Undergraduate Pharmacy Students in Sudan

Background

Adequate training in infectious diseases and antibiotic resistance is crucial for pharmacy students to participate in antibiotic stewardship programs and understand microbiology careers.

Aim

The study was carried out to assess the knowledge and self-reported confidence in antibiotic resistance, antibiotic therapy, and antimicrobial stewardship (AMS) among final-year undergraduate pharmacy students in Sudan.

Methods

A cross-sectional study was conducted in three universities using a 57-item online questionnaire between April and May 2022.

Results

A total of 109 students (response rate 36%) participated and showed average knowledge scores of 5.6±1.7 (out of 10.0) for antibiotic resistance, 4.9±2.0 (out of 5.0) for appropriate antibiotic therapy, and 3.1±1.4 (out of 5.0) for AMS. No significant differences were observed among schools. Some students reported poor knowledge about antibiotic therapy and the consequences of resistance. One-third of students lacked confidence in interpreting microbiological results. Knowledge of antibiotic resistance among students' practice area after graduation was higher (p=0.017) and those interested in ID careers (5.8 vs 4.8) (p=0.037). Male students (5.6 vs 4.5) and those interested in ID careers (4.3 vs 3.4) (p<0.001) had higher scores of appropriate antibiotic therapy. Students attended antibiotic resistance courses (51.5 vs 45.2), and those interested in ID significantly had higher self-confidence (55.3 vs 45.8) (p=0.008).

Conclusion

Pharmacy students in Sudan have substantial knowledge of AMS and antibiotic resistance with poor knowledge of antibiotic therapy. Adequate training about infectious diseases and related topics is recommended to improve pharmacy students' understanding of microbiological findings, other competencies, and skills to incorporate in antimicrobial stewardship.

Pharmacists' Perceptions of Handling Antimicrobial Resistance (AMR): A Case Study in Saudi Arabia

Introduction

Saudi Arabia is one of the countries facing the emergence of antimicrobial resistance (AMR). The pharmacist is an important stakeholder in the healthcare system who plays a crucial role in avoiding AMR and implementing antimicrobial stewardship (AMS).

Methods

A cross-sectional design was used in this study. The online questionnaire collected data regarding the enablers that have helped in preparing pharmacists to handle AMR and the barriers faced by pharmacy personnel in handling AMR, as well as the strategies used to overcome the identified barriers.

Results

A total of 109 participants were included in the study. Just under two thirds (62.4%) of participants were female and the majority (70.6%) worked as pharmacists. Just under half (41.7%) had between 6 and 10 years of work experience. Three quarters (74.3%) had antimicrobial stewardship in place and around the same number (73.4%) were involved in handling infectious disease management during the COVID-19 pandemic. Pharmacists have found that preparatory items/tasks, pharmacy college curriculum, pharmacy rotation, years of experience and self-education related to AMR handling to be natural, with a mean of 3.2. The participants found all the barriers - insufficient background, in site education and training, limited time, limited CPD activities, limited educational tools and no free access to relevant clinical journals - to be relevant, with a mean of 4.05. The participants found all the enablers - CPD activities, funded educational programs, allowing time for self-education, accessible educational resources and tools, annual evolution of competencies - to be relevant, with a mean of 4.12.

Conclusion

The study concluded that the barriers preventing the handling of AMR could be overcome through allowing pharmacists more time for self-directed continuous education, providing access to tools and online educational resources, and offering pharmacists funded courses to equip them with the knowledge, skills and competencies needed to handle AMR.