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BackgroundAntimicrobial use is very common in hospitalized children. An assessment of clinician’s prevailing knowledge and clinical approach to prescribing antimicrobials is helpful in order to develop the best strategies for successful stewardship programs. The objectives of the study were to determine fundamental knowledge of principles, approach to antimicrobial use through the clinical vignettes and to identify perceived challenges in decreasing antimicrobial use.MethodsA questionnaire was developed by subject matter experts and pretested to ensure validity. Using a cross-sectional prospective design, the questionnaire was completed anonymously by staff and trainee physicians at a single tertiary care pediatric hospital between late November 2011 and February 2012.ResultsOf 159 eligible physicians, 86 (54.1%) responded, of which 77 (46 staff and 31 trainees) reported regularly prescribing antimicrobials. The majority of physicians had modest knowledge of factors that would increase risk of resistance however, less than 20% had correct knowledge of local resistance patterns for common bacteria. Almost half of physicians correctly answered the clinical vignettes. Over half of trainees and one third of staff relied most on online manuals for information regarding antimicrobials to assist prescription decision-making. Overall, physicians perceived that discontinuing empiric antimicrobials was the most difficult to achieve to decrease antibiotic use.ConclusionsOur results highlight several challenges that pediatric practioners face with respect to knowledge and approach to antimicrobial prescribing. Pediatric stewardship programs could in this setting focus on discontinuing antimicrobials appropriately and promoting local antibiograms in the proper clinical setting to decrease overall use of antimicrobials.

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In recent years, plants have shown potential as sources of antimicrobial agents due to their immense phytochemical constituents, and there is a need to continuously search and develop potent antimicrobial agents to combat the growing threat of antimicrobial resistance worldwide. The challenges facing the utilization of ethnomedicine are lack of sufficient studies to ascertain their therapeutic use. Sarcophyte is a holoparasite plant and trophic guild parasite. Its native ranges from Southern parts of Ethiopia to South Africa. It has a vital medicinal value in managing various disorders. This review article purposes to offer a complete rundown literature regarding Sarcophyte genus: Phylogeny, medicinal values, phytochemistry and toxicity that have been outlined in diverse journals and articles. This review has been developed with the aid of books, articles, peer reviewed articles, theses, Google Scholar, Science Direct and validated internet sources. Sarcophyte piriei has been utilized customarily to manage a variety of disorders among Africans for ages. It is employed to treat diseases but is not limited to sores, bruises, sore throat, swollen glands, toothache, abdominal pain, diarrhoea, shingles, cancer, snake bites and menstrual disorders. Alkaloids, flavonoids, phenols, saponins, terpenoids and tannins have shown to be the major phytochemical constituents correlated with the antimicrobial properties of the holoparasite and contributed to the antibacterial prospects of the plant against Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Streptococcus pyogenes, Klebsiella pneumonia and Proteus mirabilis. Its safety and toxicity have not been well established hence the need for evaluation. More studies are required to elucidate more phytochemical composition, medicinal values, efficacy, potency, safety and toxicity measures. Sarcophyte genus will provide a novelty in new remedies for the emerging antimicrobial resistance to conventional antimicrobial agents.