Although cefepime-induced thrombocytopenia is rare, clinicians should be alert to this potential adverse effect among critically ill patients.

No abstract

Antimicrobial Stewardship Program (ASP) has been implemented in major public hospitals in Malaysia, with pharmacists playing a key role in ensuring the appropriate use of antibiotics. This survey aimed to assess the practices, perceptions, and knowledge of public hospital pharmacists on antibiotic use and resistance. A cross-sectional survey involving pharmacists from six public hospitals in Penang was conducted using a self-administered validated questionnaire. The majority of pharmacists perceived that polypharmacy (92%, n = 270) and overuse of broad-spectrum antibiotics (85%, n = 252) can potentially induce resistance of microorganisms and that ensuring the rational use of antibiotics is a shared responsibility between clinicians and pharmacists (94%, n = 278). A large majority of the pharmacists think that formal training in infectious disease should be a pre-requisite for pharmacists in ASP (93%, n = 273). In terms of antibiotic selection, the availability of antibiotics in hospital (81%, n = 234) and patient’s clinical condition (68%, n = 196) are more of a concern to the pharmacists. A total of 65% of the respondents (n = 192) demonstrated good levels of knowledge with a mean knowledge score of 10.1 out of 13 (95% CI: 9.95; 10.31). Pharmacists from the managerial level, ward pharmacy, in-patient, and medication therapy adherence clinic (MTAC) unit had better knowledge of antibiotics compared to pharmacists from other units (p < 0.001). Antibiotic knowledge gap had been identified among pharmacists in different work settings, and longer years of service does not warrant good antibiotic knowledge.

Inappropriate prescribing of antibiotics is one of the factors that lead to the development of antibiotic resistance. Therefore, understanding doctors’ practice, perception and knowledge is vital in targeting strategies to prevent antibiotic resistance. The aim of the study is to determine the practice, perception and knowledge of doctors on antibiotic use and resistance in Penang government hospitals. This is a cross sectional survey carried out in 6 Penang government hospitals from 9th January 2017 to 20th January 2017. A face-and-content validated questionnaire adapted from Abbo et al., was distributed to house officers (HO), medical officers (MO) and specialists/consultants (SC) and collected back within 5 working days. A total of 243 questionnaires were completed with a response rate of 60.45%. Majority of our respondents (91.6%) considered whether patient is critically ill and/or immunocompromised when selecting an antibiotic. Regardless of their position, doctors agreed that antibiotics are overused and antibiotic resistance is a significant problem nationally. However, MO tended to perceive antibiotic management programmes as an obstacle to good patient care. The mean knowledge score among respondents was 5.88 (1.92) out of 10. Adjusted analysis showed that SC have significantly higher mean knowledge score compared to HO and MO (p