Antibiotic Prescribing in DR Congo: A Knowledge, Attitude and Practice Survey among Medical Doctors and Students

Abstract

ObjectivesAntibiotic resistance (ABR) particularly hits resource poor countries, and is fuelled by irrational antibiotic (AB) prescribing. We surveyed knowledge, attitudes and practices of AB prescribing among medical students and doctors in Kisangani, DR Congo.MethodsSelf-administered questionnaires.ResultsA total of 184 questionnaires were completed (response rate 94.4%). Knowledge about AB was low (mean score 4.9/8 points), as was the estimation of local resistance rates of S. Typhi and Klebsiella spp.(correct by 42.5% and 6.9% of respondents respectively). ABR was recognized as a problem though less in their own practice (67.4%) than nation- or worldwide (92.9% and 85.5%, p<.0001). Confidence in AB prescribing was high (88.6%) and students consulted more frequently colleagues than medical doctors when prescribing (25.4% versus 11.6%, p = 0.19). Sources of AB prescribing included pharmaceutical companies (73.9%), antibiotic guidelines (66.3%), university courses (63.6%), internet-sites (45.7%) and WHO guidelines (26.6%). Only 30.4% and 16.3% respondents perceived AB procured through the central procurement and local pharmacies as of good quality. Local AB guidelines and courses about AB prescribing are welcomed (73.4% and 98.8% respectively).ConclusionsThis data shows the need for interventions that support rational AB prescribing.

Do final‐year medical students have sufficient prescribing competencies? A systematic literature review

“…The median number of students per study was 104 (range 1–2413). Besides final‐year medical students, some studies also involved 1–5th year students ( n = 20) 24, 25, 26, 28, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, junior doctors and residents ( n = 8) 25, 28, 33, 46, 47, 48, 49, 50, medical specialists ( n = 2) 48, 50, pharmacy students ( n = 3) 32, 51, 52, dental students ( n = 2) 31, 41 and nonhealthcare students ( n = 1) 40.…”

“…Fifteen articles evaluated students' attitudes to, and knowledge of, appropriate antimicrobial prescribing and resistance 23, 24, 35, 36, 37, 39, 40, 44, 48, 49, 52, 76, 77, 78, 79. Students generally had positive attitudes and perceptions about antimicrobial overuse and resistance 35, 49, 76, 77.…”

“…Students generally had positive attitudes and perceptions about antimicrobial overuse and resistance 35, 49, 76, 77. However, they had poor knowledge of the local prevalence of resistant bacteria 35, 49, 77, 79 and of the treatment and prevention of common infections 24, 49, 78, 79. Additionally, they lacked self‐reported confidence in choosing the correct antibiotic, deciding when to use combination therapy, and choosing the correct dose and interval of administration 35, 36, 77.…”

“…Additionally, they lacked self‐reported confidence in choosing the correct antibiotic, deciding when to use combination therapy, and choosing the correct dose and interval of administration 35, 36, 77. Only four studies reported a moderate‐to‐high level of knowledge about appropriate antimicrobial use among students 37, 40, 44, 52, and two described a moderate‐to‐high level of self‐reported confidence 39, 49. Most students (74–98%) wanted more training in rational antibiotic selection during medical training 23, 35, 36, 39, 76, 77.…”

Misuse of Antibiotic Therapy among University Community in South Jordan

“…In a study in the Northeast of the United States, medical students emphasized the need for both education and feedback on antimicrobial prescribing in order to control overuse or misuse which was high among the population in general [11]. In addition, it was reported that University students misuse antibiotic [12,13]. Furthermore, in China the widespread prescribing of unnecessary antibiotics, especially antibiotics administered parentally [12].…”