Antimicrobial resistance awareness and antibiotic prescribing behavior among healthcare workers in Nigeria: a national survey

Chukwu, Emelda E.; Oladele, David; Enwuru, Christian A.; Gogwan, Peter L.; Dennis, Alice B.; Audu, Rosemary; Ogunsola, Folasade

doi:10.1186/s12879-020-05689-x

Cited by 40 publications

(39 citation statements)

References 21 publications

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“…This was also reported in a German study that assessed the effect of knowledge about antibiotic resistance on the prescribing pattern among practitioners; awareness about antimicrobial resistance highly influenced the practitioners' pattern in prescribing antibiotics to their patients, and this was confirmed in additional studies in Iran and Croatia [27][28][29]. Conversely, two studies in Cambodia and Nigeria found that physicians were alert about the challenge related to the misuse of antibiotics, but this did not influence their practice in managing antibiotic prescribing [30,31]. Understanding the factors associated with overprescribing of antibiotics including prescribers' knowledge is crucial to find strategies to overcome this challenge [32][33][34].…”

Section: Discussionmentioning

confidence: 69%

Prescribers’ Knowledge, Attitudes and Behaviors on Antibiotics, Antibiotic Use and Antibiotic Resistance in Jordan

et al. 2021

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More research is needed on the drivers of irrational antibiotic prescribing among healthcare professionals and to ensure effective prescribing and an adequate understanding of the issue of antibiotic resistance. This study aimed at evaluating prescribers’ knowledge, attitudes and behaviors about antibiotic use and antibiotic resistance. A cross-sectional study was conducted utilizing an online questionnaire and included physicians and dentists from all sectors in Jordan. A total of 613 prescribers were included (physicians n = 409, dentists n = 204). Respondents’ knowledge on effective use, unnecessary use or associated side effects of antibiotics was high (>90%), compared with their knowledge on the spread of antibiotic resistance (62.2%). For ease of access to the required guidelines on managing infections, and to materials that advise on prudent antibiotic use and antibiotic resistance, prescribers agreed in 62% and 46.1% of cases, respectively. 28.4% of respondents had prescribed antibiotics when they would have preferred not to do so more than once a day or more than once a week. Among respondents who prescribed antibiotics, 63.4% would never or rarely give out resources on prudent use of antibiotics for infections. The findings are of importance to inform antibiotic stewardships about relevant interventions aimed at changing prescribers’ behaviors and improving antibiotic prescribing practices.

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Section: Discussionmentioning

confidence: 69%

Prescribers’ Knowledge, Attitudes and Behaviors on Antibiotics, Antibiotic Use and Antibiotic Resistance in Jordan

et al. 2021

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“…Despite the potentially dire consequences of AMR on animal and public health in sub-Saharan countries, public awareness remains poor. Also, many professionals within the various One Health sectors are poorly aware of their role in ensuring antimicrobial stewardship (AMS) (11,12,(16)(17)(18). There is still a limited appreciation of collaborative planning and data sharing needed to guarantee an enhanced response to the challenge of suboptimal antibiotic use and to mitigate the spread of AMR.…”

Section: Low Level Of Awareness Of Amr Among the Public And Professionalsmentioning

confidence: 99%

“…At the heart of operationalising One Health is the need to mainstream AMR into other educational and public discussions that emphasise AMR management as a healthy public policy. Firstly, the country needs to rethink and reframe the way we communicate AMR especially due to poor understanding of AMR by the lay public and even among health professionals (16,17). The challenges AMR pose-including economic lossesneed to be presented as a problem of the present and the future, and communicated appropriately for adequate risk perception.…”

Section: Way Forwardmentioning

confidence: 99%

Operationalising One Health in Nigeria: Reflections From a High-Level Expert Panel Discussion Commemorating the 2020 World Antibiotics Awareness Week

Achi

Ayobami

Mark

et al. 2021

Front. Public Health

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Antimicrobial resistance (AMR) poses an important One Health challenge for all countries of the world. As human, animal and environmental health are closely linked, it is essential that interventions targeted at reducing the spread of AMR and those promoting antimicrobial stewardship are conducted with all sectors in mind. Tackling this global slow-moving pandemic (AMR) also requires action and strong commitment from all countries of the world. Nigeria, like many other countries, have made considerable progress in implementing the National Action Plan on Antimicrobial Resistance. The accomplishments and ongoing work led by the National Technical Working Group on AMR is commendable. However, gaps still exist in terms of operationalising One Health interventions for AMR, especially regarding rational antimicrobial use and antimicrobial stewardship. The 2020 World Antimicrobial Awareness Week presented an opportunity to convene a multi-sectoral expert panel from national government agencies, research, academia and the World Health Organisation across the Nigerian One Health space. The panel discussion analysed the progress made so far and identified the barriers and the opportunities for operationalising One Health interventions on AMR. The discussion highlighted poor awareness and the fear phenomenon, driven by technical and socio-economic factors, as a common cross-sectoral denominator at the heart of inappropriate antibiotic use within the country. At the system level, suboptimal use of antimicrobials fuelled by the ease of purchase, poor regulations and insufficient enforcement of prescription-only access to antimicrobials, and limited infection prevention and biosecurity measures resonated as drivers of AMR across One Health sectors in Nigeria. Looking forward, the panel discussion identified substantial investment in the governance of the existing One Health component structures, inclusive bottom-up institutional antimicrobial stewardship that fosters community participation and multi-level cross-sectoral collaborations as the next level strategic imperatives. In this respect is the need for a strengthened One Health infrastructure, including an operational workforce, educational strategies to elevate AMR and rational antimicrobial use into public consciousness, and the use of improved data systems as countermeasures to the challenge of AMR.

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“…Antimicrobial resistance (AMR) is a global problem that puts the treatment of infectious diseases at risk [1]. It is hazardous to one's health and development [2].…”

Section: Introductionmentioning

confidence: 99%

AmpC Beta-Lactamase Prevalence in Isolates of Escherichia coli and Klebsiella pneumoniae in Enugu, Nigeria

Maduakor

Ajiromanus

Onyemelukwe

2022

JAMPS

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Background: Pathogenic bacteria with beta lactamase-resistant determinants have emerged, posing a worldwide health threat. They confer resistance to a large array of \(\beta\) -lactam agents and \(\beta\)-lactam inhibitors. Aim: This study evaluated the prevalence and resistance profiles of plasmid-mediated AmpC \(\beta\) -lactamase producing isolates among Escherichia coli and Klebsiella pneumoniae from clinical and environmental sources in the Enugu metropolis. Methodology: The work was done in the Microbiological Laboratory of the University of Nigeria Teaching Hospital Ituku-Ozalla. A total of 150 non-duplicate isolates processed in the microbiology laboratories of three referral hospitals and some private laboratories were used in this study including 85 and 65 isolates of Escherichia coli and Klebsiella pneumoniae respectively. Isolates were identified and characterized using standard microbiological protocols. Antimicrobial susceptibility was performed using the Kirby-Bauer disc diffusion procedure. Phenotypic detection of AmpC \(\beta\)-Lactamase production was determined using Cefoxitin/Cloxacillin double-disc synergy (CCDST). Results: Of the 67 isolates of E. coli from clinical samples, AmpC production was confirmed in 20(29.9%) and of the 18 isolates from environmental sources, only 5(27.8%) were confirmed. Of the 60 isolates of Klebsiella pneumoniae from clinical samples 16(26.6%) were AmpC producers while 1(20%) out of the 5 isolates from environmental samples was an AmpC producer. The prevalence of AmpC \(\beta\)-lactamase producers was 28%. There was no statistical difference in the proportion of AmpC producers in clinical and environmental isolates in E.coli and Klesiella pneumoniae p = .86 and p = .74 respectively. Antimicrobial resistance was high in both AmpC and non-AmpC \(\beta\)-lactamase producers. Impenem’s susceptibility was found in 75.4 percent of the isolates. Conclusion: This research revealed a high prevalence of AmpC beta-lactamase in the Enugu metropolis. The identification of AmpC beta-lactamase enzymes regularly is crucial to preventing therapeutic failures. The proper usage of antimicrobial drugs is critical.

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Antimicrobial resistance awareness and antibiotic prescribing behavior among healthcare workers in Nigeria: a national survey

Cited by 40 publications

References 21 publications

Prescribers’ Knowledge, Attitudes and Behaviors on Antibiotics, Antibiotic Use and Antibiotic Resistance in Jordan

Prescribers’ Knowledge, Attitudes and Behaviors on Antibiotics, Antibiotic Use and Antibiotic Resistance in Jordan

Operationalising One Health in Nigeria: Reflections From a High-Level Expert Panel Discussion Commemorating the 2020 World Antibiotics Awareness Week

AmpC Beta-Lactamase Prevalence in Isolates of Escherichia coli and Klebsiella pneumoniae in Enugu, Nigeria

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