Does the problem begin at the beginning? Medical students’ knowledge and beliefs regarding antibiotics and resistance: a systematic review

Abstract

Background Studies have detected that prescribers display gaps in knowledge and inappropriate attitudes regarding antibiotics and resistances, but it is not known whether these are generated during professional practice or derive from the undergraduate stage of their education. Accordingly, the aim of this study was to identify medical students’ knowledge, beliefs and attitudes regarding antibiotic use and antibiotic resistance, and whether these change over the course of their time at medical school. Methods We conducted a search of the MEDLINE and EMBASE databases, and included studies that measured knowledge and/or beliefs and/or attitudes regarding antibiotic prescribing and/or resistance, among medical students. Results Of the 509 studies retrieved, 22 met the inclusion criteria. While medical students perceived resistance as posing a major public health problem, both worldwide and in their own countries, students in the last two course years were more aware of overprescription of antibiotics in general, and of broad-spectrum antibiotics, at their teaching hospital. There was a considerable lack of knowledge about the treatment of high-incidence infections, and upper respiratory tract infections in particular (41–69% of participants believed antibiotics to be useful for treating these), without any differences by course year. Students were conscious of their personal shortcomings and thus showed willing to improve their education. Conclusions Future physicians display important gaps in knowledge, particularly in terms of treatment of high-incidence infections. This finding may be of use when it comes to designing more effective training in antibiotic stewardship for undergraduates.

How Are We Educating Future Physicians and Pharmacists in Pakistan? A Survey of the Medical and Pharmacy Student’s Perception on Learning and Preparedness to Assume Future Roles in Antibiotic Use and Resistance

“…A study in Nepal highlighted the successful teaching of antimicrobials through a problem-solving approach as part of pharmacology lectures [20]. Furthermore, in terms of adult learning behaviour, it is always beneficial to teach concepts from a disease-oriented approach (e.g., urinary tract infections) or problem-oriented approach (e.g., antimicrobial resistance) rather than a drug-oriented approach (e.g., cramming classification of antibiotics) or a pathogen-oriented approach (e.g., methicillin-resistant Staphylococcus aureus) [5,18].…”

“…The learning outcomes may be translated later into competencies that can be objectively measured by a concerned body for the accreditation purposes. Similarly, in the United States, a new curriculum on antimicrobial stewardship has been jointly designed by the U.S. Centres for Disease Control and Prevention and the Association of American Medical Colleges [5,21]. While, in Pakistan, conversion of a Bachelor of Pharmacy (a four years degree program) to Doctor of Pharmacy (a five years degree program) happened in 2003 with an aim to inculcate a more patient-oriented (clinical) curricula to pharmacy students.…”

“…Finally, various studies have concluded that it is easier to shape behaviours during early education and training than changing established habits later during professional life [5,22]. While, traditionally, a major focus of education has been on the experienced prescribers and pharmacists, students or residents received little attention.…”

“…The World Health Organization's Global Action Plan emphasizes the education and training of the prescriber and other healthcare professionals as one of five priority interventions to clampdown growing bacterial resistance and optimize the use of antibiotics [4]. Education of healthcare professionals is a continuous process, however, the undergraduate level of medical, pharmacy or any other allied health discipline is the first step to acquire related knowledge and build a strong foundation for any further specialty [5]. Notably, medical and pharmacy students are future healthcare professionals who will be dealing with antibiotics in hospitals, primary care and community settings.…”

Carriage of Multidrug-Resistant Bacteria in Healthy People: Recognition of Several Risk Groups

“…The medical staff (mainly general practitioners) is not sufficiently instructed about antibiotic prescriptions. Guidelines are often complex and not routinely used, while online training sessions seem to be more successful [44].…”