Exploring Nurses’ Perception of Antibiotic Use and Resistance: A Qualitative Inquiry

Abstract

Purpose Quality use of antibiotics and the development of antibiotic resistance is a global catastrophe. In the conceptual context, the phenomenon is correlated with the healthcare practitioners’ understanding of antibiotic use and resistance. Therefore, the study aimed to highlight nurses’ perception of antibiotic use and resistance at a public healthcare institute in Quetta City, Pakistan. Respondents and Methods By using a semi-structured interview guide through the phenomenology-based approach, in-depth, face-to-face interviews were conducted. Nurses practicing at the surgical and medical units of Sandeman Provincial Hospital (SPH), Quetta, were approached for the study. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework. Results Although the saturation was reached after the 13th interview, an additional two were interviewed for absolute validation. Content analysis revealed five major themes: (1) defining antibiotics and antibiotic resistance, (2) antibiotic use: awareness and concern, (3) antimicrobial resistance: awareness and concern, (4) responding to antibiotic use and resistance, and (5) barriers to quality use of antibiotics and prevention of antibiotic resistance. Even though the understanding of nurses regarding antibiotic use and resistance was promising, certain apprehensions were also observed. The respondents were aware of the critical situation and provided valuable insights that can offer significant input while promoting the quality use of antibiotics in a developing country. Conclusion While the perception towards antibiotics appeared positive, potential areas of concern and contributing factors regarding antibiotic resistance were also identified. Importantly, nurses too highlighted possible solutions to address the issue of irrational antibiotic use and the development of antibiotic resistance.

Drivers of inappropriate use of antimicrobials in South Asia: A systematic review of qualitative literature

“…Multiple studies reported a widespread shortage of medical infrastructure, equipment, and personnel across diverse settings, resulting in poor access to laboratory testing and diagnostics. In urban settings, there is a shortage of hospital personnel paired with a high volume of patients, leading to the prescription of common antimicrobial regimens without in-depth assessment of patients or laboratory testing [ 82 , 88 , 95 , 99 , 102 , 103 ]. Additionally, physicians are often unavailable or there are long wait times, prompting individuals to obtain antimicrobials on their own rather than access these formal facilities [ 28 , 66 , 77 , 84 ].…”

“…receiving an antimicrobial prescription because they believe it will successfully treat their children, elders, and other vulnerable groups [81,86]. The high value placed on antimicrobials and belief in their power leads patients to expect and even demand antimicrobials when seeking medical care [87][88][89]. Patients will "doctor shop" or seek care only from providers who are known to readily provide antimicrobials or pharmacies that are liberal with their distribution [65,[90][91][92].…”

Drivers of inappropriate use of antimicrobials in South Asia: A systematic review of qualitative literature

“…Additionally, caregivers report feeling a sense of emotional relief receiving an antimicrobial prescription because they believe it will successfully treat their children, elders, and other vulnerable groups (81,86). The high value placed on antimicrobials and belief in their power leads patients to expect and even demand antimicrobials when seeking medical care (87)(88)(89).…”

Effect of Educational Guidelines regarding Preventive Measures of Antibiotic Resistance on Nursing Students’ Knowledge and Attitude

“…Poor knowledge of the healthcare professionals regarding quality use of antibiotics, lack of antibiotic stewardship programs for healthcare professionals including nurses, self-medication by the general public due to insufficient knowledge and financial crisis especially in the developing countries are the main contributing factors towards the development of antimicrobial resistance. Also, the patients' expectation for antibiotics is another factor influencing physicians' antibiotic prescribing behaviors (Anwar et al, 2021).…”

“…Among all healthcare professionals, nurses are an integral component of the healthcare system. Nurses have direct interaction with the patients during the drug administration process and play an important role in ensuring quality use of medicines (Anwar et al, 2021).…”