Understanding of Future Prescribers About Antimicrobial Resistance and Their Preparedness Towards Antimicrobial Stewardship Activities in Pakistan: Findings and Implications

Abstract

Background: Insufficient antimicrobial-related training for physicians during their undergraduate education could have a negative impact on their prescribing. Unlike previous studies, this study not only explored the understanding and perception of Pakistani medical students about antibiotics and resistance, but also their preparedness towards antimicrobial stewardship programs.Methods: An online cross-sectional study was undertaken with final-year medical students using a validated questionnaire from January 2021 to May 2021. Descriptive and inference statistics were applied for data analysis.Results: Of 411 students, only 6.3% had undergone antimicrobial resistance (AMR) training. 16.1% of students believed that antibiotics are effective for viral ailments. More than half of the students agreed that AMR is a major healthcare problem in Pakistan (65.9%). Most students viewed poor infection control practices (66.9%), the use of too many broad-spectrum antibiotics (68.4%) for a longer duration (62.8%) with inadequate doses (67.9%) as the causes of AMR. The student’s preparation was insufficient in interpreting microbiological and pathological results (26.3%), selecting the correct antibiotics (22.1%), and awareness of the antibiotic spectrum (20.9%). The median preparedness score showed significant differences with sex (p = 0.049), age (p < 0.001), institute type (p = 0.014), and family income (p = 0.006).Conclusion: Pakistani medical students showed adequate understanding of antibiotics, but lacked preparedness for several components of ASPs, including interpretation of microbiological results and spectrum of antibiotics. More steps need to be taken to prepare medical students for AMR and stewardship initiatives adequately.

Knowledge, Attitudes and Practices of Antibiotic Use and Antimicrobial Resistance among Medical Students in a Private University in Dominica, West Indies

“…This is contradictory to a study in Central India on the knowledge, attitude and where 94% of the respondents were aware that bacteria were not responsible for causing colds and influenza [17] and another study in Pakistan which reported that of 83.5% responding medical students were aware of the ineffectiveness of antibiotics against viral infections [18]. However, a study in Egypt reported findings similar to our study where 36% of the medical students thought that bacteria cause common cold and influenza [19].…”

Exploring Knowledge of Antibiotic Use, Resistance, and Stewardship Programs among Pharmacy Technicians Serving in Ambulatory Care Settings in Pakistan and the Implications

“…We are aware that previous studies have been undertaken among HCWs in the different regions of Pakistan, including physicians and pharmacists as well as medical and pharmacy students, to ascertain key aspects regarding antibiotics use, AMR, and ASPs [ 38 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ]. However, we are unaware of any studies that have been conducted to fully evaluate knowledge of antibiotic use, AMR, and ASPs among pharmacy technicians serving specifically in ambulatory care facilities.…”

Understanding of Final Year Medical, Pharmacy and Nursing Students in Pakistan towards Antibiotic Use, Antimicrobial Resistance and Stewardship: Findings and Implications

“…We believe that this is the first paper in Pakistan that has evaluated the different perspectives of antibiotic use, AMR and ASPs among future medical doctors, pharmacists and nurses among both public and private sector institutions in Pakistan. We are aware that studies have been published with different student cohorts across LMICs including Pakistan; however, we are unaware of any studies that have combined all three key student populations among both public and private universities in LMICs [69,70,[72][73][74][75][76][77][78][79][80][81][82][83]. This is increasingly important, with multidisciplinary teams being key to improving future antibiotic prescribing as part of ASPs [27].…”

“…Moreover, the WHO has stressed that awareness, training, appropriate use, diagnostic stewardship and surveillance, as well as coordination among HCWs, is necessary to combat rising AMR rates [68]. To date, only a few studies have been conducted among medical and pharmacy students in Pakistan about their awareness concerning antibiotic use, AMR and ASPs [69,70]. The current study aimed to address this by evaluating the knowledge of antibiotic use and AMR, and the preparedness towards ASPs, among final year medical, pharmacy and nursing students from Punjab Province in Pakistan.…”