RESEARCH ARTICLE: Knowledge and self-reported confidence in antimicrobial stewardship programme among final year pharmacy undergraduate students in Malaysia and Nigeria
DOI:
https://doi.org/10.46542/pe.2021.211.298305Keywords:
Antibiotic resistance, Antimicrobial stewardship, Antimicrobial therapy, Malaysia, Nigeria, Pharmacy studentsAbstract
Objective: This study evaluated the knowledge and self-reported confidence of antimicrobial stewardship (AMS) among pharmacy students in Malaysia and Nigeria.
Methods: A cross-sectional study was conducted among final year undergraduate pharmacy students in a university from both Nigeria and Malaysia using a 59-item online questionnaire.
Results: A total of 150 final year undergraduate pharmacy students completed the questionnaire. Exposure to infectious diseases clerkship was higher among the Malaysian students (78.2% versus 25.4%; p < 0.001). Overall, the knowledge score for antibiotic resistance and AMS were comparable (6.2 ± 1.5 and 3.6 ± 1.2, respectively versus 5.9 ± 1.6 and 3.3 ± 1.3). The knowledge of antibiotic therapy was higher among the Malaysian students (5.4 ± 1.8 versus 4.2 ± 1.8; p < 0.001) while self-reported confidence to participate in AMS was higher among the Nigerian students (median 48.0, IQR 26 – 75 versus median 36.5, IQR 15 – 75; p < 0.001).
Conclusions: Pharmacy students in Malaysia and Nigeria have appreciable knowledge of antibiotic resistance, antibiotic therapy and AMS. More training on topics is recommended to improve the skills and competency of future pharmacists to participate in AMS.
References
Ab Rahman, N., Teng, C. L., & Sivasampu, S. (2016). Antibiotic prescribing in public and private practice: a cross-sectional study in primary care clinics in Malaysia. BMC infectious diseases, 16(1), 208. https://doi.org/10.1186/s12879-016-1530-2
Abubakar, U. (2020). Practices and perceptions of Nigerian community pharmacists toward antimicrobial stewardship program. International Journal of Pharmacy and Pharmaceutical Sciences, 12(4), 37-42. https://doi.org/10.22159/ijpps.2020v12i4.36505
Abubakar, U. (2020). Antibiotic use among hospitalized patients in northern Nigeria: a multicenter point-prevalence survey. BMC Infectious Diseases, 20(1), 86. https://doi.org/10.1186/s12879-020-4815-4
Abubakar, U., & Tangiisuran, B. (2020). Knowledge and practices of community pharmacists towards non-prescription dispensing of antibiotics in Northern Nigeria. International journal of clinical pharmacy, 1-9. https://doi.org/10.1007/s11096-020-01019-y
Abubakar, U., & Tangiisuran, B. (2020). Nationwide survey of pharmacists’ involvement in antimicrobial stewardship programs in Nigerian tertiary hospitals. Journal of global antimicrobial resistance, 21, 148-153. https://doi.org/10.1016/j.jgar.2019.10.007
Abubakar, U., Muhammad, H. T., Sulaiman, S. A. S., Ramatillah, D. L., & Amir, O. (2020). Knowledge and self-confidence of antibiotic resistance, appropriate antibiotic therapy, and antibiotic stewardship among pharmacy undergraduate students in three Asian countries. Currents in Pharmacy Teaching and Learning. https://doi.org/10.1016/j.cptl.2019.12.002
Abubakar, U., Sulaiman, S. S., & Adesiyun, A. G. (2018). Utilization of surgical antibiotic prophylaxis for obstetrics and gynaecology surgeries in Northern Nigeria. International journal of clinical pharmacy, 40(5), 1037-1043. https://doi.org/10.1007/s11096-018-0702-0
Abubakar, U., Syed Sulaiman, S. A., & Adesiyun, A. G. (2019). Impact of pharmacist-led antibiotic stewardship interventions on compliance with surgical antibiotic prophylaxis in obstetric and gynecologic surgeries in Nigeria. PloS one, 14(3), e0213395. https://doi.org/10.1371/journal.pone.0213395
Auta, A., Hadi, M. A., Oga, E., Adewuyi, E. O., Abdu-Aguye, S. N., Adeloye, D., ... & Morgan, D. J. (2019). Global access to antibiotics without prescription in community pharmacies: A systematic review and meta-analysis. Journal of Infection, 78(1), 8-18. https://doi.org/10.1016/j.jinf.2018.07.001
Brink, A. J., Messina, A. P., Feldman, C., Richards, G. A., Becker, P. J., Goff, D. A., ... & Alliance, N. A. S. S. (2016). Antimicrobial stewardship across 47 South African hospitals: an implementation study. The Lancet Infectious Diseases, 16(9), 1017-1025. https://doi.org/10.1016/S1473-3099(16)30012-3
Burger, M., Fourie, J., Loots, D., Mnisi, T., Schellack, N., Bezuidenhout, S., & Meyer, J. C. (2016). Knowledge and perceptions of antimicrobial stewardship concepts among final year pharmacy students in pharmacy schools across South Africa. Southern African Journal of Infectious Diseases, 31(3), 84-90. https://doi.org/10.1080/23120053.2016.1192808
Centers for Disease Control and Prevention. (2017). Core elements of hospital antibiotic stewardship programs. Atlanta, GA: US Department of Health and Human Services, CDC; 2014
European Centre for Disease Prevention and Control & European Medicines Agency. The Bacterial Challenge: Time to React-A Call to Narrow the Gap between Multidrug-Resistant Bacteria in the EU and the Development of New Antibacterial Agents. ECDC/EMEA Joint Technical report. 2009
Justo, J. A., Gauthier, T. P., Scheetz, M. H., Chahine, E. B., Bookstaver, P. B., Gallagher, J. C., ... & Esterly, J. S. (2014). Knowledge and attitudes of doctor of pharmacy students regarding the appropriate use of antimicrobials. Clinical Infectious Diseases, 59(suppl_3), S162-S169. https://doi.org/10.1093/cid/ciu537
Pollack, L. A., & Srinivasan, A. (2014). Core elements of hospital antibiotic stewardship programs from the Centers for Disease Control and Prevention. Clinical Infectious Diseases, 59(suppl_3), S97-S100. https://doi.org/10.1093/cid/ciu542
Ponto, J. A. (2010). ASHP statement on the pharmacist’s role in antimicrobial stewardship and infection prevention and control. Am J Health Syst Pharm, 67, 575. https://doi.org/10.2146/sp100001
Rizvi, T., Thompson, A., Williams, M., & Zaidi, S. T. R. (2018). Perceptions and current practices of community pharmacists regarding antimicrobial stewardship in Tasmania. International journal of clinical pharmacy, 40(5), 1380-1387. https://doi.org/10.1007/s11096-018-0701-1
Tham, D. W. J., Abubakar, U., & Tangiisuran, B. (2020). Prevalence and predictors of antibiotic use among children visiting the Emergency Department in a Tertiary Hospital in Malaysia. European Journal of Pediatrics, 1-6. https://doi.org/10.1007/s00431-019-03560-z
US Department of Health and Human Services. Antibiotic resistance threats in the United States. Centers for Disease Control and Prevention. (2013). Available at: https://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf
Wang, J., Dong, M., Lu, Y., Zhao, X., Li, X., & Wen, A. (2015). Impact of pharmacist interventions on rational prophylactic antibiotic use and cost saving in elective cesarean section. International Journal of Clinical Pharmacology and Therapeutics, 53(8), 605-15. https://doi.org/10.5414/CP202334
Weier, N., Tebano, G., Thilly, N., Demoré, B., Pulcini, C., & Zaidi, S. T. R. (2018). Pharmacist participation in antimicrobial stewardship in Australian and French hospitals: a cross-sectional nationwide survey. Journal of Antimicrobial Chemotherapy, 73(3), 804-813. https://doi.org/10.1093/jac/dkx435
Wickens, H. J., Farrell, S., Ashiru-Oredope, D. A. I., Jacklin, A., Holmes, A., Antimicrobial Stewardship Group of the Department of Health Advisory Committee on Antimicrobial Resistance and Health Care-Associated Infections (ASG-ARHAI), ... & Dryden, M. (2013). The increasing role of pharmacists in antimicrobial stewardship in English hospitals. Journal of Antimicrobial Chemotherapy, 68(11), 2675-2681. https://doi.org/10.1093/jac/dkt241
World Health Organization. (2014). Antimicrobial resistance: global report on surveillance. World Health Organization