Understanding of Pharmacy Students towards Antibiotic Use, Antibiotic Resistance and Antibiotic Stewardship Programs: A Cross-Sectional Study from Punjab, Pakistan
Abstract
:1. Introduction
2. Methodology
2.1. Study Setting
2.2. Questionnaire Development
2.3. Sample Size
2.4. Data Collection
2.5. Ethics Approval
2.6. Statistical Analysis
3. Results
3.1. Demographics
3.2. Understanding towards Antibiotic Use
3.3. Understanding of Antibiotic Resistance
3.4. Understanding of the Mode of Action of Antibiotics
3.5. Understanding of the Factors of Antibiotic Resistance
3.6. Attitude toward Reducing Antibiotic Resistance
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Martin, J.K.; Sheehan, J.P.; Bratton, B.P.; Moore, G.M.; Mateus, A.; Li, S.H.-J.; Kim, H.; Rabinowitz, J.D.; Typas, A.; Savitski, M.M.; et al. A Dual-Mechanism Antibiotic Kills Gram-Negative Bacteria and Avoids Drug Resistance. Cell 2020, 181, 1518–1532.e14. [Google Scholar] [CrossRef] [PubMed]
- Implementation of the Global Action Plan on AMR. WHO GAP AMR Newletter No. 24. Available online: https://www.who.int/antimicrobial-resistance/news/who-gap-amr-newsletter-march-2017.pdf (accessed on 10 December 2020).
- US Department of Health and Human Services. Antibiotic Resistance Threats in the United States, Centers for disease control and prevention. Available online: https://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf (accessed on 10 December 2020).
- ECDC/EMEA Joint Technical Report. 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. European Centre for Disease Prevention and Control & European Medicines Agency. Available online: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/0909_TER_The_Bacterial_Challenge_Time_to_React.pdf (accessed on 10 December 2020).
- Auta, A.; Hadi, M.A.; Oga, E.; Adewuyi, E.O.; Abdu-Aguye, S.N.; Adeloye, D.; Strickland-Hodge, B.; Morgan, D.J. Global access to antibiotics without prescription in community pharmacies: A systematic review and meta-analysis. J. Infect. 2019, 78, 8–18. [Google Scholar] [CrossRef] [PubMed]
- Hayat, K.; Rosenthal, M.M.; Gillani, A.H.; Zhai, P.; Aziz, M.M.; Li, J.; Chang, J.; Hu, H.; Fang, Y. Perspective of Pakistani Physicians towards Hospital Antimicrobial Stewardship Programs: A Multisite Exploratory Qualitative Study. Int. J. Environ. Res. Public Health 2019, 16, 1565. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Hayat, K.; Li, P.; Rosenthal, M.; Xu, S.; Chang, J.; Gillani, A.H.; Khan, F.U.; Sarwar, M.R.; Ji, S.; Shi, L.; et al. Perspective of community pharmacists about community-based antimicrobial stewardship programs. A multicenter cross-sectional study from China. Expert Rev. Anti-Infect. Ther. 2019, 17, 1043–1050. [Google Scholar] [CrossRef] [PubMed]
- Chaintarli, K.; Ingle, S.M.; Bhattacharya, A.; Ashiru-Oredope, D.; Oliver, I.; Gobin, M. Impact of a United Kingdom-wide campaign to tackle antimicrobial resistance on self-reported knowledge and behaviour change. BMC Public Health 2016, 16, 393. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lim, J.M.; Singh, S.R.; Duong, M.C.; Legido-Quigley, H.; Hsu, L.Y.; Tam, C. Impact of national interventions to promote responsible antibiotic use: A systematic review. J. Antimicrob. Chemother. 2020, 75, 14–29. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- World Health Organization. Global Action Plan on Antimicrobial Resistance. Available online: http://www.wpro.who.int/entity/drug_resistance/resources/global_action_plan_eng.pdf (accessed on 10 December 2020).
- Justo, J.A.; Gauthier, T.P.; Scheetz, M.H.; Chahine, E.B.; Bookstaver, P.B.; Gallagher, J.C.; Hermsen, E.D.; DePestel, D.D.; Ernst, E.J.; Jacobs, D.M.; et al. Knowledge and Attitudes of Doctor of Pharmacy Students Regarding the Appropriate Use of Antimicrobials. Clin. Infect. Dis. 2014, 59, S162–S169. [Google Scholar] [CrossRef] [Green Version]
- Fay, L.N.; Wolf, L.M.; Brandt, K.L.; Deyoung, G.R.; Anderson, A.M.; Egwuatu, N.E.; Dumkow, L.E. Pharmacist-led antimicrobial stewardship program in an urgent care setting. Am. J. Health Pharm. 2019, 76, 175–181. [Google Scholar] [CrossRef]
- Westerhof, L.R.; Dumkow, L.E.; Hanrahan, T.L.; McPharlin, S.V.; Egwuatu, N.E. Outcomes of an ambulatory care pharmacist-led antimicrobial stewardship program within a family medicine resident clinic. Infect. Control. Hosp. Epidemiol. 2020, 1–7. [Google Scholar] [CrossRef]
- Gebretekle, G.B.; Mariam, D.H.; Taye, W.A.; Fentie, A.M.; Degu, W.A.; Alemayehu, T.; Beyene, T.; Libman, M.; Fenta, T.G.; Yansouni, C.P.; et al. Half of Prescribed Antibiotics Are Not Needed: A Pharmacist-Led Antimicrobial Stewardship Intervention and Clinical Outcomes in a Referral Hospital in Ethiopia. Front. Public Health 2020, 8, 109. [Google Scholar] [CrossRef] [Green Version]
- Deshpande, P.R.; Vantipalli, R.; Lakshmi, C.H.C.; Rao, E.J.; Regmi, B.; Ahad, A.; Nirojini, P.S. Clinical pharmacists: The major support to Indian healthcare system in near future. J. Pharm. Bioallied Sci. 2015, 7, 161–174. [Google Scholar] [CrossRef]
- Bhagavathula, A.S.; Sarkar, B.R.; Patel, I. Clinical pharmacy practice in developing countries: Focus on India and Pakistan. Arch. Pharm. Pr. 2014, 5, 91. [Google Scholar] [CrossRef]
- Shi, L.; Chang, J.; Liu, X.; Zhai, P.; Hu, S.; Li, P.; Hayat, K.; Kabba, J.A.; Feng, Z.; Yang, C.; et al. Dispensing Antibiotics without a Prescription for Acute Cough Associated with Common Cold at Community Pharmacies in Shenyang, Northeastern China: A Cross-Sectional Study. Antibiotics 2020, 9, 163. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ashraf, M.S.; Chung, P.; Neukirch, A.; Bergman, S.; Cavalieri, R.J.; Ortmeier, R.; Rupp, M.; Wichman, C.; Van Schooneveld, T.C. Impact of Training Consultant Pharmacists on Antimicrobial Stewardship Programs in Long-Term Care Facilities. Infect. Control. Hosp. Epidemiol. 2020, 41, s446–s448. [Google Scholar] [CrossRef]
- The Drug Act. Available online: http://punjablaws.gov.pk/laws/1458a.html (accessed on 12 December 2020).
- Pharmacy Council of Pakistan. Available online: https://www.pharmacycouncil.org.pk/ (accessed on 12 December 2020).
- Rajiah, K.; Ren, W.S.; Jamshed, S.Q. Evaluation of the understanding of antibiotic resistance among Malaysian pharmacy students at public universities: An exploratory study. J. Infect. Public Health 2015, 8, 266–273. [Google Scholar] [CrossRef] [Green Version]
- Inácio, J.; Barnes, L.-M.; Jeffs, S.; Castanheira, P.S.P.; Wiseman, M.; Inácio, S.; Bowler, L.; Lansley, A. Master of Pharmacy students’ knowledge and awareness of antibiotic use, resistance and stewardship. Curr. Pharm. Teach. Learn. 2017, 9, 551–559. [Google Scholar] [CrossRef]
- Zhou, X.D.; Wang, X.; Tucker, J.D.; Little, P.; Moore, M.; Fukuda, K.; Zhou, X.D. Knowledge, Attitude, and Practice with Respect to Antibiotic Use among Chinese Medical Students: A Multicentre Cross-Sectional Study. Int. J. Environ. Res. Public Health 2018, 15, 1165. [Google Scholar] [CrossRef] [Green Version]
- Sakeena, M.H.F.; Bennett, A.A.; Jamshed, S.Q.; Mohamed, F.; Herath, D.R.; Gawarammana, I.; McLachlan, A.J. Investigating knowledge regarding antibiotics and antimicrobial resistance among pharmacy students in Sri Lankan universities. BMC Infect. Dis. 2018, 18, 209. [Google Scholar] [CrossRef]
- Burger, M.; Fourie, J.; Loots, D.; Mnisi, T.; Schellack, N.; Bezuidenhout, S.; Meyer, J.C. Knowledge and perceptions of antimicrobial stewardship concepts among final year pharmacy students in pharmacy schools across South Africa. South. Afr. J. Infect. Dis. 2016, 31, 84–90. [Google Scholar]
- Gottlieb, T.; Nimmo, G.R. Antibiotic resistance is an emerging threat to public health: An urgent call to action at the Antimicrobial Resistance Summit. Med. J. Aust. 2011, 194, 281–283. [Google Scholar] [CrossRef]
- Zaidi, S.F.; Alotaibi, R.; Nagro, A.; AlSalmi, M.; Almansouri, H.; Khan, M.A.; Khan, A.; Memon, I. Knowledge and Attitude Towards Antibiotic Usage: A Questionnaire-Based Survey Among Pre-Professional Students at King Saud bin Abdulaziz University for Health Sciences on Jeddah Campus, Saudi Arabia. Pharmacy 2020, 8, 5. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Sun, Q.; Dyar, O.J.; Zhao, L.; Tomson, G.; Nilsson, L.E.; Grape, M.; Song, Y.; Yan, L.; Lundborg, C.S. Overuse of antibiotics for the common cold—attitudes and behaviors among doctors in rural areas of Shandong Province, China. BMC Pharmacol. Toxicol. 2015, 16, 1–6. [Google Scholar] [CrossRef] [PubMed]
- Hayat, K.; Li, P.; Rosenthal, M.; Ji, S.; Fang, Y. Community pharmacists’ knowledge about antibiotics and their perceptions of and participation in community-based antimicrobial stewardship programmes: A cross-sectional survey from central China. Lancet 2019, 394, S68. [Google Scholar] [CrossRef]
- Li, P.; Hayat, K.; Shi, L.; Lambojon, K.; Saeed, A.; Aziz, M.M.; Liu, T.; Ji, S.; Gong, Y.; Feng, Z.; et al. Knowledge, Attitude, and Practices of Antibiotics and Antibiotic Resistance Among Chinese Pharmacy Customers: A Multicenter Survey Study. Antibiotics 2020, 9, 184. [Google Scholar] [CrossRef] [PubMed]
- Ali, M.; Abbasi, B.H.; Ahmad, N.; Fazal, H.; Khan, J.; Ali, S.S. Over-the-counter medicines in Pakistan: Misuse and overuse. Lancet 2020, 395, 116. [Google Scholar] [CrossRef] [Green Version]
- Saleem, Z.; Hassali, M.A.; Godman, B.; Fatima, M.; Ahmad, Z.; Sajid, A.; Rehman, I.U.; Nadeem, M.U.; Javaid, Z.; Malik, M.; et al. Sale of WHO AWaRe groups antibiotics without a prescription in Pakistan: A simulated client study. J. Pharm. Policy Pr. 2020, 13, 1–8. [Google Scholar] [CrossRef] [PubMed]
- Hayat, K.; Rosenthal, M.; Gillani, A.H.; Chang, J.; Ji, W.; Yang, C.; Jiang, M.; Zhao, M.; Fang, Y. Perspective of Key Healthcare Professionals on Antimicrobial Resistance and Stewardship Programs: A Multicenter Cross-Sectional Study from Pakistan. Front. Pharmacol. 2020, 10, 1520. [Google Scholar] [CrossRef]
- Asghar, S.; Atif, M.; Mushtaq, I.; Malik, I.; Hayat, K.; Babar, Z.-U.-D. Factors associated with inappropriate dispensing of antibiotics among non-pharmacist pharmacy workers. Res. Soc. Adm. Pharm. 2020, 16, 805–811. [Google Scholar] [CrossRef]
- Dulon, M.; Peters, C.; Schablon, A.; Nienhaus, A. MRSA carriage among healthcare workers in non-outbreak settings in Europe and the United States: A systematic review. BMC Infect. Dis. 2014, 14, 363. [Google Scholar] [CrossRef] [Green Version]
- Da Silva, L.S.; Andrade, Y.M.S.; Oliveira, A.C.; Cunha, B.C.; Oliveira, E.G.; Cunha, T.S.; Mafra, S.S.; Almeida, J.B.; Carvalho, S.P.; Nascimento, F.S.; et al. Prevalence of methicillin-resistant Staphylococcus aureus colonization among healthcare workers at a tertiary care hospital in northeastern Brazil. Infect. Prev. Pr. 2020, 2, 100084. [Google Scholar] [CrossRef]
- Joachim, A.; Moyo, S.J.; Nkinda, L.; Majigo, M.V.; Rugarabamu, S.; Mkashabani, E.G.; Mmbaga, E.J.; Mbembati, N.; Aboud, S.; Lyamuya, E.F. Nasal Carriage of Methicillin-Resistant Staphylococcus aureus among Health Care Workers in Tertiary and Regional Hospitals in Dar es Salam, Tanzania. Int. J. Microbiol. 2018, 2018, 5058390–5058397. [Google Scholar] [CrossRef] [Green Version]
- Wilson, H.L.; Daveson, K.; Del Mar, C.B. Optimal antimicrobial duration for common bacterial infections. Aust. Prescr. 2019, 42, 5–9. [Google Scholar] [CrossRef] [PubMed]
- Zilahi, G.; McMahon, M.A.; Póvoa, P.; Martin-Loeches, I. Duration of antibiotic therapy in the intensive care unit. J. Thorac. Dis. 2016, 8, 3774–3780. [Google Scholar] [CrossRef] [Green Version]
- Lucet, J.-C.; Nicolas-Chanoine, M.-H.; Roy, C.; Riveros-Palacios, O.; Diamantis, S.; Le Grand, J.; Papy, E.; Rioux, C.; Fantin, B.; Lefort, A.; et al. Antibiotic use: Knowledge and perceptions in two university hospitals. J. Antimicrob. Chemother. 2011, 66, 936–940. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Hayat, K.; Rosenthal, M.; Zhu, S.; Gillani, A.H.; Chang, J.; Bogale, A.A.; Kabba, J.A.; Yang, C.; Jiang, M.; Zhao, M.; et al. Attitude of clinicians towards hospital-based antimicrobial stewardship programs: A multicenter cross-sectional study from Punjab, Pakistan. Expert Rev. Anti-Infect. Ther. 2019, 17, 661–669. [Google Scholar] [CrossRef] [PubMed]
- Kufel, W.D.; Jeffres, M.N.; MacDougall, C.; Cho, J.C.; Marx, A.H.; Williams, D.M. Antimicrobial stewardship education in US colleges and schools of pharmacy. J. Antimicrob. Chemother. 2018, 73, 2252–2258. [Google Scholar] [CrossRef]
- Khan, Y.; Kritiotis, L.; Coetzee, R.; McCartney, J.; Boschmans, S.-A. An Antimicrobial Stewardship Curriculum to Incorporate in the South African Bachelor of Pharmacy Degree Program. Am. J. Pharm. Educ. 2019, 84, ajpe7669. [Google Scholar] [CrossRef]
- McNulty, C.; Cookson, B.D.; Lewis, M.A.O. Education of healthcare professionals and the public. J. Antimicrob. Chemother. 2012, 67, i11–i18. [Google Scholar] [CrossRef] [Green Version]
- Majumder, A.A.; Singh, K.; Hilaire, M.G.-S.; Rahman, S.; Sa, B.; Haque, M. Tackling Antimicrobial Resistance by promoting Antimicrobial stewardship in Medical and Allied Health Professional Curricula. Expert Rev. Anti-Infect. Ther. 2020, 18, 1245–1258. [Google Scholar] [CrossRef]
- Kandeel, A.; Palms, D.L.; Afifi, S.; Kandeel, Y.; Etman, A.; Hicks, L.A.; Talaat, M. An educational intervention to promote appropriate antibiotic use for acute respiratory infections in a district in Egypt-pilot study. BMC Public Health 2019, 19, 498. [Google Scholar] [CrossRef]
- Gajdács, M.; Paulik, E.; Szabó, A. Knowledge, attitude and practice of community pharmacists regarding antibiotic use and infectious diseases: A cross-sectional survey in Hungary (KAPPhA-HU). Antibiotics 2020, 9, 41. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Nisabwe, L.; Brice, H.; Umuhire, M.C.; Gwira, O.; Harelimana, J.D.D.; Nzeyimana, Z.; Sebatunzi, O.R.; Rusingiza, E.; Hahirwa, I.; Muvunyi, C.M. Knowledge and attitudes towards antibiotic use and resistance among undergraduate healthcare students at University of Rwanda. J. Pharm. Policy Pr. 2020, 13, 1–8. [Google Scholar] [CrossRef] [PubMed]
- Daina, L.G.; Sabău, M.; Daina, C.M.; Neamțu, C.; Tit, D.M.; Buhaș, C.L.; Bungau, C.; Aleya, L.; Bungau, S. Improving performance of a pharmacy in a Romanian hospital through implementation of an internal management control system. Sci. Total. Environ. 2019, 675, 51–61. [Google Scholar] [CrossRef] [PubMed]
Variable | Frequency (n) | Percentage (%) |
---|---|---|
Gender | ||
Male | 112 | 37.8 |
Female | 184 | 62.2 |
Age (years) | ||
19–21 | 59 | 19.9 |
22–24 | 231 | 78.0 |
>24 | 6 | 2.0 |
Type of University | ||
Public | 148 | 50.0 |
Private | 148 | 50.0 |
Questions | Yes | No | Do Not Know | Correct Rate | Median (IQR) |
---|---|---|---|---|---|
Antibiotics are the most commonly prescribed anti-infective agents by public health-care sector facilities | 261 (88.2) | 30 (10.1) | 5 (1.7) | 261 (88.2) | 1 (0) |
Antibiotics are the most commonly prescribed anti-infective agents by private health-care sector facilities | 219 (74.0) | 67 (22.6) | 10 (3.4) | 219 (74.0) | 1 (1) |
Common cold if treated with antibiotics will make the patients recover more quickly | 129 (43.6) | 130 (43.9) | 37 (12.5) | 130 (43.9) | 2 (1) |
Antibiotics should be prescribed as preventive measures to fight against future microbial attacks | 152 (51.4) | 124 (41.9) | 20 (6.8) | 124 (41.9) | 1 (1) |
Antibiotics cannot treat influenza | 134 (45.3) | 138 (46.6) | 24 (8.1) | 134 (45.3) | 2 (1) |
Antibiotics are indicated to relieve pain | 100 (33.8) | 164 (55.4) | 32 (10.8) | 164 (55.4) | 2 (1) |
Antibiotics might develop allergy in susceptible individuals | 215 (72.6) | 58 (19.6) | 23 (7.8) | 215 (72.6) | 1 (1) |
Diphenhydramine is an antibiotic used in treating upper respiratory infections | 149 (50.3) | 117 (39.5) | 30 (10.1) | 117 (39.5) | 1 (1) |
Cefotaxime belongs to the third-generation cephalosporins | 179 (60.5) | 69 (23.3) | 48 (16.2) | 179 (60.5) | 1 (1) |
Patients can stop taking antibiotics when the symptoms are improving | 98 (33.1) | 161 (54.4) | 37 (12.5) | 161 (54.4) | 2 (1) |
Keeping the left-over antibiotic course for the next time treatment of the same type of infection is a good practice | 68 (23.0) | 211 (71.3) | 17 (5.7) | 211 (71.3) | 2 (0) |
Antibiotics treatment can eliminate most of the sensitive bacterial cells from patients | 170 (57.4) | 100 (33.8) | 26 (8.8) | 170 (57.4) | 1 (1) |
Antibiotics can be obtained without a prescription in Pakistan | 221 (74.7) | 63 (21.3) | 12 (4.1) | 221 (74.7) | 1 (1) |
Antibiotics are the first line of treatment in sore throat | 123 (41.6) | 132 (44.6) | 41 (13.9) | 132 (44.6) | 2 (1) |
Questions | Yes | No | Do Not Know | Correct Rate | Median (IQR) |
---|---|---|---|---|---|
A resistant bacterium cannot spread in healthcare institutions | 121 (40.9) | 168 (56.8) | 7 (2.4) | 168 (56.8) | 2 (1) |
Health care workers serve as vectors carrying resistant strains from infected patients to normal patients | 160 (54.1) | 120 (40.5) | 16 (5.4) | 160 (54.1) | 1 (1) |
Exposure to antibiotics appears to be the principal risk factor for the emergence of antibiotic-resistant bacteria | 215 (72.6) | 59 (19.9) | 22 (7.4) | 215 (72.6) | 1 (1) |
Inadequate duration of therapy contributes to antibiotic resistance leading to poor patient compliance | 189 (63.9) | 90 (30.4) | 17 (5.7) | 189 (63.9) | 1 (1) |
Inadequate doses contribute to antibiotic resistance due to poorly designed dosing regimen | 222 (75.0) | 57 (19.3) | 17 (5.7) | 222 (75.0) | 1 (0.75) |
Antimicrobial resistance can be minimized through changing empiric therapy to a selected narrow-spectrum therapy in response to the availability of culture and sensitivity results | 219 (74.0) | 60 (20.3) | 17 (5.7) | 219 (74.0) | 1 (1) |
Cross-resistance is the condition in which resistance occurs to a particular antibiotic that often results in resistance to other antibiotics, usually from a similar class | 185 (62.5) | 83 (28.0) | 28 (9.5) | 185 (62.5) | 1 (1) |
Lack of enforcement regulation sometimes permits antibiotics to be purchased without a prescription from pharmacies | 206 (69.6) | 80 (27.0) | 10 (3.4) | 206 (69.6) | 1 (1) |
Questions | Yes | No | Do Not Know | Correct Rate | Median (IQR) |
---|---|---|---|---|---|
Beta-lactamase is an enzyme produced by bacteria that breakdown the beta-lactam antibiotics | 213 (72.0) | 72 (24.3) | 11 (3.7) | 213 (72.0) | 1 (1) |
Bacteria acquire efflux pumps that extrude the antibacterial agent from the cell before it can reach its target site and exert its effect | 164 (55.4) | 67 (22.6) | 65 (22.0) | 164 (55.4) | 1 (1) |
There is no resistance to penicillin for Streptococcus pyogenes bacteria | 90 (30.4) | 113 (38.2) | 93 (31.4) | 90 (30.4) | 2 (2) |
Bacteriostatic antibiotics are the same as bactericidal antibiotics | 48 (16.2) | 191 (64.5) | 57 (19.3) | 191 (64.5) | 2 (0) |
Antibiotic refers to any agent used to kill or inhibit the growth of microorganisms | 180 (60.8) | 70 (23.6) | 46 (15.5) | 180 (60.8) | 1 (1) |
Enterococcus is a vancomycin-resistant bacterium | 115 (38.9) | 79 (26.7) | 102 (34.5) | 115 (38.9) | 2 (2) |
Questions | Yes | No | Do Not Know | Correct Rate | Median (IQR) |
---|---|---|---|---|---|
The mutation is a prevalence factor in changing the bacterial protein, which is often the target of antibiotic treatment | 188 (63.5) | 61 (20.6) | 47 (15.9) | 188 (63.5) | 1 (1) |
The use of broad-spectrum antibiotics (e.g., 4th generation cephalosporins) as initial therapy for mild infection may increase the risk of antibiotic resistance | 189 (63.9) | 83 (28.0) | 24 (8.1) | 189 (63.9) | 1 (1) |
The use of commercially available biocide antiseptics in soaps is highly recommended to patients who have skin infections | 182 (61.5) | 87 (29.4) | 27 (9.1) | 87 (29.4) | 1 (1) |
Antibiotic resistance tends to be a feature of urban social change | 199 (67.2) | 58 (19.6) | 39 (13.2) | 199 (67.2) | 1 (1) |
Healthcare acquired infections are a breeding ground for antimicrobial resistance | 194 (65.5) | 65 (22.0) | 37 (12.5) | 194 (65.5) | 1 (1) |
Questions | Strongly Agree | Agree | Neutral | Disagree | Strongly Disagree | Median (IQR) |
---|---|---|---|---|---|---|
Educating healthcare professional in terms of appropriate antibiotic prescribing | 158 (53.4) | 99 (33.4) | 31 (10.5) | 4 (1.4) | 4 (1.4) | 1 (1) |
Formal teaching on the proper usage of antimicrobial agents among health care students may minimize the phenomenon of antibiotic resistance | 150 (50.7) | 101 (34.1) | 27 (9.1) | 17 (5.7) | 1 (0.3) | 1 (1) |
Antimicrobial education is needed to be well received by healthcare practitioners | 164 (55.4) | 91 (30.7) | 23 (7.8) | 12 (4.1) | 6 (2.0) | 1 (1) |
The usage of antibiotics must be related to specialities to enhance the awareness of antibiotic resistance | 126 (42.6) | 132 (44.6) | 17 (5.7) | 13 (4.4) | 8 (2.7) | 2 (1) |
Appropriate use of the antibiotic may not have any impact on the hospital’s total cost expenses on medications | 18 (6.1) | 0(0.0) | 49 (16.6) | 171 (57.8) | 58 (19.6) | 4 (0) |
Prescribing antibiotics over the phone is a good patient care | 67 (22.6) | 0(0.0) | 58 (19.6) | 155 (52.4) | 16 (5.4) | 4 (1) |
The patient should be advised to keep part of the antibiotic course for another occasion which will help them in cutting down the medical cost | 21 (7.1) | 116 (39.2) | 56 (18.9) | 60 (20.3) | 43 (14.5) | 3 (2) |
Pharmacists should be encouraged to dispense antibiotics to meet the patients demands | 81 (27.4) | 123 (41.6) | 41 (13.9) | 25 (8.4) | 26 (8.8) | 6 (4) |
Variable | Median ABU Score (IQR) | p-Value | Median Knowledge Score (IQR) | p-Value | Median ABR Mechanism Score (IQR) | p-Value | Median FAR Score (IQR) | p-Value | Median Attitude Score (IQR) | p-Value |
---|---|---|---|---|---|---|---|---|---|---|
Gender * | ||||||||||
Male | 1.5 (1.00) | 0.235 | 1.0 (0.88) | 0.491 | 1.5 (0.50) | 0.116 | 1.0 (1.00) | 0.527 | 2.0 (0.50) | 0.010 |
Female | 1.0 (1.00) | 1.0 (0.50) | 1.5 (0.50) | 1.0 (1.00) | 2.0 (0.50) | |||||
Age (years) ** | ||||||||||
19–21 | 1.5 (1.00) | 0.128 | 1.5 (1.00) | 0.001 | 2.0 (0.50) | 0.002 | 1.0 (1.00) | 0.798 | 2.0 (1.00) | 0.043 |
22 to 24 | 1.0 (1.00) | 1.0 (0.50) | 1.5 (1.00) | 1.0 (1.00) | 2.0 (1.00) | |||||
>24 | 1.0 (1.00) | 1.0 (1.00) | 2.0 (0.75) | 1.0 (1.25) | 2.0 (0.50) | |||||
University type * | ||||||||||
Public | 1.5 (1.00) | <0.001 | 1.5 (1.00) | <0.001 | 1.5 (1.00) | 0.143 | 1.0 (1.00) | <0.001 | 2.0 (1.50) | 0.002 |
Private | 1.0 (0.88) | 1.0 (0.00) | 1.5 (1.00) | 1.0 (0.00) | 2.0 (0.50) |
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Hayat, K.; Jamshed, S.; Rosenthal, M.; Haq, N.U.; Chang, J.; Rasool, M.F.; Malik, U.R.; Rehman, A.U.; Khan, K.M.; Fang, Y. Understanding of Pharmacy Students towards Antibiotic Use, Antibiotic Resistance and Antibiotic Stewardship Programs: A Cross-Sectional Study from Punjab, Pakistan. Antibiotics 2021, 10, 66. https://doi.org/10.3390/antibiotics10010066
Hayat K, Jamshed S, Rosenthal M, Haq NU, Chang J, Rasool MF, Malik UR, Rehman AU, Khan KM, Fang Y. Understanding of Pharmacy Students towards Antibiotic Use, Antibiotic Resistance and Antibiotic Stewardship Programs: A Cross-Sectional Study from Punjab, Pakistan. Antibiotics. 2021; 10(1):66. https://doi.org/10.3390/antibiotics10010066
Chicago/Turabian StyleHayat, Khezar, Shazia Jamshed, Meagen Rosenthal, Noman Ul Haq, Jie Chang, Muhammad Fawad Rasool, Usman Rashid Malik, Anees Ur Rehman, Kashif Maqbool Khan, and Yu Fang. 2021. "Understanding of Pharmacy Students towards Antibiotic Use, Antibiotic Resistance and Antibiotic Stewardship Programs: A Cross-Sectional Study from Punjab, Pakistan" Antibiotics 10, no. 1: 66. https://doi.org/10.3390/antibiotics10010066
APA StyleHayat, K., Jamshed, S., Rosenthal, M., Haq, N. U., Chang, J., Rasool, M. F., Malik, U. R., Rehman, A. U., Khan, K. M., & Fang, Y. (2021). Understanding of Pharmacy Students towards Antibiotic Use, Antibiotic Resistance and Antibiotic Stewardship Programs: A Cross-Sectional Study from Punjab, Pakistan. Antibiotics, 10(1), 66. https://doi.org/10.3390/antibiotics10010066