Antimicrobial Resistance in Clinical Infection and Antibiotic Stewardship

A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: 30 September 2024 | Viewed by 5031

Special Issue Editor


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Guest Editor
Department of Pharmacy, Augusta University Medical Center, Augusta, GA 30912, USA
Interests: antimicrobial stewardship; antimicrobial resistance

Special Issue Information

Dear Colleagues,

Antimicrobial resistance represents a pressing public health concern. Robust antimicrobial stewardship programs are employed as a method of mitigating the further development of antimicrobial resistance. While there has been an influx of recent literature concerning antimicrobial resistance as a consequence of inappropriate antimicrobial utilization, there remains a need for evidence supporting innovative antimicrobial stewardship initiatives and their correlation with the prevention of antimicrobial resistance.

This Special Issue aims to provide a comprehensive update on novel or adapted antimicrobial stewardship initiatives and the relative impact seen on antimicrobial resistance. Manuscripts reporting antimicrobial resistance rates and correlations with antimicrobial utilization, as well as those describing antimicrobial stewardship program development, initiatives, and outcomes, will be considered for publication. We welcome original research articles, reviews, or meta-analyses geared at addressing the aforementioned considerations. I hope you will consider submitting your work to this Special Issue of Antibiotics.  

Dr. Daniel T. Anderson
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • antimicrobial stewardship
  • antimicrobial resistance
  • treatment
  • antimicrobials

Published Papers (3 papers)

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Research

15 pages, 358 KiB  
Article
Knowledge and Perceptions of Final-Year Nursing Students Regarding Antimicrobials, Antimicrobial Resistance, and Antimicrobial Stewardship in South Africa: Findings and Implications to Reduce Resistance
by Elisma Teague, Selente Bezuidenhout, Johanna C. Meyer, Brian Godman and Deirdré Engler
Antibiotics 2023, 12(12), 1742; https://doi.org/10.3390/antibiotics12121742 - 16 Dec 2023
Viewed by 1183
Abstract
Antimicrobial resistance (AMR) is being increasingly seen as the next pandemic due to high morbidity and mortality rates, with Sub-Saharan Africa currently having the highest mortality rates driven by high rates of inappropriate prescribing in ambulatory care. In South Africa, nurses typically provide [...] Read more.
Antimicrobial resistance (AMR) is being increasingly seen as the next pandemic due to high morbidity and mortality rates, with Sub-Saharan Africa currently having the highest mortality rates driven by high rates of inappropriate prescribing in ambulatory care. In South Africa, nurses typically provide a range of services, including prescribing, in public ambulatory care clinics. However, little is currently known about the perception of final-year nursing students regarding antibiotic use, AMR, and antimicrobial stewardship (AMS). Consequently, we sought to address this important evidence gap. A quantitative descriptive study using a self-administered online questionnaire via Google Forms® was undertaken among six universities in South Africa offering a Baccalaureus of Nursing. Knowledge on the classes of antibiotics, organisms covered, and mechanism of action was lacking. The sample size to achieve a confidence interval of 95% with a 5% error margin was 174, increased to 200 to compensate for possible attrition. Only 15.3% of nurses knew that ceftazidime is not a fourth-generation cephalosporin, and only 16.1% knew that clavulanic acid does not decrease inflammation at the site of infection. In addition, only 58.9% and 67.7% agreed that the prescribing of broad-spectrum antibiotics and poor infection control, respectively, increase AMR. AMS was also not a well-known concept among final-year nurses. The lack of knowledge regarding antibiotics, AMR, and AMS among final-year nurses could have important repercussions in practice once these nurses are qualified. Consequently, this information gap needs to be urgently addressed going forward with updated curricula and post-qualification educational activities to reduce AMR in South Africa Full article
28 pages, 464 KiB  
Article
A Narrative Review of Antibiotic Prescribing Practices in Primary Care Settings in South Africa and Potential Ways Forward to Reduce Antimicrobial Resistance
by Audrey Chigome, Nishana Ramdas, Phumzile Skosana, Aislinn Cook, Natalie Schellack, Stephen Campbell, Giulia Lorenzetti, Zikria Saleem, Brian Godman and Johanna C. Meyer
Antibiotics 2023, 12(10), 1540; https://doi.org/10.3390/antibiotics12101540 - 14 Oct 2023
Cited by 8 | Viewed by 2096
Abstract
There are concerns with the current prescribing of antibiotics in both the private and public primary care settings in South Africa. These concerns need to be addressed going forward to reduce rising antimicrobial resistance (AMR) rates in South Africa. Concerns include adherence to [...] Read more.
There are concerns with the current prescribing of antibiotics in both the private and public primary care settings in South Africa. These concerns need to be addressed going forward to reduce rising antimicrobial resistance (AMR) rates in South Africa. Concerns include adherence to current prescribing guidelines. Consequently, there is a need to comprehensively summarise current antibiotic utilization patterns from published studies as well as potential activities to improve prescribing, including indicators and antimicrobial stewardship programs (ASPs). Published studies showed that there was an appreciable prescribing of antibiotics for patients with acute respiratory infections, i.e., 52.9% to 78% or more across the sectors. However, this was not universal, with appreciable adherence to prescribing guidelines in community health centres. Encouragingly, the majority of antibiotics prescribed, albeit often inappropriately, were from the ‘Access’ group of antibiotics in the AWaRe (Access/Watch/Reserve) classification rather than ‘Watch’ antibiotics to limit AMR. Inappropriate prescribing of antibiotics in primary care is not helped by concerns with current knowledge regarding antibiotics, AMR and ASPs among prescribers and patients in primary care. This needs to be addressed going forward. However, studies have shown it is crucial for prescribers to use a language that patients understand when discussing key aspects to enhance appropriate antibiotic use. Recommended activities for the future include improved education for all groups as well as regularly monitoring prescribing against agreed-upon guidelines and indicators. Full article
16 pages, 323 KiB  
Article
A Multicenter Cross-Sectional Survey of Knowledge, Attitude, and Practices of Healthcare Professionals towards Antimicrobial Stewardship in Ghana: Findings and Implications
by Israel Abebrese Sefah, Sarentha Chetty, Peter Yamoah, Johanna C. Meyer, Audrey Chigome, Brian Godman and Varsha Bangalee
Antibiotics 2023, 12(10), 1497; https://doi.org/10.3390/antibiotics12101497 - 29 Sep 2023
Cited by 2 | Viewed by 1356
Abstract
Antimicrobial stewardship (AMS) programs are part of the key activities that contribute to reducing antimicrobial resistance (AMR). Good knowledge, attitudes, and practices (KAP) among healthcare professionals (HCPs) are essential to improving future antimicrobial use and reducing AMR, which is a priority in Ghana. [...] Read more.
Antimicrobial stewardship (AMS) programs are part of the key activities that contribute to reducing antimicrobial resistance (AMR). Good knowledge, attitudes, and practices (KAP) among healthcare professionals (HCPs) are essential to improving future antimicrobial use and reducing AMR, which is a priority in Ghana. A multicenter cross-sectional survey was conducted in six public hospitals in Ghana among key HCPs to assess their level of KAP towards AMS using a validated self-administered electronic questionnaire. Data analyses included descriptive and inferential statistics using STATA version 14. Overall, 339 out of 355 HCPs responded to the questionnaire, giving a response rate of 95.5%. Most responders were nurses (n = 256, 78.2%), followed by medical doctors (n = 45, 13.3%). The study recorded both poor knowledge (8.9%) and practice levels (35.4%), as well as a good attitude (78.8%) towards AMS. Ongoing exposure to AMS structured training, exposure to continuous professional development training on AMS in the previous year, and the number of years of working experience were predictors of the HCPs’ level of knowledge (aOR = 3.02 C.I = 1.12–8.11), attitude (aOR = 0.37 C.I = 0.20–0.69) and practice (aOR = 2.09 C.I =1.09–3.99), respectively. Consequently, concentrated efforts must be made to address current low levels of knowledge and poor practices regarding AMS among HCPs in Ghana as part of ongoing strategies in the National Action Plan to reduce AMR. Full article
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