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BackgroundMuch effort has been made over the last two decades to educate and train healthcare professionals working on antimicrobial resistance in French hospitals. However, little has been done in France to assess perceptions, attitudes and knowledge regarding multidrug resistant organisms (MDROs) and, more globally, these have never been evaluated in a large-scale population of medical and non-medical healthcare workers (HCWs). Our aim was to explore awareness among HCWs by evaluating their knowledge of MDROs and the associated control measures, by comparing perceptions between professional categories and by studying the impact of training and health beliefs.MethodsA multicentre cross-sectional study was conducted in 58 randomly selected French healthcare facilities with questionnaires including professional and demographic characteristics, and knowledge and perception of MDRO transmission and control. A knowledge score was calculated and used in a logistic regression analysis to identify factors associated with higher knowledge of MDROs, and the association between knowledge and perception.ResultsBetween June 2014 and March 2016, 8716/11,753 (participation rate, 74%) questionnaires were completed. The mean knowledge score was 4.7/8 (SD: 1.3) and 3.6/8 (SD: 1.4) in medical and non-medical HCWs, respectively. Five variables were positively associated with higher knowledge: working in a university hospital (adjusted odds ratio, 1.41, 95% CI 1.16–1.70); age classes 26–35 years (1.43, 1.23–1.6) and 36–45 years (1.19, 1.01–1.40); medical professional status (3.7, 3.09–4.44), working in an intensive care unit (1.28, 1.06–1.55), and having been trained on control of antimicrobial resistance (1.31, 1.16–1.48). After adjustment for these variables, greater knowledge was significantly associated with four cognitive factors: perceived susceptibility, attitude toward hand hygiene, self-efficacy, and motivation.ConclusionsWe found a low level of MDRO awareness and knowledge of associated control measures among French HCWs. Training on hand hygiene and measures to control MDRO spread may be helpful in shaping beliefs and perceptions on MDRO control among other possible associated factors. Messages should be tailored to professional status and their perception. Other approaches should be designed, with more effective methods of training and cognitive interventions.Trial registrationClinical Trials.gov NCT02265471. Registered 16 October 2014 - Retrospectively registered.
BackgroundMuch effort has been made over the last two decades to educate and train healthcare professionals working on antimicrobial resistance in French hospitals. However, little has been done in France to assess perceptions, attitudes and knowledge regarding multidrug resistant organisms (MDROs) and, more globally, these have never been evaluated in a large-scale population of medical and non-medical healthcare workers (HCWs). Our aim was to explore awareness among HCWs by evaluating their knowledge of MDROs and the associated control measures, by comparing perceptions between professional categories and by studying the impact of training and health beliefs.MethodsA multicentre cross-sectional study was conducted in 58 randomly selected French healthcare facilities with questionnaires including professional and demographic characteristics, and knowledge and perception of MDRO transmission and control. A knowledge score was calculated and used in a logistic regression analysis to identify factors associated with higher knowledge of MDROs, and the association between knowledge and perception.ResultsBetween June 2014 and March 2016, 8716/11,753 (participation rate, 74%) questionnaires were completed. The mean knowledge score was 4.7/8 (SD: 1.3) and 3.6/8 (SD: 1.4) in medical and non-medical HCWs, respectively. Five variables were positively associated with higher knowledge: working in a university hospital (adjusted odds ratio, 1.41, 95% CI 1.16–1.70); age classes 26–35 years (1.43, 1.23–1.6) and 36–45 years (1.19, 1.01–1.40); medical professional status (3.7, 3.09–4.44), working in an intensive care unit (1.28, 1.06–1.55), and having been trained on control of antimicrobial resistance (1.31, 1.16–1.48). After adjustment for these variables, greater knowledge was significantly associated with four cognitive factors: perceived susceptibility, attitude toward hand hygiene, self-efficacy, and motivation.ConclusionsWe found a low level of MDRO awareness and knowledge of associated control measures among French HCWs. Training on hand hygiene and measures to control MDRO spread may be helpful in shaping beliefs and perceptions on MDRO control among other possible associated factors. Messages should be tailored to professional status and their perception. Other approaches should be designed, with more effective methods of training and cognitive interventions.Trial registrationClinical Trials.gov NCT02265471. Registered 16 October 2014 - Retrospectively registered.
Antibiotics are indicated in the prevention and treatment of bacterial infections. Antibiotic resistance is a global healthcare problem, strongly connected to hospital-acquired infections. As drug resistance is world-wild problem new educational programs and prescribing and utilization strategies should be developed. Evaluation of the implementation of the measures by Committee for control and prevention of infections at Clinical Hospital Acibadem Sistina-Skopje and assessment of its function in the monitoring of the level of infections and rationalization in antibiotics prescription in hospitalized patients. Isolates taken from patients in the Clinical Hospital Acibadem Sistina-Skopje were used in this study. Monthly and annual analysis was performed by pharmacist for a controlled group of antibiotics prescribed based on obtained antibiogram results confirmed by a microbiologist.The Committee for Control and Prevention of Infections also monitors the consumption of antibiotics on a monthly and annual basis calculated through the list of published antibiotics in defined daily doses (DDD-Defined daily doses) per 1000 hospital days. Obtained results present that consumption of controlled antibiotics is stable in the evaluated period with a tendency of declination. They are used in indicated patients with the exception of Imipenem/Cilastatin. The evaluation of previously applied to proscribe routine for this combined antibiotic suggested that the patients were sub-dosed. The applied measure resulted in rational and appropriate dosing of the patients and coherent increased consumption of Imipenem/Cilastatin. The second measure applied was associated with the rationalization of surgical profilaxis and substitution of ceftriaxone with cefazolin. The costs in 2016 were 12 421 100 MKD (201 969 Eur), compared to the expenditures in 2017 of 11 891 000 MKD. (193 349 Eur). Implementation of appropriate measures by establishment of the Committee led to the reduction of irrational antibiotics utilization and decrease of the antibiotics associated expenditure in the Clinical Hospital Acibadem Sistina. Keywords: antibiotics, antibiotic resistance, rational antibiotic utilization, expenditures
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