Antimicrobial Prescribing Confidence and Knowledge Regarding Drug Resistance: Perception of Medical Students in Malaysia and the Implications

Abstract

Background: Worldwide, microbes are becoming more challenging by acquiring virulent skills to adapt and develop antimicrobial resistance (AMR). This is a concern as AMR increases morbidity, mortality, and costs. Consequently, physicians need to be trained on appropriate antimicrobial prescribing, starting as medical students. Objective: To evaluate medical students’ confidence in antimicrobial prescribing and AMR. Methods: Cross-sectional study assessing medical students’ knowledge, perception, and confidence in prescribing antimicrobials and AMR in a Malaysian University. A universal sampling method was used. Results: Most responding students believed that educational input regarding overall prescribing was sufficient. Regarding the principle of appropriate and accurate prescriptions, female medical students had less knowledge (odds ratio (OR) = 0.51; 95% confidence interval (CI) 0.25–0.99; p = 0.050). Year-IV and year-V medical students had more excellent knowledge than year-III students regarding confidence in potential antibiotic prescribing once qualified. Year-V students also showed an appreciably higher confidence in the broad principles of prescribing, including antibiotics for infectious diseases, compared to those in other years. Conclusion: Overall, medical students gain more knowledge and confidence regarding the potential prescribing of antimicrobials as their academic careers progress. This is important given concerns with the current excessive use of antimicrobials in Malaysia.

Evaluation of Healthcare Students’ Knowledge on Antibiotic Use, Antimicrobial Resistance and Antimicrobial Stewardship Programs and Associated Factors in a Tertiary University in Ghana: Findings and Implications

“…We believe this is the first study of its kind in Ghana involving both health and allied science students in a single university. Encouragingly, there was a good overall level of knowledge regarding antibiotics among most of the healthcare students at the University of Health and Allied Sciences in Ghana, which is similar to some studies conducted among students in LMICs [ 53 , 54 , 58 , 59 ]. However, this is different from other studies conducted among students in LMICs where there have been concerns with their knowledge [ 46 , 55 , 56 , 64 , 82 , 83 ].…”

“…This could be due to differences in the structure and depth of the curriculum among these different healthcare students regarding these key subject areas. As a result, leading to a greater exposure to the principles of antimicrobial stewardship (AMS) among the former group compared to the latter, similar to other studies conducted among LMICs [ 54 , 65 , 82 , 84 ]. The healthcare students from the School of Pharmacy were also observed as having a slightly better overall knowledge with respect to these subject areas.…”

“…A structured self-administered 35-item questionnaire was developed using online google forms for the survey, based on published literature of similar student studies including validated questionnaires, combined with the considerable knowledge and experience of the co-authors [ 54 , 58 , 60 , 66 , 89 ]. We have used this approach previously to investigate key issues and their implications across LMICs [ 8 , 31 , 81 , 86 , 90 , 91 , 92 , 93 ].…”

“…However, most studies particularly in LMICs that have evaluated the knowledge of healthcare students regarding antibiotics and AMR have typically been conducted separately among medical students [ 47 , 51 , 52 , 53 , 54 , 55 , 56 ], pharmacy students [ 57 , 58 , 59 , 60 , 61 , 62 ], nursing and paramedic students with only a limited number of studies conducted among a combination of healthcare students [ 48 , 63 , 64 , 65 , 66 , 67 , 68 ]. This is a concern as a good uniform knowledge regarding antibiotic use, AMR, and ASPs is essential to optimize the future use of antimicrobials with all key stakeholders involved, which is in line with the goals of the Ghanaian NAP and beyond [ 30 , 32 ].…”

Knowledge, attitudes and behaviours regarding antibiotics use among Cypriot university students: a multi-disciplinary survey

“…Similarly, a number of studies from several different countries have also recommended improvements in the knowledge and use of antibiotics among dental students [ 31 – 33 ]. In terms of medical students, Haque et al reported better knowledge scores among medical students in years 4–5, than among those in year three [ 34 ].…”