Antimicrobial stewardship knowledge and perception among physicians and pharmacists at leading tertiary teaching hospitals in Zambia: implications for future policy and practice

Kalungia, Aubrey; Mwambula, Haabingozi; Munkombwe, Derick; Marshall, Stephen; Schellack, Natalie; May, Claire; Jones, Anja St Claire; Godman, Brian

doi:10.1080/1120009x.2019.1622293

Cited by 72 publications

(48 citation statements)

References 73 publications

(81 reference statements)

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“…Moreover, strengthening antimicrobial stewardships in all health facilities would create an continual platform of discussion for fresh prescribers and pharmacists to draw evidence-based solutions on antimicrobial resistance [29,30].…”

Section: Discussionmentioning

confidence: 99%

Knowledge and attitudes towards antibiotic use and resistance among undergraduate healthcare students at University of Rwanda

Nisabwe

Brice

Umuhire

et al. 2020

J of Pharm Policy and Pract

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Background: Antimicrobial resistance (AMR) is an imminent threat to modern medicine. As the efficacy of treatment regimens is reduced, mortality and morbidity attributed to infectious diseases is expected to rise dramatically across the globe. Antimicrobial stewardship and good prescription practices are critical to conserving available therapeutics; it is appropriate, therefore, to appraise our attitudes and knowledge of antimicrobial resistance, particularly for the future healthcare practitioners. Methods: This is a descriptive cross-sectional study that was conducted among 282 medicals, dental and pharmacy students from the University of Rwanda. Questionnaires were used to collect data from the 4th to 29th March 2017. Results: Students from Level 3 to level 6 have demonstrated a good knowledge on antibiotics and antimicrobial resistance. Generally, 95% (n = 218) agreed that the inappropriate use of antibiotics could lead to antibiotic resistance. It was found that 96% (n = 220) of the respondents had heard about AMR outside their degree courses. 49% (n = 112) of the participants reported that they are able to purchase antibiotics without a prescription. 96% (n = 220) agreed that it was important for healthcare students to be knowledgeable about antimicrobial resistance. Perhaps most surprisingly, it was found that 83% (n = 191) of participants were unfamiliar with the concept of antimicrobial stewardship and 49% (n = 21) had not yet discussed antimicrobial resistance as part of their education, albeit only 1% (n = 3) was completely unfamiliar with the term. Furthermore, 38% (n = 86) did not support that the antibiotics were overused in Rwanda, 23% (n = 10) did not agree that inappropriate antimicrobial use contributed to antimicrobial resistance, and 50% (n = 22) of participants agreed that antibiotics were indicated in the treatment of pain and inflammation.

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Section: Discussionmentioning

confidence: 99%

Knowledge and attitudes towards antibiotic use and resistance among undergraduate healthcare students at University of Rwanda

Nisabwe

Brice

Umuhire

et al. 2020

J of Pharm Policy and Pract

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“…Excessive and inappropriate use of antibiotics has been a major contributor to the emerging problem of antibiotic resistance [17]. Paediatric patients are largely prone to be a victim of irrational antibiotic usage practice [18].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Prescribing Patterns in Paediatric Patients at Levy Mwanawasa University Teaching Hospital in Lusaka, Zambia

Mudenda¹

2020

Int J Pharm Pharmacol

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The use of antimicrobial agents has become a routine practice for the treatment of paediatric illnesses. The uncontrolled use of antibiotics has caused a rise in antimicrobial resistance. This study aimed to assess the antibiotic prescribing patterns in paediatric patients at Levy Mwanawasa University Teaching Hospital in Lusaka, Zambia. This was a cross-sectional study conducted between April 2019 to July 2019. The study population included both in-patients and outpatients aged between one month and eighteen years whose medical files were reviewed. A sample size of 357 medical files was conveniently sampled. Statistical Package for Social Sciences version 21.0 was used for data analysis. A chi-square test was used to assess the association between categorical variables. A p<0.05 was considered to be statistically significant at 95% confidence level. The majority of the medical files 230 (64.4%) were for paediatrics in the age group of 1 month to 5 years. Antibiotic prescribing was found to be 78.7%. The study revealed that 119 (33.3%) of patients required antibiotics and were on antibiotic treatment while 46 (12.9%) did not require antibiotics but were on antibiotic treatment. The most common diseases 147 (41.2%) were those affecting the respiratory system. The most commonly prescribed antibiotics were penicillins 154 (54.8%), followed by cephalosporins 88 (31.3%). The association between age, white blood cell count status, and system of illness with antibiotic use were statistically significant (χ 2 =15.083, p=0.001; χ 2 = 6.571, p=0.037 and χ 2 =27.717, p<0.0001). The study also found that the frequency of antibiotic use was high among paediatric patients as per the World Health Organization's prescribing indicators. The most commonly prescribed antibiotics to paediatric patients were penicillins.

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“…The importance of AMR surveillance is beginning to gain traction in Africa [9,21,22], although it is often difficult to identify whether data is collated, let alone what trends in prevalence exist. Implementing an effective antimicrobial stewardship programme poses a big challenge in real world settings and legislative knowledge is often low among physicians, pharmacists and veterinarians [13,23]. Alongside surveillance databases and committees, the need to identify country-specific preparedness for potential public health risks, including AMR, resulted in the publication of Joint External Evaluations (JEEs) [24].…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial resistance preparedness in sub-Saharan African countries

Elton

Thomason

Tembo

et al. 2020

Antimicrob Resist Infect Control

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Background: Antimicrobial resistance (AMR) is of growing concern globally and AMR status in sub-Saharan Africa (SSA) is undefined due to a lack of real-time data recording, surveillance and regulation. World Health Organization (WHO) Joint External Evaluation (JEE) reports are voluntary, collaborative processes to assess country capacities and preparedness to prevent, detect and rapidly respond to public health risks, including AMR. The data from SSA JEE reports were analysed to gain an overview of how SSA is working towards AMR preparedness and where strengths and weaknesses lie. Methods: SSA country JEE AMR preparedness scores were analysed. A cumulative mean of all the SSA country AMR preparedness scores was calculated and compared to the overall mean SSA JEE score. AMR preparedness indicators were analysed, and data were weighted by region. Findings: The mean SSA AMR preparedness score was 53% less than the overall mean SSA JEE score. East Africa had the highest percentage of countries reporting having AMR National Action Plans in place, as well as human and animal pathogen AMR surveillance programmes. Southern Africa reported the highest percentage of countries with training programmes and antimicrobial stewardship. Conclusions: The low mean AMR preparedness score compared to overall JEE score, along with the majority of countries lacking implemented National Action Plans, suggests that until now AMR has not been a priority for most SSA countries. By identifying regional and One Health strengths, AMR preparedness can be fortified across SSA with a multisectoral approach.

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Antimicrobial stewardship knowledge and perception among physicians and pharmacists at leading tertiary teaching hospitals in Zambia: implications for future policy and practice

Abstract: Brian (2019) Antimicrobial stewardship knowledge and perception among physicians and pharmacists at leading tertiary teaching hospitals in Zambia: implications for future policy and practice. Journal of Chemotherapy. pp. 1-10.

Cited by 72 publications

References 73 publications

Knowledge and attitudes towards antibiotic use and resistance among undergraduate healthcare students at University of Rwanda

Knowledge and attitudes towards antibiotic use and resistance among undergraduate healthcare students at University of Rwanda

Antibiotic Prescribing Patterns in Paediatric Patients at Levy Mwanawasa University Teaching Hospital in Lusaka, Zambia

Antimicrobial resistance preparedness in sub-Saharan African countries

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