Knowledge and perceptions of antimicrobial stewardship concepts among final year pharmacy students in pharmacy schools across South Africa

Abstract

Background: Antimicrobial stewardship is currently not mandatory as part of the undergraduate training of pharmacists. Identifying gaps in knowledge and a better understanding of pharmacy students’ perceptions about antimicrobial stewardship could assist in recommendations for appropriate changes to the pharmacy degree curricula that may lead to more appropriate use of antimicrobials, within the multi-disciplinary team.Methods: A descriptive quantitative study with a survey design was conducted at the eight universities offering the pharmacy degree in South Africa. An electronic questionnaire with four main categories on antimicrobial stewardship was administered to final (fourth) year pharmacy students (June–August 2015).Results: An overall response rate of 26.6% (n = 260) was obtained from 978 students, despite a weekly reminder. Most of the respondents were familiar with antimicrobial stewardship programmes in South Africa (71.9%), and claimed to know what antimicrobial stewardship is (83.5%) with significant differences between the universities (p 0.001). Only 37.7% of the respondents recalled having had formal training on antimicrobial stewardship, with responses from the eight universities differing significantly (p 0.001). However, almost all respondents (98.5%) felt that a strong knowledge of antimicrobials was important for their future career, with 90.0% indicating that they would like more training on antimicrobial stewardship at undergraduate level.Conclusion: There were significant differences between the eight universities with regards to undergraduate education on antimicrobial stewardship. In order to help prevent antimicrobial resistance, efforts should be made to introduce concepts of antimicrobial stewardship into the undergraduate pharmacy curricula to promote better use of antimicrobials and prevent antimicrobial resistance.

Perceptions and current practices of community pharmacists regarding antimicrobial stewardship in Tasmania

“…Likewise, pharmacists also believed that AMS programs in the community will reduce inappropriate antibiotic use and healthcare costs. Our results are consistent with the study of Burger et al [ 25 ] where the majority of respondents indicated that AMR is a worldwide problem and pharmacists have an important role to play in tackling this problem. The perceived barriers pharmacists reported in the study included lack of access to patient’s clinical and laboratory data and lack of co-operation from the GP when the community pharmacist intervenes regarding selection of antibiotics, both of which can be inter-related.…”

Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan

“…However, our findings are similar to the findings of Shahid et al where there were concerns with the knowledge and attitude of healthcare professionals towards AMR32 as well as among pharmacy students and community pharmacies in other countries 10 33. There are also concerns regarding the knowledge of ASPs among pharmacy students in South Africa 16…”

“…In addition, in a number of LMICs, patients cannot afford to see both a physician and purchase any medicine. This is leading to calls to improve the education of pharmacists about the aetiology of common infections, side-effects of antimicrobials and appropriate dispensing of antimicrobials, starting in pharmacy schools and continuing with the production of appropriate guidelines for pharmacists, which is beginning to happen and will continue 16. We are aware of the high rates of self-purchasing of antimicrobials and other medicines in Pakistan often for economic reasons as well as ease of access 17–19.…”

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

“…A lack of knowledge of antibiotics and resistance was highlighted among pharmacy students and physicians in India and Pakistan, with the majority of physicians admitting to no training on rational antibiotic use (63,73,74). Similarly, there were concerns about the level of knowledge of antibiotics and AMR among medical students in South Africa (75) as well as appreciable differences in the knowledge and perception of AMS programmes among final year pharmacy students in South Africa (62). The majority of physicians and nurses in Ethiopia also lack knowledge about antimicrobials and AMR (60), with physicians in Saudi Arabia believing education and adherence to guidelines can reduce AMR rates in hospitals (61).…”

“…However, to develop and provide potential initiatives to address irrational antimicrobial use in Zambia, there is a need to identify and address knowledge gaps including practice and behaviours of healthcare providers, which may be driving up AMR rates (51). We are aware through previous research by other scholars that there is variable knowledge of antibiotics and AMR among key stakeholder groups including physicians and pharmacists (52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63), with pharmacists typically being a member of AMS groups within hospitals (35,64,65). Lack of knowledge about antibiotic utilisation, AMR and AMS practice is a concern in the local setting.…”