Perspectives on Antibiotic Stewardship Programs among Health Care Providers at Two University Hospitals in Egypt

Abstract

The perspectives of healthcare professionals on antibiotic stewardship programs (ASPs) should be explored. Any antibiotic stewardship strategy must be individualized based on patient needs, prescription habits, and local resources. The current study aimed to explore the perspectives of healthcare providers on antibiotics stewardship and their awareness of these perspectives. Furthermore, potential barriers to the application of ASPs should be identified and addressed. This exploratory cross-sectional study utilized a qualitative method to evaluate critical care physicians, pediatricians, and clinical pharmacists (n = 43). The mean age of the physicians was 32 ± 1.5 years. Among them, approximately two-thirds (66%) were women. A thematic content analysis was performed to examine the responses of the participants and to prioritize the recommendations for and barriers to the implementation of ASPs from the perspective of healthcare providers. According to the interviewees, the primary obstacles include lack of time in implementation and monitoring and lack of awareness of the need for ASPs. All respondents recommended the implementation of supervised and continuous trainings. In conclusion, the abovementioned barriers must be adequately addressed to facilitate the implementation of ASPs.

Barriers, facilitators, perceptions and impact of interventions in implementing antimicrobial stewardship programs in hospitals of low-middle and middle countries: a scoping review

“…Other identified barriers included inadequate orientation and training on ASP including rational antimicrobial use [ 27 , 30 , 36 , 41 , 44 , 46 ], prescribers’ negative attitudes to changes in antibiotic practices [ 27 , 30 , 33 , 35 , 37 , 43 , 47 ], and a lack of dedicated ASP funds [ 28 , 32 , 33 , 36 , 37 , 41 ]. Five studies each cited the absence of approved national guidelines or educational programs [ 27 , 36 , 43 , 45 , 48 ], and time constraints for prescribers [ 28 , 30 , 36 , 41 , 48 ] as barriers. The ‘Others’ category included challenges like incomplete electronic medical records (EMR), long waiting times for tests, overcrowding in wards [ 30 , 46 ], the perception of AMR as an ‘external problem’ [ 49 ], frequent staff turnover, lack of specific ASP goals [ 36 ], stock shortage of antimicrobials [ 35 ], and suboptimal salary [ 36 ].…”

Assessment of Physicians’ Practice in Implementing Antibiotic Stewardship Program in Najran City, Saudi Arabia: A Cross-Sectional Study

“…In order to design the first version of the questionnaire, an extensive review of the relevant literature [1,[3][4][5][6][7][8][9]12,13] was carried out. Subsequently, experts in the fields of community medicine, pharmacy, and epidemiology were consulted to ensure the content validity of the questionnaire.…”

“…It was noted that many doctors had misconceptions about the rational use of antibiotics, and Antibiotic Stewardship Programs were perceived poorly [3]. A study conducted in two university hospitals in Egypt found that most physicians and clinical pharmacists had limited awareness of ASPs and inconsistent knowledge regarding their usefulness, efficacy, and applications in ASPs [7]. In Bangladesh, a recent study has found the irrational use of antimicrobials to be prevalent among many physicians, which showed that 81% of the prescriptions had at least two antibiotics [8].…”

The Role of Government Initiatives in Supporting Education and Health Issues in the Arab World Study in Egypt and Saudi Arabia

“…In Egypt government should focus on healthcare professionals' perspectives on antibiotic stewardship programs, as they have considered barriers like time and awareness, emphasizing the need for supervised training and successful implementation (Salem et al, 2023). Egypt should prioritise the foundational education, practical training and exploring the potential funding in healthcare to promote pharmacogenetic implementation (Nagy et al, 2020).…”