The knowledge, attitude and practice of health practitioners towards antibiotic prescribing and resistance in developing countries—A systematic review

Chaw, Pa Saidou; Höpner, Jens; Mikolajczyk, Rafael

doi:10.1111/jcpt.12730

Cited by 46 publications

(45 citation statements)

References 36 publications

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“…Different surveys across the globe indicate that many patients firmly believe antibacterial agents would help with viral diseases like the common cold or flu 9. Furthermore, in many developing countries where there are deficiencies in proper diagnostic tools, patient management is predominantly contingent upon the prescription of medicine, particularly antibiotics 18. Administering antibiotics when they are actually not needed for the treatment is another example of common misuse of them 4,18.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, in many developing countries where there are deficiencies in proper diagnostic tools, patient management is predominantly contingent upon the prescription of medicine, particularly antibiotics 18. Administering antibiotics when they are actually not needed for the treatment is another example of common misuse of them 4,18. Moreover, many antibiotics are of poor quality and sold over the counter in the developing countries 4.…”

Section: Introductionmentioning

confidence: 99%

“…According to Klein et al, between 2000 and 2015, global antibiotic use elevated by 65% 34. This significant rise in global antibiotic use is predominantly because of overconsumption of antibiotics in developing countries which is the direct result of rising incomes 18,34. In other words, the rise in Growth Domestic Product (GDP) as well as living standards in low and middle-income countries (LMICs) have shown to be positively correlated with antibiotic consumption 34,35.…”

Section: Introductionmentioning

confidence: 99%

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Antimicrobial Resistance: Implications and Costs

Dadgostar¹

2019

IDR

1,043

729

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Antimicrobial resistance (AMR) has developed as one of the major urgent threats to public health causing serious issues to successful prevention and treatment of persistent diseases. In spite of different actions taken in recent decades to tackle this issue, the trends of global AMR demonstrate no signs of slowing down. Misusing and overusing different antibacterial agents in the health care setting as well as in the agricultural industry are considered the major reasons behind the emergence of antimicrobial resistance. In addition, the spontaneous evolution, mutation of bacteria, and passing the resistant genes through horizontal gene transfer are significant contributors to antimicrobial resistance. Many studies have demonstrated the disastrous financial consequences of AMR including extremely high healthcare costs due to an increase in hospital admissions and drug usage. The literature review, which included articles published after the year 2012, was performed using Scopus, PubMed and Google Scholar with the utilization of keyword searches. Results indicated that the multifactorial threat of antimicrobial resistance has resulted in different complex issues affecting countries across the globe. These impacts found in the sources are categorized into three different levels: patient, healthcare, and economic. Although gaps in knowledge about AMR and areas for improvement are obvious, there is not any clearly understood progress to put an end to the persistent trends of antimicrobial resistance.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Antimicrobial Resistance: Implications and Costs

Dadgostar¹

2019

IDR

1,043

729

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“…These all contribute to the existence of burden of AMR. 11 One major challenge in developing countries is selfmedication with antibiotics (53.5%). 12 AMR is a problem with multi-damage that can be tackled by the public if it is used responsibly.…”

Section: Introductionmentioning

confidence: 99%

Knowledge and Attitude Towards Antimicrobial Resistance of Graduating Health Science Students of Wollega University

Fetensa¹,

Tolossa²,

Fekadu³

et al. 2020

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Background: Antimicrobial resistance is a worldwide concern due to the inappropriate and irrational use of antibiotics. Thus, this study was aimed at determining the knowledge and attitude of graduating health science students of Wollega University towards antimicrobial resistance. Methods: An institution-based cross-sectional study design was employed from June to July 2019. Epi-data version 3.1 was used to receive data and exported to SPSS version 25 for further analysis. Both bivariable and multivariable logistic regression analysis were done to find factors associated with attitudes of students towards antibiotic consumption and resistance at a 95% confidence level. The strength of association was measured with the odds ratio. Variables with a p-value of <0.05 at multivariable analysis were considered to be a significant variable. Finally, texts and simple frequency tables were used to present the findings. Results: Out of 249, 232 students were included in this survey yielding a response rate of 93.6%. Hundred fifty-eight (68.1%) of them had adequate knowledge about antibiotic identification, role, side effects, and resistance. Students with a family member who works in health and related professions had a lower probability of stopping antibiotics when they feel better (AOR = 0.50, 95% CI: 0.28-0.90) and using leftover antibiotics (AOR = 0.51, 95% CI: 0.28-0.92) compared to their counterparts. Conclusion: Students' knowledge on antibiotic identification, role, side effects, and resistance was suboptimal, and the attitude of students towards antibiotic consumption was unfavorable. Respondents having a family member in a health-related field showed a good attitude. Respondents with three years of study also had a good attitude, female gender showed good attitude, and urban residence were independent predictors of attitude toward antibiotic consumption. Training on antimicrobial resistance should be arranged for graduating class nursing and medical students, as they are the future prescribers.

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“…Antibiotic resistance is a global health threat, largely because of antibiotic use [ 1 – 3 ]. Use of antibiotics is also associated with unfavourable effects (e.g.…”

Section: Introductionmentioning

confidence: 99%

Oral prednisolone for acute otitis media in children: a pilot, pragmatic, randomised, open-label, controlled study (OPAL study)

Ranakusuma

McCullough

Safitri

et al. 2020

Pilot Feasibility Stud

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Background Acute otitis media (AOM) is associated with high antibiotic prescribing rates. Antibiotics are somewhat effective in improving pain and middle ear effusion (MEE); however, they have unfavourable effects. Alternative treatments, such as corticosteroids as anti-inflammatory agents, are needed. Evidence for the efficacy of these remains inconclusive. We conducted a pilot study to test feasibility of a proposed large-scale randomised controlled trial (RCT) to assess the efficacy of corticosteroids for AOM. Methods We conducted a pilot, pragmatic, parallel, open-label RCT of oral corticosteroids for paediatric AOM in primary and secondary/tertiary care centres in Indonesia. Children aged 6 months–12 years with AOM were randomised to either prednisolone or control (1:1). Physicians were blinded to allocation. Our objectives were to test the feasibility of our full RCT procedures and design, and assess the mechanistic effect of corticosteroids, using tympanometry, in suppressing middle ear inflammation by reducing MEE. Results We screened 512 children; 62 (38%) of 161 eligible children were randomised and 60 were analysed for the primary clinical outcome. All study procedures were completed successfully by healthcare personnel and parents/caregivers, despite time constraints and high workload. All eligible, consenting children were appropriately randomised. One child did not take the medication and four received additional oral corticosteroids. Our revised sample size calculation verified 444 children are needed for the full RCT. Oral corticosteroids did not have any discernible effects on MEE resolution and duration. There was no correlation between pain or other symptoms and MEE change. However, prednisolone may reduce pain intensity at day 3 (Visual Analogue Scale mean difference − 7.4 mm, 95% confidence interval (CI) − 13.4 to − 1.3, p = 0.018), but cause drowsiness (relative risk (RR) 1.8, 95% CI 1.1 to 2.8, p = 0.016). Tympanometry curves at day 7 may be improved (RR 1.8, 95% CI 1.0 to 2.9). We cannot yet confirm these as effects of corticosteroids due to insufficient sample size in this pilot study. Conclusions It is feasible to conduct a large, pragmatic RCT of corticosteroids for paediatric AOM in Indonesia. Although oral corticosteroids may reduce pain and improve tympanometry curves, it requires an adequately powered clinical trial to confirm this. Trial registration Study registry number: ACTRN12618000049279. Name of registry: the Australian New Zealand Clinical Trials Registry (ANZCTR). Date of registration: 16 January 2018.

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The knowledge, attitude and practice of health practitioners towards antibiotic prescribing and resistance in developing countries—A systematic review

Cited by 46 publications

References 36 publications

<p>Antimicrobial Resistance: Implications and Costs</p>

<p>Antimicrobial Resistance: Implications and Costs</p>

<p>Knowledge and Attitude Towards Antimicrobial Resistance of Graduating Health Science Students of Wollega University</p>

Oral prednisolone for acute otitis media in children: a pilot, pragmatic, randomised, open-label, controlled study (OPAL study)

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