Veterinarians’ Perception, Knowledge and Practices of Antibiotic Stewardship in Enugu State Southeast, Nigeria

Abstract

A cross-sectional survey utilizing structured questionnaires was used to study the veterinarians' perception, knowledge and practices of antibiotic stewardship (ABS) in Enugu State, Southeastern Nigeria. Data obtained were analyzed using chi-square on SPSS (Version 15.0) at a significance level of P < 0.05 to determine possible associations between variables and perceptions/knowledge about ABS. Out of 280 respondents, 41 (17.1%) had heard about ABS. Minority of the respondents perceived/knew that using antibiotics only when necessary (6.4%, 18), administering antibiotics at the appropriate dose (6.4%, 18) and administering antibiotics for appropriate duration in every case (4.3%, 12) were among the principles of ABS. The study also showed that age, gender, qualification, years of practice and locations did not exert any influence (P > 0.05) on the awareness of respondents about ABS. More than one-third of the respondents wrongly perceived that increasing the use of broad-spectrum antibiotics (35.4%, 99) is one of the goals of ABS, whereas the minority of the respondents rightly perceived/knew that minimizing toxicity and other adverse effects (16.8%, 47) and reducing antibiotic resistance (ABR) (43.2%, 121) are also goals of ABS. Only 21.4% (60) had overall knowledge of ABS. Prescribing antibiotics without seeing/examining the patient, prescribing antibiotics for any case suspected to be infectious, prescribing broad-spectrum antibiotics despite availability of narrow-spectrum antibiotics, prescribing different classes/types of antibiotics concurrently to ensure therapeutic efficacy, prescribing overdose of antibiotics to ensure efficacy and non-consultation of the veterinary formulary/other resources when in doubt during prescription, are some of inappropriate/untoward ABS practices/behaviors/attitudes amongst the respondents. No significant association (P > 0.05) was found between practices of ABS and age, gender, qualification, years of practice and location. In conclusion, the veterinarians' awareness/perception and practices of ABS is abysmally poor in the study area, thus education of Nigerian veterinarians about ABS and the teaching of the principles and practices of ABS during veterinary schools are recommended.

Veterinary Medical Students’ Perceptions, Attitude and Knowledge about Antibiotic Resistance and Stewardship: How Prepared Are Our Future Prescribers?

“…In Nigeria, a fresh VM graduate is expected to start prescribing drugs from inception of a compulsory one year national youth service, thus every Nigerian veterinarian is a potential prescriber and dispenser of AB (Fairles, 2013;Anyanwu and Kolade, 2017), and there are limited opportunities (if there is any) for postgraduate training in ABS, particularly outside the academic setting (Wasserman et al, 2017). Further, there is no residency (house job/internship) programme for fresh VM graduates, and veterinarians (most of which have no experience/skill on graduation) are allowed to start prescribing (with or without supervision by senior veterinarians) and dispensing AB immediately on graduation from veterinary schools (Anyanwu and Kolade, 2017). Given the importance of veterinarians as key partners in ABS efforts, VMS should therefore be knowledgeable about ABR and ABS (Brink et al, 2017).…”

“…Ferdoush et al (2016) reported that 6% among 171 4th-year students in 3 Bangladeshi medical schools were familiar with the term AMS while less than two-third of 289 final-year students in 3 South African medical schools reported familiarity with the term ABS (Wasserman et al, 2017). Anyanwu and Kolade (2017) reported that 17.1% among 280 practicing/teaching veterinarians in Enugu State Nigeria have heard of ABS. The disparities in these studies may be due to differences in ABS awareness education that has been conducted in the various health profession institutions, degree of integration in the curricula and teaching of AMS education in the institutions, and/or the degree of AMS education awareness that has been conducted via sources such as mass media, journals, peers, etc in the study area (Lee et al, 2015;Anyanwu and Kolade, 2017).…”

“…Anyanwu and Kolade (2017) reported that 17.1% among 280 practicing/teaching veterinarians in Enugu State Nigeria have heard of ABS. The disparities in these studies may be due to differences in ABS awareness education that has been conducted in the various health profession institutions, degree of integration in the curricula and teaching of AMS education in the institutions, and/or the degree of AMS education awareness that has been conducted via sources such as mass media, journals, peers, etc in the study area (Lee et al, 2015;Anyanwu and Kolade, 2017). Among the NVS that reported familiarity with the term ABS, highest number reported that they heard about ABS from their lecturer while a very minority of them heard/learnt of ABS from their peers, senior colleagues, mass media and/or scientific journals (Lee et al, 2015).…”

“…The low awareness about ABS observed in this study, suggested that there is little or no effort in Nigeria to educate veterinary students about ABS and there is also little or no ABS education awareness in form of seminars, symposium, radio jingles, etc in Nigeria (Lee et al, 2015). It also suggested that the curricula of Nigerian veterinary medical schools might be deficient on issues of ABS (Anyanwu and Kolade, 2017).…”

“…In Nigerian veterinary medical schools, courses on ABR are taught in the 3 rd and 4 th years in Microbiology and Pharmacology, and students are further exposed to AB sensitivity testing and prescription in the 6 th (final) year during clinical postings/rotations in their respective institutional veterinary teaching hospitals (VTHs) (Anyanwu and Kolade, 2017). No study has evaluated Nigerian veterinary medical students' perceptions, attitude and knowledge about ABR and ABS.…”