Understanding of Future Prescribers About Antimicrobial Resistance and Their Preparedness Towards Antimicrobial Stewardship Activities in Pakistan: Findings and Implications

doi:10.3389/fphar.2022.771083

. 2022 Mar 8:13:771083.

doi: 10.3389/fphar.2022.771083. eCollection 2022.

Understanding of Future Prescribers About Antimicrobial Resistance and Their Preparedness Towards Antimicrobial Stewardship Activities in Pakistan: Findings and Implications

Khezar Hayat^{1

2

3

4}, Noor Fatima⁵, Muhammad Farooq Umer⁶, Farman Ullah Khan^{1

2

3}, Faiz Ullah Khan^{1

2

3}, Zia Ul Rehman Najeeb⁵, Muhammad Abuzar Ghaffari⁷, Syed Qasim Raza⁸, Wenchen Liu^{1

2

3}, Chen Chen^{1

2

3}, Yu Fang^{1

2

3}

Affiliations

¹ Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.
² Centre for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.
³ Shaanxi Centre for Health Reform and Development Research, Xi'an, China.
⁴ Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan.
⁵ Department of Pharmacology, Central Park Medical College, Lahore, Pakistan.
⁶ Al-Shifa School of Public Health, Rawalpindi, Pakistan.
⁷ Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan.
⁸ Institute of Biochemistry and Biotechnology, University of Veterinary and Animal Sciences, Lahore, Pakistan.

PMID: 35350757
PMCID: PMC8957880
DOI: 10.3389/fphar.2022.771083

Understanding of Future Prescribers About Antimicrobial Resistance and Their Preparedness Towards Antimicrobial Stewardship Activities in Pakistan: Findings and Implications

Khezar Hayat et al. Front Pharmacol. 2022.

. 2022 Mar 8:13:771083.

doi: 10.3389/fphar.2022.771083. eCollection 2022.

Authors

Affiliations

¹ Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China.
² Centre for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.
³ Shaanxi Centre for Health Reform and Development Research, Xi'an, China.
⁴ Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan.
⁵ Department of Pharmacology, Central Park Medical College, Lahore, Pakistan.
⁶ Al-Shifa School of Public Health, Rawalpindi, Pakistan.
⁷ Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan.
⁸ Institute of Biochemistry and Biotechnology, University of Veterinary and Animal Sciences, Lahore, Pakistan.

PMID: 35350757
PMCID: PMC8957880
DOI: 10.3389/fphar.2022.771083

Abstract

Background: Insufficient antimicrobial-related training for physicians during their undergraduate education could have a negative impact on their prescribing. Unlike previous studies, this study not only explored the understanding and perception of Pakistani medical students about antibiotics and resistance, but also their preparedness towards antimicrobial stewardship programs. Methods: An online cross-sectional study was undertaken with final-year medical students using a validated questionnaire from January 2021 to May 2021. Descriptive and inference statistics were applied for data analysis. Results: Of 411 students, only 6.3% had undergone antimicrobial resistance (AMR) training. 16.1% of students believed that antibiotics are effective for viral ailments. More than half of the students agreed that AMR is a major healthcare problem in Pakistan (65.9%). Most students viewed poor infection control practices (66.9%), the use of too many broad-spectrum antibiotics (68.4%) for a longer duration (62.8%) with inadequate doses (67.9%) as the causes of AMR. The student's preparation was insufficient in interpreting microbiological and pathological results (26.3%), selecting the correct antibiotics (22.1%), and awareness of the antibiotic spectrum (20.9%). The median preparedness score showed significant differences with sex (p = 0.049), age (p < 0.001), institute type (p = 0.014), and family income (p = 0.006). Conclusion: Pakistani medical students showed adequate understanding of antibiotics, but lacked preparedness for several components of ASPs, including interpretation of microbiological results and spectrum of antibiotics. More steps need to be taken to prepare medical students for AMR and stewardship initiatives adequately.

Keywords: Pakistan; antibiotics; antimicrobial resistance; antimicrobial stewardship programs; medical students; preparedness.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

**FIGURE 1**
Resources used by medial students for antimicrobial resistant related information (Always and often combined).

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References

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1. Asghar S., Atif M., Mushtaq I., Malik I., Hayat K., Babar Z. U. (2020). Factors Associated with Inappropriate Dispensing of Antibiotics Among Non-pharmacist Pharmacy Workers. Res. Soc. Adm Pharm 16 (6), 805–811. 10.1016/j.sapharm.2019.09.003 - DOI - PubMed

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[1] Abbo L. M., Cosgrove S. E., Pottinger P. S., Pereyra M., Sinkowitz-Cochran R., Srinivasan A., et al. (2013). Medical Students' Perceptions and Knowledge about Antimicrobial Stewardship: How Are We Educating Our Future Prescribers. Clin. Infect. Dis. 57 (5), 631–638. 10.1093/cid/cit370 - DOI - PubMed

[2] Abbo L. M., Cosgrove S. E., Pottinger P. S., Pereyra M., Sinkowitz-Cochran R., Srinivasan A., et al. (2013). Medical Students' Perceptions and Knowledge about Antimicrobial Stewardship: How Are We Educating Our Future Prescribers. Clin. Infect. Dis. 57 (5), 631–638. 10.1093/cid/cit370 - DOI - PubMed

[3] Abrar S., Hussain S., Khan R. A., Ul Ain N., Haider H., Riaz S. (2018). Prevalence of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae: First Systematic Meta-Analysis Report from Pakistan. Antimicrob. Resist. Infect. Control. 7 (26), 26–0309. 10.1186/s13756-018-0309-1 - DOI - PMC - PubMed

[4] Abrar S., Hussain S., Khan R. A., Ul Ain N., Haider H., Riaz S. (2018). Prevalence of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae: First Systematic Meta-Analysis Report from Pakistan. Antimicrob. Resist. Infect. Control. 7 (26), 26–0309. 10.1186/s13756-018-0309-1 - DOI - PMC - PubMed

[5] Akram A., Maqsood U., Latif M. Z., Arshad H. S., Riaz H., Qureshi M. A. (2019). Self-Medication Phenomenon; A Population Based Study from Lahore. J. Pak Med. Assoc. 69 (4), 523–526. - PubMed

[6] Akram A., Maqsood U., Latif M. Z., Arshad H. S., Riaz H., Qureshi M. A. (2019). Self-Medication Phenomenon; A Population Based Study from Lahore. J. Pak Med. Assoc. 69 (4), 523–526. - PubMed

[7] Alsan M., Morden N. E., Gottlieb J. D., Zhou W., Skinner J. (2015). Antibiotic Use in Cold and Flu Season and Prescribing Quality: A Retrospective Cohort Study. Med. Care 53 (12), 1066–1071. 10.1097/MLR.0000000000000440 - DOI - PMC - PubMed

[8] Alsan M., Morden N. E., Gottlieb J. D., Zhou W., Skinner J. (2015). Antibiotic Use in Cold and Flu Season and Prescribing Quality: A Retrospective Cohort Study. Med. Care 53 (12), 1066–1071. 10.1097/MLR.0000000000000440 - DOI - PMC - PubMed

[9] Asghar S., Atif M., Mushtaq I., Malik I., Hayat K., Babar Z. U. (2020). Factors Associated with Inappropriate Dispensing of Antibiotics Among Non-pharmacist Pharmacy Workers. Res. Soc. Adm Pharm 16 (6), 805–811. 10.1016/j.sapharm.2019.09.003 - DOI - PubMed

[10] Asghar S., Atif M., Mushtaq I., Malik I., Hayat K., Babar Z. U. (2020). Factors Associated with Inappropriate Dispensing of Antibiotics Among Non-pharmacist Pharmacy Workers. Res. Soc. Adm Pharm 16 (6), 805–811. 10.1016/j.sapharm.2019.09.003 - DOI - PubMed

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Understanding of Future Prescribers About Antimicrobial Resistance and Their Preparedness Towards Antimicrobial Stewardship Activities in Pakistan: Findings and Implications

Affiliations

Understanding of Future Prescribers About Antimicrobial Resistance and Their Preparedness Towards Antimicrobial Stewardship Activities in Pakistan: Findings and Implications

Authors

Affiliations

Abstract

Conflict of interest statement

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