Antibiotics to cure or harm: - PowerPoint Presentation

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Antibiotics to cure or harm: Concept of Antibiotic Resistance among Health Professional Students in Nepal

Principal Investigator:Nayak SandeepCo-Investigators:Gupta Govind PrasadRana MunaWazir Sartaj Singh

12/8/2015

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ContentsIntroductionNeed for the study

ObjectiveMethodsResults & DiscussionConclusion & RecommendationsReferences12/8/20152

IntroductionAntibiotics are the most frequently prescribed drugs, but they are often misused. 1-2This contributes to the spread of resistant strains of bacteria. 3Main causes for antibiotic misuse is linked to

Wrong prescribing behavior amongst physicians 4-6 Patient’s wrong habit and their lack of awareness 7-1312/8/20153

Need for the study Health Professional Students are integral component of the health care delivery system.They get opportunity to interact with patients during their clinical posting.Educational initiatives on the correct use and prescription of antibiotic drugs, should be address to the new generation of health professional students.

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ObjectiveTo evaluate the knowledge, attitude and practice of health professional students about Antibiotic usage Antibiotic resistance 12/8/2015

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Research ApproachResearch Design

Sample and Sampling TechniqueData Collection ToolsData Analysis

Questionnaire based Survey

Approach

Institutional based Cross-Sectional Study

Sample size:

176

HPS

Sample Technique:

Convenience

Sampling

Questionnaire based on-

1. Demographic

2.

KAP

of

Antibiotic

Analysis was done

using

SPSS version

16.

Figure 1:

Framework of Research Methodology

Research Methodology

*

HPS

: Health Professional Students

KAP

: Knowledge Attitude Practice

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Graph 1: Knowledge on Antibiotic (N=176)Percentage12/8/20157

Graph 2: Antibiotic resistance bacteria can spread to humans through (N=171)Percentage12/8/20158

Graph 3: Indiscriminate and Injudicious use of antibiotic (N=176)Percentage12/8/20159

Graph 4: Attitudes on antibiotic (N=176)12/8/201510

Table 1: Practice of Antibiotic use (N=176)Doctor prescribes a course of antibiotic for you. After taking 2–3 doses you start feeling betterAlways(%)

Usually(%)Sometimes (%)Never (%)Stop taking further treatment5.712.5

31.2

50.6

Save

remaining antibiotics for the next time you get

sick

8.0

11.4

24.4

56.2

Discard remaining

,

leftover

medication

9.7

13.6

38.1

38.6

Give

leftover

antibiotics to your friend/roommate if they get

sick

10.8

17.6

38.1

33.5

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Graph 5: Antibiotic resistance is serious global public health issue (N=176)12/8/201512

Graph 6: Necessary action for enhancing concept and practice on antibiotic (N=176)12/8/201513

Percentage

Table 2: DiscussionVariablesPresent studyPrevious study Authors

PlaceYearConsulted doctor87.50%92.8%81.38%40.10% Khan A AK et. alScaioli G et. al

Tarao

MS et. al

India

Italy

India

2013

2013

2015

Stop taking further treatment

5.70%

5.90%

21.60%

12.7%

Tarao

MS et. al

Khan A AK et. al

Mahajan

M et. al

India

India

India

2015

2013

2014

Abuse of Antibiotics

69.90%

76.10%

Tarao

MS et. al

India2015Antibiotic resistance affect health76.10%83.60%

Tarao MS et. al India2015Antibiotic resistance is s

erious public health issue

70.50%93.00%96.51%

90.70%Tarao MS et. alMahajan M et. al

Khan A AK et. al

India

India

India

2015

2014

2013

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Conclusion The level of knowledge and attitude about antibiotics and its resistance amongst the health professional students is high, however, practice of antibiotics is still poor. 12/8/201515

RecommendationsGovernment level Further research at national level Policy- guidelines for the sale of antibiotics Campaign on rational use of antibiotics

Nepal Medical Council Guidelines on prescription and rational use of antibioticsUniversity / College level Inclusion in curriculum Change behavior of students against antibiotic usage Interventions for usage of antibiotic – training and awarenessHospital and Community level Personal measures to reduce antibiotic resistance Educate patients and general population on rational use of antibiotic12/8/2015

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Acknowledgement We are grateful to the Principals of M. B. Kedia Dental College and Teaching Hospital, and Birgunj Nursing Campus, Birgunj for giving permission of this study.

Lastly, but most importantly we are thankful to all the participants for being volunteering participating for this study.12/8/201517

ReferencesChambers HF. General principles of antimicrobial therapy. In Goodman & Gilman's The Pharmacological Basis of Therapeutics 11th edition. Editors: Brunton L, Parker K, Blumenthal D, Buxton I. New York, USA, Mc Graw Hill. 2006; pp.1095–110.World Health Organization (2014). Antimicrobial Resistance. Global Report on Surveillance. Geneva: World Health Organization, 2014. Available: http://apps.who.int/iris/bitstream/10665/112642/1/9789241564748_eng.pdf. Accessed 01 October 2015.

Centers for Disease Control and Prevention (CDC) (2013) Antibiotics Aren't Always the Answer. Available: http://www.cdc.gov/Features/GetSmart/. Accessed: 01 October 2015.Tonkin-Crine S, Yardley L, Little P. Antibiotic prescribing for acute respiratory tract infections in primary care: a systematic review and meta-ethnography. J Antimicrob Chemother. 2011; 66(10): 2215–2223.Butler CC, Rollnick S, Pill R, Maggs-Rapport F, Stott N. Understanding the culture of prescribing: qualitative study of general practitioners’ and patients’ perceptions of antibiotics for sore throats.

BMJ

. 1998; 317(7159): 637–642.

Kumar S, Little P, Britten N. Why do general practitioners prescribe antibiotics for sore throat? Grounded theory interview study.

BMJ

. 2003; 326(7381): 138.

World Health Organization (2012). The evolving threat of antimicrobial resistance. Options for action. Geneva: World Health Organization, 2012. Available:

http://whqlibdoc.who.int/publications/

2012/

9789241503181_eng.pdf

. Accessed: 01 October 2015.

Cars O,

Mölstad

S,

Melander

A. Variation in antibiotic use in the European Union. Lancet. 2001; 357 (9271): 1851–1853.

Corbett

KK

, Gonzales R,

Leeman

-Castillo BA, Flores E,

Maselli

J,

Kafadar

K. Appropriate antibiotic use: variation in knowledge and awareness by Hispanic ethnicity and language.

Prev

Med. 2005; 40 (2): 162–169.

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McNulty CAM, Boyle P, Nichols, Clappison P, Davey P. Don’t wear me out—The public’s knowledge of and attitudes to antibiotic use. J Antimicrob Chemother. 2007; 59(4): 727–738.Grigoryan L, Burgerhof

JG, Haaijer-Ruskamp FM, Degener JE, Deschepper R, Monnet DL, et al. Is self-medication with antibiotics in Europe driven by prescribed use? J Antimicrob Chemother. 2007; 59: 152–156.European Commission. Special Eurobarometer 407. Antimicrobial Resistance. Report (2013) Available: http://ec.europa.eu/health/antimicrobial_resistance/docs/ebs_407_en.pdf Accessed 05 October 2015.Gualano MR

, Gili

R,

Scaioli

G, Bert F,

Siliquini

R; General population's knowledge and attitudes about antibiotics: a systematic review and meta-analysis.

Pharmacoepidemiol

Drug

Saf

. 2015; 24(1):2–10.

Khan A K A,

Banu

G, K

K

R. Antibiotic Resistance and Usage - A Survey on the Knowledge, Attitude, Perceptions and Practices among the Medical Students of a Southern Indian Teaching Hospital. J

Clin

Diagn Res. 2013; 7(8): 1613–1616.

Scaioli G, Gualano MR, Gili R, Masucci S, Bert F, Siliquini R. Antibiotic Use: A cross-sectional survey Assessing the Knowledge, Attitudes and Practices amongst Students of a School of Medicine in Italy. Journal.pone. 2015.

Tarao MS, Nulla Polly, Zingpi M, Agatha G. A study on the Knowledge, Attitude, Perceptions and Practices of Antibiotic Usage and Resistance the medical students of JNIMS, Manipur. J of Evidence Based & Hltcare. 2015; 2(34).

Mahajan M, Dudhgaonkar S, Deshmukh S. A Questionnaires based survey on the Knowledge, Attitude and Practices about Animicrobial Resistance and Usage among the Second year MBBS Students of a Teaching tertiary care Hsopital in Central India. International Journal of Pharmacological Reseacrh. 2014; 4(4):175-179.

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Thank You!!!12/8/201520

Causes of Antibiotic Resistance Important Unimportant

Unsure`Use of antibiotics for self-limited non bacterial infections89 (50.6)48 (27.3)39 (22.2)Use of antibiotics with a broader than necessary spectrum72 (40.9)59 (33.5)

45 (25.6)

Use of antibiotics for shorter than standard duration

75 (42.6)

79 (44.9)

22 (12.5)

Poor infection control measures

93 (52.8)

50 (28.4)

33 (18.8)

Use of antibiotics for self limited bacterial infections

114 (64.8)

48 (27.3)

14 (8.0)

Mutational and evolutionary changes in the micro organism

71 (40.3)

44 (25.0)

61 (34.7)

Lack of restrictions on antibiotic usage

82 (46.6)

64 (36.4)

30 (17.0)

Excessive antibiotic use in live stock (Animals reared for food)

49 (27.8)

74 (42.0)

53 (30.1)

Use of antibiotics for longer than standard duration

69 (39.2)

92 (52.3)

15 (8.5)

19.69

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