Knowledge, attitude and practice among Malaysian medical students, doctors, other health professionals and common people regarding antibiotic use, prescribing and resistance: A systematic review

Abstract

The use of antibiotics has been associated with the sizeable cutback of infectious disease mortality. Antibiotics also tremendously support the treatment of cancer, transplantation and many other surgeries. Currently, the development of new antibiotics has been slow down. Besides, there is a rapid process of antimicrobial resistance (AMR) against almost all available antibiotics. Moreover, there is quick progress of microbial development with multiple antibiotic resistant which adds more fatality. An independent search was performed from inception until January 2019 using electronic databases, including Medline, Scopus, Web of Science and PubMed for published articles. Seventeen articles were included; six among the medical professionals and students and 11 among the general public across the country. The quality of the included studies was deemed average. Medical, pharmacy and other university subjects' students' knowledge level were low to average. Often, medical and pharmacy students' knowledge level was better than others. One study clearly denoted that there is a gap between theoretical and practical input regarding antibiotic prescribing. Although medical officers and general physician knowledge level was good, but actual real-life attitude and practice cannot be assessed because of the study design. Common people had a lot of misunderstanding regarding antibiotic use and AMR. All these studies incorporated suggested that further educational intervention is warranted to promote prudent use of antibiotic and prevent AMR. This review similarly advocates educational interventions among all stakeholders of healthcare with a special emphasis on antibiotics stewardship and regulatory enforcement programme to promote rational use of antimicrobial and to prevent AMR.