Antibiotic Awareness Research Articles

P-1314. Assessment of the Effect of WHO and USA Antibiotic Awareness Campaigns on Search Engine Queries for Antimicrobial Resistance

Abstract Background Antimicrobial resistance (AMR) is a public health threat according to the World Health Organization (WHO), affecting all countries and at all income levels. Since the WHO’s initial action plan in 2001, multiple campaigns have arisen such as the WHO AMR Awareness Week and the CDC’s U.S. Antibiotic Awareness Week (November 18 to 24). Here, we use Google Trends (GTr) to assess the effects of three awareness campaigns on online search queries related to AMR in the US from their inception to April 2024. Methods GTr analyzes a sample of Google® web searches and allows users to make relative comparisons among searched terms by reporting the highest search volume as 100 and all other search volumes as a proportion of 100. Search queries related to AMR and AMR-related campaigns were used in GTr to generate normalized relative search volumes (RSVs) for each term (Table1). AMR-related campaigns' search volumes were compared to other established disease campaigns (Table 2). GTr search data from Jan 1, 2005 to April 20, 2024 was used. Descriptive statistics were used. No inferential statistics were used due to the nature of the data. Results When assessing RSVs for AMR-related campaigns, “Antibiotic Awareness week” had the highest RSV and peaked each November after 2017 (Figure 1a). When compared to established campaigns for other diseases, the average RSVs over time for AMR-related campaigns was smaller by a ratio of 8 (prostate cancer) to 219 times (breast cancer) (Figure 1b). Amongst AMR-related terms, “antibiotic resistance” was more searched over other terms and had only a slight increase in RSV over the years (Figure 2a). Notably, RSVs for “antibiotic resistance” each year peaked in Feb-Apr and not in November, the month of the AMR campaign (Figure 2b and 2c). Conclusion Despite AMR being one of the most concerning public health threats in the coming decade, public knowledge of this issue trails behind other health related campaigns. RSVs related to AMR did not increase over time despite awareness efforts. Although AMR-related campaigns take place in November, it was not the month with highest RSVs. These findings suggest that more resources may be needed to support the success of these campaign efforts. Disclosures All Authors: No reported disclosures

P-958. Leveling Up Education Interventions: Antimicrobial Stewardship and Infection Prevention Education Through Gamification

Abstract Background Kaizen-Education is an app-based, formative question bank infused with gamification for a fun, yet competitive learning environment. This provides an engaging and flexible way to learn new competencies and test retention. Originally developed at University of Alabama at Birmingham (UAB), it has been used in multiple areas of medical education with high learner engagement. Optional participation, team-based competition, leaderboards, and prizes are game elements used to motivate completion of the formative questions. We created two educational games, one for UAB Antimicrobial Stewardship Program (ASP) and another for Infection Prevention (IP), to see if we could engage learners within the hospital system surrounding these topics. Methods For the IP game, infection preventionists developed questions for nursing staff. For the ASP game, ID pharmacists developed questions for providers. Both occurred within special weeks: National Nurses Week and U.S. Antibiotic Awareness Week. Recruitment strategies for both games included email invitations and peer-to-peer communication. Teams for the IP game were nursing units, while the ASP game allowed creation of teams of 4 providers. Winning teams were awarded prizes and were recognized via email, certificate, and highlighted on the institution's website. At the conclusion of the games, participants were invited to provide feedback through a post-game survey. Participant Survey Results Results 61 and 156 participants answered at least one question in the ASP and IP games respectively. Retention, defined as completing all questions, was 80% of players in ASP game and 69% in IP game. Across both games, 4,182 questions were answered representing unique teaching moments. Reviewing accuracy based of learning domains (Figure 1), we were able to identify knowledge gaps at our institution. Finally almost all learners who responded to feedback survey agreed the activity increased knowledge in relevant domains (Figure 2). Conclusion We found a group of both nurses and providers interested in participating in quality educational activities within Antibiotic Stewardship and Infection Prevention. Retention was high in those that began the activity. Finally, feedback from question performance could be used to identify knowledge gaps for future interventions. Disclosures All Authors: No reported disclosures

P-1764. Point Prevalence Study of Antibiotic Appropriateness and Economical Cost in a Tertiary Care Trauma Hospital of Northern India to Tailor Antibiotic Stewardship Interventions

Abstract Background Conducting Point prevalence surveys (PPSs) is challenging, especially in developing countries, in the absence of electronic records, lack of dedicated resources and high patient load. This survey was conducted to provide background data for strengthening antimicrobial stewardship(AMS) practices and estimate the economic cost of antimicrobial resistance per antibiotic consumed in a tertiary care trauma hospital in India. Summary of Quality indicators of antibiotic prescribing (in %) Methods The survey included all inpatients admitted in wards and intensive care units of the hospital (300 beds) during World Antibiotic Awareness Week 2023. Standardised modules were adopted from the Global PPS for collecting data on patient demographics, prescribed antimicrobial agents with dosage, indication(s) and duration of treatment, and microbiolgical results. Further, the cost minimization analysis was carried out to assess the treatment cost and variations in costs arising due to generic or branded prescribing. Results Among the 254 patients admitted, the patients treated with at least one antimicrobial was 88.6% (N=225). The median (IQR) day of hospitalization was 7 (3.75) days. The highest prevalence of antimicrobial use was in the ICU (100%), followed by Emergency medicine (97.5%). The majority of patients received empiric than targeted antimicrobial therapy. Antimicrobial prescription was mostly for surgical prophylaxis (49.04%). Among patients for >7 days on treatment, microbiological culture were sent in 16.7% (5/30) patients. Antibiotic quality indicators such as reason in notes and documentation of review date were comparatively lower (Figure-1). Treatment costs varied significantly with prescriptions of maximum and minimum-priced brands, ranging from 69.81%-1490%. Branded therapy were three times costlier than generic therapy in 36 (52.9%) regimens. Conclusion Poor transition from empiricism to rationalism, continuation of surgical prophylaxis for more than one day and underutilization of microbiological tests were noted. There was large variations in treatment cost of infections depending on regimen chosen. Adherence to local antibiotic policy, optimal dosing and regular audit with positive feedback of antibiotic use to treating physician can be useful approaches to implement the AMS Program in the study centre. Disclosures All Authors: No reported disclosures

What do we know and how do we act: knowledge, attitude and practices around antimicrobial resistance

Background: The overuse and misuse of antibiotics has influenced a rise in antimicrobial resistance (AMR) thereby posing a significant threat to global health. Information on AMR has been available to the public; however, a gap exists in relay of information due to lack of effective interventions. This study focuses on exploring the knowledge, attitudes and practices (KAP) among rural, semi-urban and urban populations from Delhi NCR, India. Methods: This study was a cross-sectional questionnaire based online survey conducted across rural, semi-urban and urban areas of Delhi NCR for one month (June-July 2024). The questionnaire comprising 28 close-ended questions was administered in English and Hindi languages to participants aged 15-80 years. The questionnaire focused on knowledge, awareness and practices of antibiotics and antimicrobial resistance. Results: A total of 500 participants attempted the survey out of which 435 (87%) were aware about antibiotics. About 479 (95.8%) participants had earlier consumed antibiotics out of which 336/497 (70.1%) participants consumed antibiotics prescribed by doctors. Among 479 participants, 253 (52.8%) completed the course however 311 (69.1%) of the participants kept the antibiotics for reuse. Nearly 191/479 (39.9%) participants practiced antibiotics misuse by consumption of antibiotics when having similar symptoms as previously observed. The assessment of participants revealed that only 216/500 (43.2%) participants were knowledgeable about AMR. The participants aware of AMR agreed that the antibiotic practices of reuse (n=69/216, 31.9%), poor quality (n=87/216, 40.3%), lower dosage (n=81/216, 37.5%) and not completion of course (n=77/216, 35.6%) can result in AMR. Conclusions: The study highlights that despite the participants being informed about antibiotics and followed medical advice their practice of reusing antibiotics raises the need for tailored interventions to promote awareness about AMR and appropriate use of antibiotics.

Unveiling Awareness: Exploring Antibiotic Hypersensitivity among International Islamic University Malaysia (IIUM) Undergraduates in Kuantan, Pahang

Background: The condition known as antibiotic hypersensitivity, or antibiotic allergy, poses serious problems for the medical field. Despite its importance, little is known about the awareness of antibiotic hypersensitivity, particularly among undergraduate students in Malaysia. The purpose of this study is to assess the awareness of antibiotic hypersensitivity among IIUM Kuantan undergraduate students to improve drug allergy education and healthcare practices. Methods: A general qualitative design was used to conduct the study. Semi-structured interviews were used to gather information about the awareness of antibiotic hypersensitivity. Due to their similar prevalence of antibiotic hypersensitivity, medical students served as a representative sample of Malaysia's adult population among undergraduate students from a variety of faculties. Thematic analysis was used to analyse the data. Results: Six people in all were enlisted to take part in the study. Most of the participants were female Malay students at International Islamic University Malaysia (IIUM) Kuantan Campus, Pahang, Malaysia. Two primary themes emerged from the study: (1) Antibiotic hypersensitivity awareness and (2) Factors contributing to antibiotic hypersensitivity. This finding indicated that students' knowledge of antibiotic hypersensitivity is still lacking. Conclusion: The research found evidence to suggest that additional intervention is necessary to raise awareness within the current community. Putting skill training into practice could be a good way to raise students' awareness in this area. On the other hand, more information is needed to determine the precise kind of skill training that Malaysia should adopt.

The Awareness of Antimicrobial Resistance Among Adult Population in an Urban Setting of Rawalpindi

O Objective: To determine the association of various aspects of antimicrobial resistance awareness and socio-demographic determinants among residents of Rawalpindi. Study Design: Cross-sectional analytical study. Place and Duration of Study: Rawalpindi Cantonment, Pakistan, from Jan to Dec 2021. Methodology: A validated (World Health Organization) multi-country questionnaire was completed by a total of 400 participants, aged 16 years and older, by using two-stage sampling technique. The relationship between social and dependent variables was analyzed using chi-square test of significance. Results: Study results showed that 53.8% of participants were aware of the term ‘antibiotic resistance’ whereas only 29.5% understood what antimicrobial resistance meant. In comparison to males, more females (65.3%) knew the term antibiotic resistance. Antibiotic resistance awareness was higher among young adults aged 16-24 years (67.8%) than among older age groups (p=0.001). Antibiotic resistance awareness in relation to gender (p<0.001), education level (p<0.001), occupation (p<0.001) and monthly household income (p<0.001) was found statistically significant. Antibiotic resistance, according to nearly one-third of respondents (31.8%), was a problem in other countries but not in Pakistan. Conclusion: Awareness and level of understanding regarding spread of antimicrobial resistance and antibiotic resistance itself were found to be low. The study findings revealed that older adults, those with lower education and lower socioeconomic status had the least knowledge and attitudes regarding antibiotic resistance and antimicrobial resistance as compared to other groups.

Perception of antibiotic misuse and awareness of antibiotic resistance among adults in delta state Nigeria

BackgroundMisuse of antibiotics leads to propagation and proliferation of resistant bacteria strains. Antibiotic resistance is a public health problem on a global scale. It occurs when changes take place in bacteria that impair the bactericidal or bacteriostatic action of antibiotics on bacteria.ObjectiveTo determine the knowledge of antibiotics, the perceptions of antibiotic misuse and the awareness of antibiotic resistance among adults in Delta state.MethodsA cross-sectional study was carried out among adults who are non-healthcare providers in Delta state, Nigeria. A total of 420 participants were enrolled in the study. An internet based pretested questionnaire was used to collect data. SPSS version 24, was used to run both descriptive and inferential statistics, with a p ≤ 0.05 considered statistically significant. Pearson’s chi-square test was used to determine the association between the measured variables.ResultsMost of the respondents exhibited good knowledge of antibiotics; 296 (73.1%), with 266 (65.7%) respondents observed to have a good perception of antibiotic misuse. However, 234 (57.8%) respondents had poor awareness of antibiotic resistance.ConclusionsDespite having good knowledge of antibiotics and good perception of antibiotic misuse, most of the respondents exhibited a lack of comprehensive awareness about the intricacies of antibiotic resistance. Addressing the awareness gap surrounding antibiotic resistance is an essential step towards creating a more informed and responsible populace, ultimately contributing to the global effort to preserve the effectiveness of antibiotics.

Knowledge, Attitudes, and Practices of Parents Regarding Antibiotic Use for Acute Upper Respiratory Tract Infections in Children in Basrah, Iraq.

Upper respiratory tract infections (URTIs) are mainly caused by viral infections, but parental attitudes often lead to inappropriate antibiotic prescriptions, thereby increasing antibiotic resistance. This study aimed to evaluate parents' knowledge, attitudes, and practices (KAP) regarding antibiotic use for children with URTIs in Basrah, Iraq. A cross-sectional study was conducted at 14 primary healthcare centers in Basrah from November 2023 to April 2024. A questionnaire was designed and administered to determine parents' KAP regarding antibiotic use for children suffering from URTIs. Four hundred parents completed the questionnaire. The majority (81%) of parents were aware that antibiotic misuse leads to bacterial resistance. Sixty percent of respondents disagreed that viral infection is a leading cause of URTI and that it can be self-limited without antibiotics. A total of 67.6% of the parents were aware of the possibility of having side effects from antibiotic consumption. Moreover, more than half of parents (58.8%) never asked their pediatricians for an antibiotic prescription for their children. Educational interventions are necessary to raise parents' awareness of antibiotics to reduce inappropriate use and its consequences.

Can patient education initiatives in primary care increase patient knowledge of appropriate antibiotic use and decrease expectations for unnecessary antibiotic prescriptions?

Healthcare globally is increasingly threatened by antibiotic resistance. Misunderstanding of the appropriate use of antibiotics is common within the general population, therefore patient education could be a useful tool to employ against antibiotic resistance. Patient satisfaction with healthcare is important, and antibiotic awareness is crucial to avoid disappointment when antibiotic stewardship is practiced. This review aims to identify whether patient education is an effective tool to improve knowledge and awareness of the appropriate use of antibiotics and whether it has an effect on expectations of or prescription rates of antibiotics. Embase, Medline, Web of Science, PubMed, and Cochrane Library were searched to identify studies examining the impact of various forms of patient education on awareness of appropriate antibiotic use and antibiotic prescription rates. Reference lists of eligible studies were also screened. Three hundred and fourteen unique studies were identified, of which 18 were eligible for inclusion. All studies were of good quality. Three studies examined public health campaigns, five examined leaflets, two examined posters, three examined videos, four used mixed interventions and one study examined a presentation. The results were too heterogenous to perform a meta-analysis. Patient education is an effective tool to increase public knowledge and awareness of the appropriate use of antibiotics, and can reduce the expectation of or prescription rates of antibiotics. The form of patient education matters, as interventions involving active learning and engagement demonstrate significant positive outcomes, whereas passive forms of learning do not appear to have any effect on understanding or prescriptions.

Prevalence of antibiotic self-medication and knowledge of antimicrobial resistance among community members in Neno District rural Malawi: A cross-sectional study

ObjectivesDespite global efforts to address antibiotic self-medication, it is still significantly prevalent. This study aimed to investigate the prevalence of antibiotic self-medication and assess knowledge of antibiotic resistance among community members in Neno District, rural Malawi. MethodsA cross-sectional, community-based study was conducted from September to November 2023, using simple random sampling across 169 villages. Participants from two households per village were surveyed using a “drug bag” method, focusing on those who had taken antibiotics within the preceding 6 months. In addition, drug retailers were selected via snowball sampling for interviews. ResultsOf the 531 participants and 39 drug retailers, 71.1% reported antibiotic use, with 69.5% self-medicating in the past 6 months, with convenience (31.5%) and confidence (26.7%) being the reasons. Common symptoms prompting self-medication included cough (29.9%), sore throat (28.6%), and aches and pain (28.6%). Amoxicillin (61.1%) and cotrimoxazole (29.6%) were the most used antibiotics. More than half (53.1%) reused leftover antibiotics from health facilities, with employed participants significantly more likely to self-medicate. Awareness of antibiotic resistance was low (16.1%), mainly learned from hospitals. Unlawful antibiotic sales by drug retailers (46.2%) were noted. ConclusionsThe study highlights the urgent need for government-led efforts to regulate antibiotic use and increase public awareness to mitigate the impact on public health.

The Impact of Antibiotic Awareness on Usage Among University Students in Kabul, Afghanistan

Antibiotic resistance poses a significant global health challenge, exacerbated by inappropriate self-medication practices. This study explores the level of awareness and practices concerning antibiotic use among university students in Afghanistan. The research aimed to evaluate university students' knowledge of antibiotic resistance, their self-medication behaviors, and overall understanding of appropriate antibiotic use. The goal was to identify gaps in knowledge and inform strategies for educational interventions. An online survey was administered via Google Forms to 150 students from various provinces in Afghanistan. Participants were selected to represent a diverse geographical distribution, including Kabul (35.71%) and seven other provinces. The survey assessed participants' knowledge about antibiotics, awareness of resistance risks, and self-medication practices. The survey results indicated a moderate level of awareness about antibiotic resistance among students. Despite this, many students reported engaging in self-medication. Knowledge deficiencies were observed regarding the proper use of antibiotics and the implications of resistance. The study found significant variability in understanding, with some students showing high confidence while others lacked basic knowledge. The study underscores the need for targeted educational programs to improve awareness and correct misconceptions about antibiotics among university students. Addressing these knowledge gaps is essential for promoting responsible antibiotic use and combating resistance. Future research should evaluate the impact of such educational interventions on altering self-medication behaviors and enhancing antibiotic stewardship.

A Systematic Review of Misuse of Antibiotics in Jordan

Background: Antibiotic misuse has become a major global public health issue and this weapon against bacteria is becoming increasingly threatened by the misuse of antibiotics. In Jordan specifically, the availability of antibiotics over the counter, the ease of purchasing antibiotics without prescription, and their misuse could lead to a major health problem. Objectives: This systematic review aims to explore the published literature on antibiotic misuse in Jordan, and to explore the factors contributing to this issue and its effects and propose strategies for reducing antibiotic misuse in Jordan. Methods: Published articles on antibiotic misuse in Jordan from January 2013 to January 2023 were searched via several databases including PubMed, Insight Medical Publishing, ResearchGate, and Semantic Scholar. We included 28 articles discussing the prevalence of antibiotic misuse, knowledge, awareness, and factors contributing to the issue, its impact, and mitigating intervention strategies . Results: The literature indicated a high prevalence of antibiotic misuse among the Jordanian population, especially among children with upper respiratory tract infections. There are numerous reasons for the high prevalence, and several contributing factors were reported, including, but not limited to, cultural factors, financial circumstances, and the level of education. Conclusion: This review highlights antibiotic misuse as a major health problem at the community level and in the Jordanian healthcare system. effective strategies are needed to address this major health challenge.

Awareness, perspectives and practices of antibiotics deprescribing among physicians in Jordan: a cross-sectional study.

Antibiotics have significantly reduced mortality and improved outcomes across various medical fields; however, the rise of antibiotic resistance poses a major challenge, causing millions of deaths annually. Deprescribing, a process that involves discontinuing unnecessary antibiotics, is crucial for combating this threat. This study was designed to assess the knowledge, perceptions, and practices of physicians regarding antibiotic deprescribing in Jordan. A cross-sectional survey was conducted between January-February 2024 to assess the knowledge, perceptions, and practices of physicians regarding antibiotic deprescribing in Jordan. An electronic questionnaire served as the data collection tool. Descriptive analysis was performed using SPSS software version 26. Additionally, logistic regression analysis was carried out to identify independent factors associated with physicians' willingness to deprescribe antibiotics. The study involved 252 physicians, primarily male (n = 168, 67.7%), with a median age of 33 years. Regarding antibiotics deprescribing, 21.8% (n = 55) expressed willingness to deprescribe inappropriate antibiotics.High awareness of deprescribing was evident, with 92.9% (n = 234) familiar with the concept, 94% (n = 237) knowledgeable about appropriate situations, and 96.8% (n = 244) recognising its potential benefits. Furthermore, 81.8% (n = 205) reported having received formal training in antibiotics deprescribing, and 85.3% (n = 215) were informed about the availability of deprescribing tools.Physicians highlighted challenges including insufficient time (44.4%, n = 112) and resistance from patients (41.3%, n = 104) and colleagues (42.1%, n = 106). Despite challenges, a significant proportion regularly assessed antibiotic necessity (46.9%, n = 117) and educated patients about antibiotic-related harms (40.5%, n = 102). Logistic regression analysis revealed no significant demographic factors influencing physicians' willingness to deprescribe antibiotics (p > 0.05). Physicians in Jordan exhibit high awareness of antibiotics deprescribing and recognise its benefits. Challenges such as time constraints and communication barriers need to be addressed to facilitate effective deprescribing practices. Comprehensive guidelines and interdisciplinary collaboration are essential for promoting judicious antibiotic use and combating antimicrobial resistance.

Antibiotic Use Awareness and Practices in the Indian Community During Later Stages of COVID-19 Pandemic: A Cross-Sectional Survey

Background: An increased overuse of antibiotics coupled with dearth of newer alternatives has worsened antibiotic resistance in LMIC’s like India. The prescription of antibiotics for symptoms similar to COVID-19 infection has aggravated the problem of antibiotic overuse, further worsening antibiotic resistance. This study aims at understanding not only the extent of overuse, but also the social patterns and causes of over-prescription or self medication of antibiotics in India. Methods: A cross-sectional survey of the knowledge, attitude and practices on antibiotic use was conducted from September to October, 2022, using a Google form questionnaire. A virtual snowball technique was used to recruit respondents. Results: A total of 309 responses were received (56% female and 44% male). 59.5% of the respondents were between 15 to 30 years. Surprisingly, in spite of a majority of respondents (around 70%) having a health sciences background, 67.8% of respondents falsely believe that antibiotics speed up recovery from most coughs and colds. 94.8% of respondents had used antibiotics in the last one year. 17.2% of respondents had taken antibiotics without the prescription of a doctor. The most common antibiotic used on prescription and self-medication was Azithromycin. Only 20.7% of respondents took antibiotics on suspicion of having COVID-19, with the most common one being Azithromycin. Conclusion: The study highlights that a greater knowledge on antibiotic use does not necessitate better attitude towards their cautious and rational use. The use of antibiotics for self-limiting indications like cough, cold and sore throat needs to be restricted through stricter regulations.

Knowledge, attitudes, practices and risk perception of cattle farmers in Namibia to antibiotic use and resistance.

The misuse of antibiotics in livestock contributes to the emergence of antibiotic resistant bacteria. The development of antibiotic resistance in bacteria of animal origin is of public health concern since drug resistant pathogens in animals can spread to humans. Several countries have therefore introduced regulations to restrict the use of antibiotics in livestock. Namibia was the first African country to ban the use of antibiotics as growth promoters and restrict the use of antibiotics to the treatment of bacterial diseases with a prescription from a veterinarian. However, there are limited studies on antibiotic stewardship among farmers in the country. The aim of this study was to determine the antibiotic awareness and usage of cattle farmers in Oshikoto region Namibia. A questionnaire on antibiotic knowledge, attitudes and practices (KAP) was administered to 274 randomly selected cattle farmers in Namibia. To calculate the KAP scores, one mark was awarded for each correct answer and zero was awarded for incorrect or unsure responses. Respondents having ≥ 50% correct answers were considered as having good KAP scores. The KAP score ranged from 8 to 73%. Forty-three per cent of the respondents had good KAP scores. Good KAP was associated with age, farm type and education status. Semi-commercial/commercial farmers had significantly better KAP than post and homestead farmers. The findings of this study indicate that there is a need to improve antibiotic usage and resistance education programmes in order to promote rational antibiotic usage.

A cross-sectional analysis of antibiotic use: Attitudes and practices in the Albanian community

BackgroundAntibiotic resistance (AR) represents a global health challenge. Within the coordinated efforts to tackle AR, community education is a key strategy to enhance awareness and improve antibiotic use. The current study intends to investigate the Albanian community's attitude and practices regarding antibiotic use, including recent health related developments, like COVID-19. MethodsA cross sectional survey was conducted among Albanian residents between December 2022 and March 2023, using a standardized questionnaire which featured three sections covering demographic data, attitudes, and practices regarding antibiotic use. Statistical analysis included both descriptive statistics and the Chi-square test to assess relationships between categorical variables. ResultsThe questionnaire was effectively completed by 519 participants. The majority were females (70.1 %) within the 18–30 age range (55.5 %) and had a college/university degree (93.3 %). 53.4 % reported antibiotic use without a medical prescription, with amoxicillin and azithromycin being the most used antibiotics. Commonly cited reasons for antibiotic use were self-reported symptoms such as flu/common cold, sore throat, cough, and fever (82.3 %). 69.0 % reported following prescribed antibiotic courses, with higher adherence among females and those with higher education. Awareness of AR was considerable (78.0 %), with females evidencing more awareness compared to males. Only 34.3 % of participants reported antibiotic use for COVID-19, mostly after testing positive, with azithromycin being the most frequently used antibiotic. ConclusionsOur study highlights concerning trends in antibiotic self-medication and awareness gaps in prudent antibiotic use emphasizing the need for tailored educational programs, regulatory oversight, and robust surveillance systems in Albania's healthcare.

EFEKTIVITAS MEDIA LEAFLET TERHADAP PENGETAHUAN PENGGUNAAN ANTIBIOTIK DI KABUPATEN BANGKA

Antibiotics are medications that physicians often prescribe to treat and prevent bacterial infections. Antibiotic resistance may be predisposed by improper antibiotic usage practices. The public’s ignorance about the proper use of antibiotics is the cause of this. The quality of a patient’s health will improve if antibiotics are used judiciously and in accordance with prescribed guidelines. If antibiotics are not used as directed, their efficacy will be diminished and the expense of recovery therapy will rise. To guarantee treatment efficiency and avoid resistance, it is essential to understand and be aware of the patients receiving antibiotics. This research sought to determine the efficacy of leaflet media in Bangka Regency, Bangka Belitung Islands Province, in promoting antibiotic use knowledge. A validity-tested questionnaire from previous research served as the study’s instrument. Quasi-experimental in nature, this kind of study uses a pretest-posttest design involving only one group. It also has a quantitative analytical focus. An unintentional sampling strategy combined with a non-random sampling method was employed in the study to acquire data. 166 people served as the study’s subjects. A questionnaire was used as the measuring tool in the study. It was sent to the participants’ community in two assessments, one month apart, and included leaflet media as an intervention. Analytical tests, both univariate and bivariate, were used to examine the data. The results show that there is a substantial difference in knowledge between the pretest and posttest, and that leaflet media is successful in increasing people’s awareness of antibiotics in Bangka Regency. The P-value is 0.001< 0.05.

Patterns of antibiotic prescription in implant dentistry and antibiotic resistance awareness among European dentists: A questionnaire-based study.

Antimicrobial resistance is an alarming global public health concern, threatening the effective treatment of common infections. This phenomenon is driven by the improper prescription of antibiotics. This study aimed to elucidate the patterns of antibiotic prescription in implant dentistry among European dentists and their awareness of antibiotic resistance. An anonymous online validated questionnaire was distributed via e-mail to 6431 recipients through the European Association for Osseointegration. It comprised of 17 structured questions investigating demographic variables, working environment, clinical experience, attitude towards antibiotic prescription in particular in relation to implant dentistry and COVID-19 pandemic, and awareness of antibiotic resistance. Data were collected from April to May 2023. 281 dentists from 33 European countries completed the survey. Almost 80% affirmed to routinely prescribe antibiotics as prophylaxis as well as after dental implant placement, especially in medically compromised patients or in cases of bone grafting. Amoxicillin, alone (61%) or in combination with clavulanic acid (56%), was the most common antibiotic of choice. Awareness of penicillin resistance among respondents was high. For peri-implantitis treatment, more than half reported the use of systemic antibiotics. The large majority (95%) did not prescribe more antibiotics since the beginning of COVID-19 pandemic. Less than 40% declared to follow national guidelines for antibiotic prescription. This survey revealed a high prescription rate of antibiotics in implant dentistry, despite the awareness about antibiotic resistance among the respondents. The development and adherence to European guidelines has been identified as a potential strategy for improving antimicrobial stewardship.

Implementing a community-based antimicrobial stewardship intervention in Malaysia.

In Malaysia, the unregulated use of antibiotics and lack of awareness about antimicrobial resistance (AMR) among pharmacists pose significant challenges. Implementing community-based Antimicrobial Stewardship (AMS) initiatives is crucial to address the rising AMR. We developed a bespoke AMS intervention, aligned with the World Health Organization's AMS modules, as a 2-day online educational seminar for community pharmacists. The effectiveness of the workshop was evaluated using pre- and post-seminar questionnaires, focusing on AMS knowledge and attitudes towards antimicrobial usage. Among 528 participants, 489 completed both questionnaires. Pre-seminar, only 59% correctly understood the concept of antibiotic resistance reversibility, which improved to 85.9% post-seminar (p = .002). The average AMS knowledge score increased from 5/10 to 8/10 post-intervention (p < .05). A significant improvement was also noted in pharmacists' ability to select appropriate antibiotic therapies, particularly for urinary tract infections, with an increase from 78% to 90% correct responses. The AMS seminar was well-received and significantly improved the AMS knowledge of community pharmacists. The results underline the need for more AMS-focused interventions in this demographic in Malaysia, contributing to the development of formalized AMS programs. Such initiatives are expected to enhance antibiotic use awareness, encourage optimal antibiotic practices, and positively shift professional conduct in community settings.

Antimicrobial resistance and stewardship: What do pharmacists know and practice in a major Nigerian tertiary health facility: A cross-sectional study

Background: Multidrug-resistant bacterial infections are still a global challenge and successful antimicrobial stewardship (AMS) requires multidisciplinary collaborative partnership. Studies have highlighted the knowledge and perceptions of pharmacists, but there is a paucity of data about practices of pharmacists in teaching hospitals in Nigeria. We set out to determine the knowledge and practices of pharmacists in a major tertiary health facility (THF) in Lagos, Nigeria, before starting an AMS intervention program. Methods: This cross-sectional survey used electronic forms to find out the knowledge and practices of pharmacists employed in a large tertiary health facility. Data were collected during a Commonwealth Partnerships for AMS program to support low- and middle-income countries to produce antimicrobial consumption surveillance data, quality improvement initiatives, and infection prevention and control (IPC) processes. Results: Two-thirds of respondents knew that antibiotics were effective against bacteria, and 48.6% knew the causes of antimicrobial resistance. Almost all (97.1%) agreed that AMS must be done, IPC is important, and they were confident to point out inappropriate prescribing. Three-quarters had advised colleagues or been involved in AMS activities; however, 62.9% had fully or mostly changed their practices based on information received, and 26.5% had participated in World Antibiotic Awareness Week. Conclusion: There are still gaps in knowledge and practices, which underscore the need to entrench regular training on the job. However, there is overall awareness of AMS and a desire for it to be carried out at all levels. Pharmacists are useful for choosing appropriate antibiotics and can play a vital role in AMS.