Antimicrobial resistance and antibiotic stewardship: knowledge, attitudes and perceptions amongst final-year undergraduate health professional students in a South African university.

Abstract

Antimicrobial resistance (AMR) is a major threat to human health. The World Health Organization (WHO) and subsequently the South African Department of Health have developed detailed plans to combat AMR including recommendations to implement Antibiotic Stewardship (ABS) in the curricula of healthcare students. A number of studies have measured the knowledge, attitudes and perceptions (KAP) of healthcare students globally. However, in South Africa, no multidisciplinary studies have been performed. This study thus ascertained KAP on AMR and antibiotic stewardship amongst final year medical, nursing and pharmacy students at a South African university by means of a cross-sectional questionnaire based survey. A total of 132 questionnaires were completed (response rate 33%), with individual response rates of 63% (n=63), 86% (n=46) and 9% (n=23) for pharmacy, nursing and medical students respectively. The mean correct knowledge score was 88.9%, with significantly lower scores seen for nursing students when compared to other two groups. The perceived seriousness of AMR at international, national and local levels was also significantly lower amongst nursing students. Only a third of all students and 45% of nursing students agreed that use of antibiotics contributes to AMR. Large percentages of nursing and medical students prefer to take antibiotics for viral illnesses whilst, 76% of all students consult a doctor before starting an antibiotic. Several knowledge gaps were identified, as well as key differences between the student groups. Curriculum review to educate students about their role in contributing to AMR and antimicrobial stewardship is imperative as sub-optimal KAP are likely to lead to negative patient outcomes.