Antibiotic therapy and awareness of antibiotic resistance problem in medical practice

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Antibiotic resistance is one of the critical public health problems worldwide and calls for special attention. The major driving factor in the emergence of antimicrobial resistance is the irrational prescribing of antibiotics by physicians.

OBJECTIVE

To analyze current foreign and local studies on antibiotic prescribing practices and physicians’ awareness of antibiotic resistance.

MATERIALS AND METHODS

The electronic search engine PubMed and the scientific electronic library eLibrary.ru were used to find original quantitative studies. The review includes studies published between January 1, 2015, and August 31, 2020, in English and Russian. Of the 829 works selected, 26 met the inclusion criteria.

RESULTS

The literature review results demonstrated that physicians consider the problem of antibiotic resistance to be of vital importance but leave it unaddressed in routine practice. Practitioners, especially in developing countries, have little knowledge of antibiotics and often have difficulty prescribing them. The choice of a drug is influenced by its cost and availability, the patient’s socioeconomic status, and patients’ demand for antibiotics. Developing countries lack microbiological diagnostic technology, so empirical antibiotic therapy predominates.

CONCLUSION

The development of educational programs for physicians and the public, infection surveillance systems, and guidelines tailored to regional antimicrobial resistance patterns can be effective means to prevent and reduce antimicrobial resistance.

Keywords:

antibiotics

antimicrobial

antibiotic resistance

usage

awareness

attitude

knowledge

physician

health care provider

Authors:

Fedorova O.S.

Siberian State Medical University

ORCID: 0000-0002-7130-9609

Fedosenko S.V.

Siberian State Medical University

ORCID: 0000-0001-6655-3300

Fedotova M.M.

Siberian State Medical University

ORCID: 0000-0001-7655-7911

Chigrina V.P.

Russian Research Institute of Health

ORCID: 0000-0002-5044-4836

Received:

26.02.2021

Accepted:

23.07.2021

List of references:

World Health Organization. Global Action Plan on Antimicrobial Resistance. Geneva: WHO; 2015.
Webale MK, Wanjala C, Guyah B, Shaviya N, Munyekenye GO, Nyanga PL, Marwa IN, Kagoiyo S, Wangai LN, Webale SK, Kamau K, Kitungulu N. Epidemiological patterns and antimicrobial resistance of bacterial diarrhea among children in Nairobi City, Kenya. Gastroenterol Hepatol Bed Bench. 2020;13(3):238-246.
Yangzom T, Tsering DC, Kar S, Kapil J. Antimicrobial Susceptibility Trends among Pathogens Isolated from Blood: A 6-Year Retrospective Study from a Tertiary Care Hospital in East Sikkim, India. J Lab Physicians. 2020; 12(01):3-9. https://doi.org/10.1055/s-0040-1712814
Zalewska A, Wilson J, Kennedy S, Lockhart M, MacLeod M, Malcolm W. Epidemiological Analysis of Antimicrobial Resistance in Staphylococcus epidermidis in Scotland, 2014—2018. Microbial Drug Resistance. 2021;27(4):485-491. https://doi.org/10.1089/mdr.2019.0502
Mouiche MMM, Moffo F, Akoachere J-FTK, Okah-Nnane NH, Mapiefou NP, Ndze VN, Wade A, Djuikwo-Teukeng FF, Toghoua DGT, Zambou HR, Feussom JMK, LeBreton M, Awah-Ndukum J. Antimicrobial resistance from a one health perspective in Cameroon: a systematic review and meta-analysis. BMC Public Health. 2019;19(1):1135. https://doi.org/10.1186/s12889-019-7450-5
Melese A, Genet C, Andualem T. Prevalence of Vancomycin resistant enterococci (VRE) in Ethiopia: a systematic review and meta-analysis. BMC Infect Dis. 2020;20(1):124. https://doi.org/10.1186/s12879-020-4833-2
Shaver A, Jacobs D, LaMonte M, Noyes K. Antibiotic prescribing for acute respiratory tract infections in the United States outpatient setting. BMC Fam Pract. 2019;20(1):91. https://doi.org/10.1186/s12875-019-0980-1
Pessoa e Costa T, Duarte B, João AL, Coelho M, Formiga A, Pinto M, Neves J. Multidrug‐resistant bacteria in diabetic foot infections: Experience from a portuguese tertiary centre. Int Wound J. 2020;17:1835-1839. https://doi.org/10.1111/iwj.13473
World Health Organizartion. Report on surveillance of antibiotic consumption: 2016—2018 early implementation. Geneva: WHO; 2018.
Shrestha P, Cooper B, Coast J, Oppong R, Do Thi Thuy N, Phodha T, Celhay O, Guerin PJ, Wertheim H, Lubell Y. Enumerating the economic cost of antimicrobial resistance per antibiotic consumed to inform the evaluation of interventions affecting their use. Antimicrobial Resistance & Infection Control. 2018;7(1):98. https://doi.org/10.1186/s13756-018-0384-3
Cassini A, Plachouras D, Monnet D. Attributable deaths caused by infections with antibiotic-resistant bacteria in France — Authors’ reply. The Lancet Infectious Diseases. 2019;19(2):129-130. https://doi.org/10.1016/s1473-3099(19)30004-0
Phodha T, Riewpaiboon A, Malathum K, Coyte P. Annual relative increased in inpatient mortality from antimicrobial resistant nosocomial infections in Thailand. Epidemiol Infect. 2019;147:133. https://doi.org/10.1017/s0950268818003436
World Health Organization. Antimicrobial resistance: a manual for developing national action plans. Geneva: WHO; 2016.
World Health Organization. Global antimicrobial resistance surveillance system (GLASS) report: early implementation 2017—2018. Geneva: WHO; 2018.
Yakovleva SV, Briko NI, Sidorenko SV, Procenko DN. Programma SKAT (Strategiya Kontrolya Antimikrobnoj Terapii) pri okazanii stacionarnoj medicinskoj pomoshchi: Rossijskie klinicheskie rekomendacii. M.: Pero; 2018. (In Russ.).
Makabenta J, Nabawy A, Li C, Schmidt-Malan S, Patel R, Rotello V. Nanomaterial-based therapeutics for antibiotic-resistant bacterial infections. Nature Reviews Microbiology. 2021;19:23-26. https://doi.org/10.1038/s41579-020-0420-1
Buchy P, Ascioglu S, Buisson Y, Datta S, Nissen M, Tambyah PA, Vong S. Impact of vaccines on antimicrobial resistance. International Journal of Infectious Diseases. 2020;90:188-196. https://doi.org/10.1016/j.ijid.2019.10.005
Baindara P, Mandal S. Antimicrobial Peptides and Vaccine Development to Control Multi-drug Resistant Bacteria. Protein & Peptide Letters. 2019; 26(5):324-331. https://doi.org/10.2174/0929866526666190228162751
Simões AS, Alves DA, Gregório J, Couto I, Dias S, Póvoa P, Viveiros M, Gonçalves L, Lapão LV. Fighting antibiotic resistance in Portuguese hospitals: Understanding antibiotic prescription behaviours to better design antibiotic stewardship programmes. J Glob Antimicrob Resist. 2018;13:226-230. https://doi.org/10.1016/j.jgar.2018.01.013
Nicholson A, Tennant I, White L, Thoms-Rodriguez CA, Cook L, Johnson S, Thompson T, Barnett J, Richards L. The knowledge, attitudes and practices of doctors regarding antibiotic resistance at a tertiary care institution in the Caribbean. Antimicrobial Resistance & Infection Control. 2018; 7(1):77. https://doi.org/10.1186/s13756-018-0315-3
Navarro-Gómez P, Gutierrez-Fernandez J, Rodriguez-Maresca M, Olvera-Porcel M, Sorlozano-Puerto A. Effectiveness of Electronic Guidelines (GERH®) to Improve the Clinical Use of Antibiotics in An Intensive Care Unit. Antibiotics. 2020;9(8):521. https://doi.org/10.3390/antibiotics9080521
Yang J, Zheng L, Guan Y, Song C. Analysis of the impact of antimicrobial management and rational use of antibiotics. European Journal of Hospital Pharmacy. 2019;27(5):286-291. https://doi.org/10.1136/ejhpharm-2018-001609
Kjærsgaard M, Leth R, Udupi A, Ank N. Antibiotic stewardship based on education: minor impact on knowledge, perception and attitude. Infect Dis (Auckl). 2019;51(10):753-763. https://doi.org/10.1080/23744235.2019.1648856
Davey P, Marwick CA, Scott CL, Charani E, McNeil K, Brown E, Gould IM, Ramsay CR, Michie S. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database of Systematic Reviews. 2017;2(2):CD003543. https://doi.org/10.1002/14651858.cd003543.pub4
Nepal A, Hendrie D, Selvey LA, Robinson S. Factors influencing the inappropriate use of antibiotics in the Rupandehi district of Nepal. Int J Health Plann Manage. 2021;36(1):42-59. https://doi.org/10.1002/hpm.3061
Lam T, Chan T, Sun K, Lam K, Kwok K, Ho P. Antibiotic prescriptions by medical interns in Hong Kong: influence of the hospital settings and prescription culture. Postgrad Med J. 2021;97(1151):558-565. https://doi.org/10.1136/postgradmedj-2020-138414
Neugebauer M, Ebert M, Vogelmann R. Mangel an Informationen und deren Bereitstellung am Arbeitsplatz als mögliche Gründe für inkorrekte Antibiotikatherapien in Deutschland. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen. 2019;144-145:35-41. https://doi.org/10.1016/j.zefq.2019.06.002
Ahmed H, Bhimani S, Khanum I, Khan A, Khetpal A, Abbas MA, Godil F, Godil A, Makhdoom IUM. Knowledge, attitude and perception survey of doctors regarding antibiotic use and resistance in Karachi, Pakistan. J Pak Med Assoc. 2020;70(6):1023-1028. https://doi.org/10.5455/jpma.6239
Om C, Vlieghe E, McLaughlin J, Daily F, McLaws M. Antibiotic prescribing practices: A national survey of Cambodian physicians. Am J Infect Control. 2016;44(10):1144-1148. https://doi.org/10.1016/j.ajic.2016.03.062
Chaw P, Höpner J, Mikolajczyk R. The knowledge, attitude and practice of health practitioners towards antibiotic prescribing and resistance in developing countries — A systematic review. J Clin Pharm Ther. 2018;43(5):606-613. https://doi.org/10.1111/jcpt.12730
Pearson M, Chandler C. Knowing antimicrobial resistance in practice: a multi-country qualitative study with human and animal healthcare professionals. Glob Health Action. 2019;12(sup1):1599560. https://doi.org/10.1080/16549716.2019.1599560
World Health Organization. Regional Office for South-East Asia. Situational analysis of antimicrobial resistance in the South-East Asia Region, 2018: an update on two years implementation of national action plans. Geneva: World Health Organization, regional Office for South-East Asia; 2019.
Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, Cousens S, Mathers C, Black RE. Global, regional, and national causes of child mortality in 2000-13, with projections to inform post-2015 priorities: an updated systematic analysis [published correction appears in Lancet. 2015 Jan 31;385(9966):420] [published correction appears in Lancet. 2016 Jun 18;387(10037):2506]. Lancet. 2015;385(9966):430-440. https://doi.org/10.1016/S0140-6736(14)61698-6
Lucet JC, Nicolas-Chanoine MH, Roy C, Riveros-Palacios O, Diamantis S, Le Grand J, Papy E, Rioux C, Fantin B, Lefort A, Ravaud P. Antibiotic use: knowledge and perceptions in two university hospitals. J Antimicrob Chemother. 2011;66(4):936-940. https://doi.org/10.1093/jac/dkq541
Navarro-San Francisco C, Del Toro MD, Cobo J, De Gea-García JH, Vañó-Galván S, Moreno-Ramos F, Rodríguez-Baño J, Paño-Pardo JR. Knowledge and perceptions of junior and senior Spanish resident doctors about antibiotic use and resistance: results of a multicenter survey. Enferm Infecc Microbiol Clin. 2013;31(4):199-204. https://doi.org/10.1016/j.eimc.2012.05.016
Mondain V, Lieutier F, Dumas S, Gaudart A, Fosse T, Roger PM, Bernard E, Farhad R, Pulcini C. An antibiotic stewardship program in a French teaching hospital. Med Mal Infect. 2013;43(1):17-21. https://doi.org/10.1016/j.medmal.2012.10.006
Gebretekle GB, Haile Mariam D, Abebe W, Amogne W, Tenna A, Fenta TG, Libman M, Yansouni CP, Semret M. Opportunities and barriers to implementing antibiotic stewardship in low and middle-income countries: Lessons from a mixed-methods study in a tertiary care hospital in Ethiopia. PLoS ONE. 2018;13(12):e0208447. https://doi.org/10.1371/journal.pone.0208447
Shahid A, Iftikhar F, Arshad MK, Javed Z, Sufyan M, Ghuman RS, Tarar Z. Knowledge and attitude of physicians about antimicrobial resistance and their prescribing practices in Services hospital, Lahore, Pakistan. J Pak Med Assoc. 2017;67(6):968.
Quet F, Vlieghe E, Leyer C, Buisson Y, Newton PN, Naphayvong P, Keoluangkhot V, Chomarat M, Longuet C, Steenkeste N, Jacobs J. Antibiotic prescription behaviours in Lao People’s Democratic Republic: a knowledge, attitude and practice survey. Bull World Health Organ. 2015;93(4):219-227. https://doi.org/10.2471/BLT.14.142844
Chaw PS, Schlinkmann KM, Raupach-Rosin H, Karch A, Pletz MW, Huebner J, Mikolajczyk R. Knowledge, attitude and practice of Gambian health practitioners towards antibiotic prescribing and microbiological testing: a cross-sectional survey. Transactions of The Royal Society of Tropical Medicine and Hygiene. 2017;111(3):117-124. https://doi.org/10.1093/trstmh/trx027
Fathi I, Sameh O, Abu-Ollo M, Naguib A, Alaa-Eldin R, Ghoneim D, Elhabashi S, Taha A, Ibrahim Y, Radwan R, Nada M, Ramadan M. Knowledge, Attitudes, and Beliefs Regarding Antimicrobial Therapy and Resistance Among Physicians in Alexandria University Teaching Hospitals and the Associated Prescription Habits. Microbial Drug Resistance. 2017; 23(1):71-78. https://doi.org/10.1089/mdr.2015.0279
Alothman A, Algwizani A, Alsulaiman M, Alalwan A, Binsalih S, Bosaeed M. Knowledge and Attitude of Physicians toward Prescribing Antibiotics and the Risk of Resistance in Two Reference Hospitals. Infect Dis (Auckl). 2016; 9:33-38. https://doi.org/10.4137/IDRT.S40047
Baadani A, Baig K, Alfahad W, Aldalbahi S, Omrani A. Physicians’ knowledge, perceptions, and attitudes toward antimicrobial prescribing in Riyadh, Saudi Arabia. SMJ. 2015;36(5):613-619. https://doi.org/10.15537/smj.2015.5.11726
Labi A-K, Obeng-Nkrumah N, Bjerrum S, Aryee NAA, Ofori-Adjei YA, Yawson AE, Newman MJ. Physicians’ knowledge, attitudes, and perceptions concerning antibiotic resistance: a survey in a Ghanaian tertiary care hospital. BMC Health Serv Res. 2018;18(1):126. https://doi.org/10.1186/s12913-018-2899-y
Ni OG, Ochakovskaya IN, Shabanova NE, Penzhoyan GA, Model’ GYu, Yakovlev SV. Anketirovanie vrachei dlya opredeleniya iskhodnogo urovnya znanii kak mekhanizm povysheniya effektivnosti obrazovatel’nykh meropriyatii v oblasti ratsional’noi antimikrobnoi terapii. Antibiotiki i Khimioterapiya. 2018;63(7-8):55-61. (In Russ.).
Green J, Gardiner SJ, Clarke SL, Thompson L, Metcalf SC, Chambers ST. Antimicrobial stewardship practice in New Zealand’s rural hospitals. N Z Med J. 2018;131(1481):16-26.
Salm F, Schneider S, Schmücker K, Petruschke I, Kramer TS, Hanke R, Schröder C, Heintze C, Schwantes U, Gastmeier P, Gensichen J; RAI-Study Group. Antibiotic prescribing behavior among general practitioners — a questionnaire-based study in Germany. BMC Infect Dis. 2018;18(1):208. https://doi.org/10.1186/s12879-018-3120-y
Asante KP, Boamah EA, Abdulai MA, Buabeng KO, Mahama E, Dzabeng F, Gavor E, Annan EA, Owusu-Agyei S, Gyansa-Lutterodt M; Ghana Antimicrobial Resistance Working Group. Knowledge of antibiotic resistance and antibiotic prescription practices among prescribers in the Brong Ahafo Region of Ghana; a cross-sectional study. BMC Health Serv Res. 2017; 17(1):422. https://doi.org/10.1186/s12913-017-2365-2
Rusic D, Bozic J, Bukic J, Vilovic M, Tomicic M, Seselja Perisin A, Leskur D, Modun D, Cohadzic T, Tomic S. Antimicrobial Resistance: Physicians’ and Pharmacists’ Perspective. Microbial Drug Resistance. 2021;27(5):670-677. https://doi.org/10.1089/mdr.2020.0272
Thakolkaran N, Shetty AV, D’Souza NDR, Shetty AK. Antibiotic prescribing knowledge, attitudes, and practice among physicians in teaching hospitals in South India. J Family Med Prim Care. 2017;6(3):526-532. https://doi.org/10.4103/2249-4863.222057
Farley E, Stewart A, Davies M-A, Govind M, Van den Bergh D, Boyles TH. Antibiotic use and resistance: Knowledge, attitudes and perceptions among primary care prescribers in South Africa. S Afr Med J. 2018;108(9):763. https://doi.org/10.7196/SAMJ.2018.v108i9.12933
Isataeva AI, Bres’ DA, Ismailova RM, Duisenova AM. Analiz ambulatornogo naznacheniya antimikrobnykh preparatov spetsialistami obshchemeditsinskoi praktiki. Nauchnoe obozrenie. Pedagogicheskie nauki. 2019;5-3:65-68. (In Russ.).
Triffault-Fillit C, Ferry T, Perpoint T, Adélaïde L, Le Ngoc Tho S, Ader F, Chidiac C, Valour F. Outpatient parenteral antibiotic therapy: Evaluation of practices and limits of use in rural areas in France. Médecine et Maladies Infectieuses. 2018;48(2):130-135. https://doi.org/10.1016/j.medmal.2017.09.008
Pereko DD, Lubbe MS, Essack SY. Antibiotic use in Namibia: prescriber practices for common community infections. South African Family Practice. 2015;57(4):231-235. https://doi.org/10.1080/20786190.2015.1024021
Ogunleye OO, Fadare JO, Yinka-Ogunleye AF, Anand Paramadhas BD, Godman B. Determinants of antibiotic prescribing among doctors in a Nigerian urban tertiary hospital. Hospital Practice. 2019;47(1):53-58. https://doi.org/10.1080/21548331.2018.1475997
Camcioglu Y, Sener Okur D, Aksaray N, Darendeliler F, Hasanoglu E. Factors affecting physicians’ perception of the overuse of antibiotics. Médecine et Maladies Infectieuses. 2020;50(8):652-657. https://doi.org/10.1016/j.medmal.2020.01.006
Gajdács M, Szabó A. Orvosok antibiotikumfelhasználással és -rezisztenciával kapcsolatos véleményének vizsgálata Magyarország délkeleti részén. OH. 2020;161(9):330-339. https://doi.org/10.1556/650.2019.31598
Kalungia AC, Mwambula H, Munkombwe D, Marshall S, Schellack N, May C, Jones ASC, Godman B. Antimicrobial stewardship knowledge and perception among physicians and pharmacists at leading tertiary teaching hospitals in Zambia: implications for future policy and practice. Journal of Chemotherapy. 2019;31(7-8):378-387. https://doi.org/10.1080/1120009X.2019.1622293
Zhusupova GK, Makalkina LG, Zhaldybaeva SS, Zhetimkarinova GE, Shakarova AM. Ocenka tekushhej situacii po ispol’zovaniju antibiotikov sredi medicinskih rabotnikov i naselenija. Farmacija Kazahstana. 2016;11(186):6-12. (In Russ.).
Smith CR, Pogany L, Foley S, Wu J, Timmerman K, Gale-Rowe M, Demers A. Canadian physicians’ knowledge and counseling practices related to antibiotic use and antimicrobial resistance: Two-cycle national survey. Can Fam Physician. 2017;63(12):526-535.

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