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      Knowledge of Antimicrobial Resistance among Veterinary Students and Their Personal Antibiotic Use Practices: A National Cross-Sectional Survey

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          Abstract

          The challenge of antimicrobial resistance (AMR) is grave in developing countries. Antimicrobials are misused yet stakeholders’ contribution to antimicrobial stewardship is low. Veterinary students are future prescribers and their knowledge could influence progress in combating AMR; hence, there is a need to assess their knowledge, attitude, and awareness of AMR. A multi-institutional questionnaire was administered to undergraduates in Nigerian veterinary schools. It comprised demographics, own personal antibiotic usage, and knowledge, attitude, and awareness of AMR in humans and animals. Descriptive statistics and logistic regression were used for analyses. Of the 426 respondents, 39.2% reported personal antimicrobial use in the previous six months. Over 60% received knowledge scores lower than average and >87% requested more education on clinical use and prescriptions pre-graduation, monitored dispensing of antimicrobials, conducting AMR research, and confirmed link among human, animal, and environmental health. Less than 25% of respondents were aware of antimicrobial stewardship and global efforts/organizations for AMR. Final year students have 9-fold and 14-fold more satisfactory knowledge on antimicrobials in humans and animals compared with other students, respectively ( p = 0.001). Final year students also have more knowledge (13×) and awareness of contributory factors (3×) on AMR ( p = 0.001) than other students. Unsatisfactory knowledge on AMR issues exists among veterinary students yet willingness to improve was observed. Identified knowledge, attitude, and gaps in AMR awareness should be targeted by veterinary schools in Nigeria.

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          Most cited references 32

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          Medical students' perceptions and knowledge about antimicrobial stewardship: how are we educating our future prescribers?

          Better understanding of medical students' perceptions, attitudes, and knowledge about antimicrobial prescribing practices could facilitate more effective education of these future prescribers.
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            Antimicrobial resistance in Africa: a systematic review

            Background Antimicrobial resistance (AMR) is widely acknowledged as a global problem, yet in many parts of the world its magnitude is still not well understood. This review, using a public health focused approach, aimed to understand and describe the current status of AMR in Africa in relation to common causes of infections and drugs recommended in WHO treatment guidelines. Methods PubMed, EMBASE and other relevant databases were searched for recent articles (2013–2016) in accordance with the PRISMA guidelines. Article retrieval and screening were done using a structured search string and strict inclusion/exclusion criteria. Median and interquartile ranges of percent resistance were calculated for each antibiotic-bacterium combination. Results AMR data was not available for 42.6% of the countries in the African continent. A total of 144 articles were included in the final analysis. 13 Gram negative and 5 Gram positive bacteria were tested against 37 different antibiotics. Penicillin resistance in Streptococcus pneumoniae was reported in 14/144studies (median resistance (MR): 26.7%). Further 18/53 (34.0%) of Haemophilus influenza isolates were resistant to amoxicillin. MR of Escherichia coli to amoxicillin, trimethoprim and gentamicin was 88.1%, 80.7% and 29.8% respectively. Ciprofloxacin resistance in Salmonella Typhi was rare. No documented ceftriaxone resistance in Neisseria gonorrhoeae was reported, while the MR for quinolone was 37.5%. Carbapenem resistance was common in Acinetobacter spp. and Pseudomonas aeruginosa but uncommon in Enterobacteriaceae. Conclusion Our review highlights three important findings. First, recent AMR data is not available for more than 40% of the countries. Second, the level of resistance to commonly prescribed antibiotics was significant. Third, the quality of microbiological data is of serious concern. Our findings underline that to conserve our current arsenal of antibiotics it is imperative to address the gaps in AMR diagnostic standardization and reporting and use available information to optimize treatment guidelines. Electronic supplementary material The online version of this article (10.1186/s12879-017-2713-1) contains supplementary material, which is available to authorized users.
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              A survey of knowledge, attitudes, and beliefs of medical students concerning antimicrobial use and resistance.

              Physicians who are insufficiently prepared to make choices on antibiotic selection may use antibiotics inappropriately. We surveyed medical students' perceptions and attitudes about their training on antimicrobial use to identify gaps in medical education. Medical students at an urban medical school in the northeast were e-mailed a link to an online survey. The survey was online for 1 week, after which time the survey responses were downloaded and analyzed. Thirty percent of medical students responded to the survey (n  =  304). The majority of third- and fourth-year medical students believe that antibiotics are overused in the hospital and in outpatient areas. Over three quarters of the students would like more education on antibiotic selection, and 83% wanted this education to be during the third year of medical school. The resources they used the most for antibiotic selection included other physicians and handheld programs such as Epocrates, but no clear resource emerged as the dominant preference. Medical students recognized the importance of judicious antibiotic use and would like greater instruction on how to choose antibiotics appropriately. Medical school curricula should be expanded in the third year of medical school to provide students with additional training timed with their clinical rotations.
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                Author and article information

                Journal
                Antibiotics (Basel)
                Antibiotics (Basel)
                antibiotics
                Antibiotics
                MDPI
                2079-6382
                29 November 2019
                December 2019
                : 8
                : 4
                Affiliations
                [1 ]Department of Veterinary Public Health and Preventive Medicine, University of Ilorin, Ilorin 240272, Kwara State, Nigeria; drghalimohd@ 123456gmail.com (I.G.-M.); abiobaku@ 123456yahoo.com (A.J.B.)
                [2 ]Department of Veterinary Public Health and Preventive Medicine, Michael Okpara University of Agriculture, Umudike 440109, Abia State, Nigeria; udiakpabio@ 123456yahoo.com
                [3 ]Public Health and Epidemiology Unit, Niger State Veterinary Hospital, Bosso, Minna 920211, Niger State, Nigeria; nmabida62@ 123456gmail.com
                [4 ]Department of Veterinary Pharmacology and Toxicology, University of Ilorin, Ilorin 240272, Kwara State, Nigeria; biobaku.kt@ 123456unilorin.edu.ng
                [5 ]Epidemiology Section, Department of Production Animal Studies, Faculty of Veterinary Science, Onderstepoort Campus 0110, University of Pretoria, Pretoria 0110, South Africa; nurudeenoloso@ 123456gmail.com
                [6 ]Department of Veterinary Public Health and Preventive Medicine, University of Ibadan, Ibadan 200284, Oyo State, Nigeria; vadetunji@ 123456gmail.com
                [7 ]Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, Onderstepoort Campus 0110, University of Pretoria, Pretoria 0110, South Africa; daydupe2003@ 123456yahoo.co.uk
                [8 ]Emergency Centre for Transboundary Animal Diseases-Food and Agriculture Organization of the United Nations (ECTAD-FAO), Dar es Salaam 14111, Tanzania
                Author notes
                [* ]Correspondence: odetokun.ia@ 123456unilorin.edu.ng ; Tel.: +234-80-3088-6018
                Article
                antibiotics-08-00243
                10.3390/antibiotics8040243
                6963658
                31795341
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

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