2023. Antimicrobial Resistance and Stewardship Knowledge and Perception among Medical and Pharmacy Students in Nigeria

Abstract

Background. Nigeria is the most populous country in Africa and has high rates of antimicrobial resistance (AMR). The practice of antimicrobial stewardship in Nigerian hospitals is very limited and the subject is rarely included in undergraduate medical and pharmacy curriculums. To further acceptance and implementation of antimicrobial stewardship programs (ASP) in Nigeria health system, baseline measurements of the knowledge and perceptions held by graduating medical and pharmacy students was deemed essential. This study evaluated the knowledge and perceptions of a cohort of Nigerian medical and pharmacy students in concepts of AMR and ASP. Methods. This was a cross-sectional questionnaire-based study of final year medical and pharmacy students from the two largest schools in the southeastern region of Nigeria. A previously published 20-items questionnaire measuring knowledge and perceptions toward AMR and ASP was adopted for the study. Results were expressed as frequencies and percentages. Results. Completed questionnaires were received from 79.3% (361 of 455 students), over half (60%) were male, and mostly between 22 and 25 years old (68.7%). More pharmacy students had formal training on ASP compared with medical students (41.3% vs. 27.5%, P < 0.05). Pharmacy students (n = 84.3% and 90.5%) were significantly more knowledgeable of factors that promote the spread of AMR and interventions to combat resistance than medical students (n = 73.9% and 82.3%), P < 0.05, respectively. Interestingly, 23.3% of medical students thought pharmacists should lead ASP teams, while 5.8% of pharmacy students thought doctors should lead ASP. However, both held poor perceptions of each other's roles in the ASP team. Conclusion. Knowledge of AMR and ASP among medical and pharmacy students in Nigeria is lacking. Inter-professional collaboration to change perceptions and drive ASP in urgently needed.