Knowledge and Perceptions of Final-Year Nursing Students Regarding Antimicrobials, Antimicrobial Resistance, and Antimicrobial Stewardship in South Africa: Findings and Implications to Reduce Resistance

• Published in: Antibiotics (Basel) 2023-12, Vol.12 (12), p.1742
• Main Authors: Teague, Elisma, Bezuidenhout, Selente, Meyer, Johanna C, Godman, Brian, Engler, Deirdré
• Format: Article
• Language: English
• Subjects: Ambulatory care; Antibiotics; Antimicrobial agents; Antimicrobial resistance; antimicrobial stewardship; antimicrobials; Bacterial infections; Ceftazidime; Cephalosporins; Clavulanic acid; Colleges & universities; Drug resistance; Drug resistance in microorganisms; GDP; Gross Domestic Product; Health aspects; Health facilities; Infection; Infection control; Infectious diseases; Knowledge; Medical personnel; Morbidity; Mortality; Nurses; Nursing; Nursing education; Nursing students; perceptions; Prescription writing; Primary care; Response rates; Students
• ISSN: 2079-6382; 2079-6382
• DOI: 10.3390/antibiotics12121742

Antimicrobial resistance (AMR) is being increasingly seen as the next pandemic due to high morbidity and mortality rates, with Sub-Saharan Africa currently having the highest mortality rates driven by high rates of inappropriate prescribing in ambulatory care. In South Africa, nurses typically provide a range of services, including prescribing, in public ambulatory care clinics. However, little is currently known about the perception of final-year nursing students regarding antibiotic use, AMR, and antimicrobial stewardship (AMS). Consequently, we sought to address this important evidence gap. A quantitative descriptive study using a self-administered online questionnaire via Google Forms was undertaken among six universities in South Africa offering a Baccalaureus of Nursing. Knowledge on the classes of antibiotics, organisms covered, and mechanism of action was lacking. The sample size to achieve a confidence interval of 95% with a 5% error margin was 174, increased to 200 to compensate for possible attrition. Only 15.3% of nurses knew that ceftazidime is not a fourth-generation cephalosporin, and only 16.1% knew that clavulanic acid does not decrease inflammation at the site of infection. In addition, only 58.9% and 67.7% agreed that the prescribing of broad-spectrum antibiotics and poor infection control, respectively, increase AMR. AMS was also not a well-known concept among final-year nurses. The lack of knowledge regarding antibiotics, AMR, and AMS among final-year nurses could have important repercussions in practice once these nurses are qualified. Consequently, this information gap needs to be urgently addressed going forward with updated curricula and post-qualification educational activities to reduce AMR in South Africa.