Facultad de Medicina, Universidad Cooperativa de Colombia, Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia.
Facultad de Medicina, Universidad Pontificia Bolivariana, Clinica Cardio VID, Medellín, Colombia.
BMC Public Health. 2020 Dec 4;20(1):1861. doi: 10.1186/s12889-020-09971-0.
This study was designed to describe the knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Medellín, Colombia.
A cross-sectional study was conducted among medical students from three universities from September to December 2018. The sample size was calculated, the classrooms were visited, and those students who were willing to participate were invited to do so. The data collection instrument was constructed in three stages: i) the literature was systematically reviewed, ii) the items from the studies identified were extracted, and iii) item reduction was performed with exploratory factor analysis. Data were analyzed by calculating absolute and relative frequencies and means for quantitative variables. The indexes of knowledge, attitude, and practice were transformed to a scale from 0 (worst possible score) to 100. Comparisons were performed using the Mann-Whitney U test, Kruskall-Wallis H test, and linear regressions.
Five hundred and thirty-two medical students were included with a response rate of 96%. Of the total participants, 49.1% reported having used antibiotics within the past year. Regarding knowledge, only 18.2% had heard of the term "antimicrobial stewardship" and 69.3% were aware that empiric antibiotic therapy contributes to antibiotic resistance. Regarding attitude, 11.6% considered that antibiotics should be discontinued as soon as symptoms disappear and 24.6% stated that it is better to prescribe broad-spectrum antibiotics to ensure that the patient is cured. Regarding practice, 28.5% recognized that resistance is a multifactorial problem, but they do not act on it because they consider that individual actions would have little impact. The adjusted linear regression showed that the variables associated with knowledge, attitude, and practice were socioeconomic status, training cycle, university, previous experience of research or education, the general perception of the training received, and antibiotic consumption.
Knowledge, attitude, and practice differ widely depending on the university, training cycle, and socioeconomic status, and a significant proportion of students consider that the standard of training received at the university on antibiotics and bacterial resistance is poor or mediocre. These findings show that there is a need to strengthen the medical students' curriculum on antibiotics, mechanisms of antibiotic resistance, and the prudent use of antibiotics as an important strategy to combat problem-resistant public health, primarily in endemic countries.
本研究旨在描述哥伦比亚麦德林市医学生对抗生素使用和耐药性的知识、态度和实践。
2018 年 9 月至 12 月期间，对来自三所大学的医学生进行了横断面研究。计算了样本量，访问了教室，并邀请了愿意参加的学生参加。数据收集工具分三个阶段构建：i）系统地回顾文献，ii）提取已确定研究的项目，iii）采用探索性因子分析进行项目缩减。对定量变量采用绝对频率和相对频率以及均值进行分析。知识、态度和实践的指标转换为从 0（最差可能得分）到 100 的量表。采用 Mann-Whitney U 检验、Kruskal-Wallis H 检验和线性回归进行比较。
共纳入 532 名医学生，应答率为 96%。在所有参与者中，49.1%报告在过去一年中使用过抗生素。在知识方面，只有 18.2%听说过“抗菌药物管理”一词，69.3%知道经验性抗生素治疗会导致抗生素耐药性。在态度方面，11.6%认为一旦症状消失就应停止使用抗生素，24.6%表示最好开广谱抗生素以确保患者痊愈。在实践方面，28.5%认识到耐药性是一个多因素问题，但他们不会采取行动，因为他们认为个人行动的影响很小。调整后的线性回归显示，与知识、态度和实践相关的变量是社会经济地位、培训周期、大学、研究或教育方面的先前经验、对所接受培训的总体看法以及抗生素的使用。
知识、态度和实践因大学、培训周期和社会经济地位而异，很大一部分学生认为大学对抗生素和细菌耐药性的培训标准较差或中等。这些发现表明，有必要加强医学生对抗生素、抗生素耐药机制以及谨慎使用抗生素的课程，这是作为应对主要在流行国家存在的抗药性公共卫生问题的重要策略。
