Schmid Katrina L, Backhouse Simon, Harduwar Kieran, Jalbert Isabelle
Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia.
School of Medicine, Deakin University, Geelong, Australia.
Clin Exp Optom. 2025 Apr;108(3):302-309. doi: 10.1080/08164622.2024.2394101. Epub 2024 Aug 28.
Antimicrobial stewardship aims to improve how antibiotics are prescribed by clinicians and used by patients, to ensure safe appropriate use, and to prevent and contain antimicrobial resistance.
Australian optometrists can prescribe a range of antimicrobial agents, but to what extent they consider antimicrobial stewardship is not known. This study evaluated what final-year optometry students and optometrists understood about antimicrobial stewardship in eye care and considered relevance to oral prescribing and education.
A knowledge, attitude, and practice (KAP) questionnaire was developed comprising four sections: i) demographic questions, ii) 10 multiple choice questions regarding Knowledge about antimicrobial agents and likely pathogens, diagnosis, treatment, and preventing resistance, iii) 10 Likert rating scale questions about thoughts and Attitudes, iv) mix of question types (5× MCQ: course of action, 16 Likert scale: confidence) related to Practice (diagnosis, management, and prescribing). Descriptive analyses were conducted (medians, mean±SD, and distributions).
Thirteen students and 36 optometrists completed the survey. Both groups had a good understanding of microbial resistance and antibiotic prescribing for ocular conditions; average knowledge scores were 9.2 ± 0.7 and 8.7 ± 1.1 for students and practitioners, respectively. Scores were neutral to agree for questions related to the need for more educational programs. The answers of practice-related MCQs had a dichotomy of answers indicating a diversity of opinion, as can be the case in practice. Average total practice confidence scores were approximately 57/80 for students and 68/80 for optometrists. Optometrists and students were very confident in their ability to conduct an appropriate case history and use their knowledge and clinical skills, including slit lamp anterior eye assessment. The lowest confidence scores were for conducting microbial testing, i.e. taking swabs for pathology.
Student and optometrist knowledge, attitudes, and practice around antimicrobial stewardship were high and in line with other health professions globally. There is scope for increased stewardship training.
抗菌药物管理旨在改善临床医生开具抗生素的方式以及患者使用抗生素的情况，以确保安全合理使用，并预防和控制抗菌药物耐药性。
澳大利亚验光师可以开具一系列抗菌药物，但他们在多大程度上考虑抗菌药物管理尚不清楚。本研究评估了验光专业最后一年的学生和验光师对眼保健中抗菌药物管理的理解，并考虑了其与口服处方和教育的相关性。
制定了一份知识、态度和实践（KAP）问卷，包括四个部分：i）人口统计学问题，ii）关于抗菌药物和可能病原体的知识、诊断、治疗及预防耐药性的10道多项选择题，iii）关于想法和态度的10道李克特量表问题，iv）与实践（诊断、管理和处方）相关的多种问题类型（5道多项选择题：行动方案，16道李克特量表：信心）。进行了描述性分析（中位数、均值±标准差和分布）。
13名学生和36名验光师完成了调查。两组对眼部疾病的微生物耐药性和抗生素处方都有较好的理解；学生和从业者的平均知识得分分别为9.2±0.7和8.7±1.1。对于与更多教育项目需求相关的问题，得分从中性到同意。与实践相关的多项选择题答案存在分歧，表明存在不同意见，这在实践中也可能如此。学生的平均总实践信心得分约为57/80，验光师为68/80。验光师和学生对他们进行适当病史询问以及运用知识和临床技能（包括裂隙灯眼前节评估）的能力非常有信心。信心得分最低的是进行微生物检测，即采集拭子进行病理学检查。
学生和验光师在抗菌药物管理方面的知识、态度和实践水平较高，与全球其他卫生专业一致。加强管理培训仍有空间。
