Khadka Sitaram, Thapa Chhetri Suchit, B K Reshu, Sah Krishna Kumar, Mehra Arav, Joshi Rinku
Shree Birendra Hospital Nepalese Army Institute of Health Sciences Kathmandu Nepal.
College of Medicine Nepalese Army Institute of Health Sciences Kathmandu Nepal.
Health Sci Rep. 2025 Jun 18;8(6):e70928. doi: 10.1002/hsr2.70928. eCollection 2025 Jun.
Antimicrobial resistance (AMR) is a pressing global issue caused and aggravated by the injudicious use of antimicrobials. The WHO has developed an Access, Watch, and Reserve (AWaRe) system to categorize antimicrobials to promote responsible use and combat resistance. The aim of the study was to assess healthcare professionals' knowledge and application of AWaRe principles in a tertiary care hospital, focusing on their relevance to AMR.
A comparative cross-sectional survey was performed among a total of 166 registered healthcare professionals in a tertiary care hospital using a pre-validated questionnaire. The socio-demographic characteristics of participants were presented as frequencies and proportions. Group differences were tested by the chi-square test ( ). Odds ratios with 95% confidence intervals were computed for the binary logistic regression analyses.
The medical professionals showed a higher level of good understanding (59.81%) and practice (60.75%). The medical professionals (OR = 0.137, 95% CI: = 0.137-0.539, < 0.001), individuals with MD/MS degrees (OR = 0.297, 95% CI: = 0.149-0.592, < 0.001), male gender (OR = 0.298, 95% CI: = 0.157-0.565, < 0.001), and those with less experience (OR = 0.528, 95% CI: = 0.285-0.979, < 0.05) had a better grasp of the AWaRe system. Similarly, individuals with more experience were more likely to engage in good practices (OR = 1.903, 95% CI: = 1.013-3.573, = 0.044). On the other hand, gender, age, faculty, qualification, and specialization did not show any significant association with practice regarding the AWaRe system.
The study highlighted significant differences in understanding and practices related to AMR among the three professional groups. Medical professionals demonstrated the highest levels of understanding and adherence, followed by pharmacy and nursing professionals. Targeted educational programs could address existing knowledge gaps and strengthen antimicrobial stewardship efforts in resource-limited settings like Nepal.
抗菌药物耐药性（AMR）是一个紧迫的全球问题，因抗菌药物的不合理使用而产生并加剧。世界卫生组织（WHO）制定了“准入、观察和储备”（AWaRe）系统，对抗菌药物进行分类，以促进合理使用并对抗耐药性。本研究的目的是评估一家三级医院中医疗保健专业人员对AWaRe原则的了解和应用情况，重点关注其与AMR的相关性。
在一家三级医院中，使用预先验证的问卷对总共166名注册医疗保健专业人员进行了一项比较横断面调查。参与者的社会人口统计学特征以频率和比例呈现。通过卡方检验（ ）检验组间差异。计算二元逻辑回归分析的比值比及其95%置信区间。
医学专业人员表现出较高水平的良好理解（59.81%）和实践（60.75%）。医学专业人员（OR = 0.137，95% CI：= 0.137 - 0.539， ＜ 0.001）、拥有医学博士/医学硕士学位的人员（OR = 0.297，95% CI：= 0.149 - 0.592， ＜ 0.001）、男性（OR = 0.298，95% CI：= 0.157 - 0.565， ＜ 0.001）以及经验较少的人员（OR = 0.528，95% CI：= 0.285 - 0.979， ＜ 0.05）对AWaRe系统的掌握更好。同样，经验更丰富的人员更有可能践行良好做法（OR = 1.903，95% CI：= 1.013 - 3.573， = 0.044）。另一方面，性别、年龄、科室、资质和专业在AWaRe系统的实践方面未显示出任何显著关联。
该研究突出了三个专业群体在与AMR相关的理解和实践方面的显著差异。医学专业人员表现出最高水平的理解和依从性，其次是药学和护理专业人员。有针对性的教育项目可以弥补现有知识差距，并加强尼泊尔等资源有限环境中的抗菌药物管理工作。
