Knowledge, Attitudes and Practices of Antibiotic Use and Antimicrobial Resistance among Medical Students in a Private University in Dominica, West Indies

Abstract

Antibiotics are indispensable to maintaining human health, however, their overuse has resulted in resistant organisms which present a significantly higher burden to the low to middle income countries, due to the high incidence of communicable diseases. Insufficient antimicrobial-related training for physicians during their undergraduate education could have a negative impact on their prescribing. This study assessed the knowledge, attitudes and practices of antibiotic use and antimicrobial resistance among medical students in a private university in Dominica, a resource-limited country, in order to facilitate more effective education of these future prescribers. A cross-sectional study was undertaken with the medical students from February 2021 to April 2021 using a 36-item questionnaire. Data analysis was achieved using descriptive statistics. A total of 85 students participated in the study, majority (70%) were female, African, aged 23.8 ± 4.6 years and single. Between 64 and 99% of the respondents reported no risk factors for communicable diseases and demonstrated a low to moderate (10% - 40%) negative response to knowledge-related questions. The majority (70%) of the respondents who had used antibiotics in the past 12 months reported efficacy and limited side-effects, but confirmed lack of knowledge about the classes of antibiotics prescribed to them. Almost half of the medical students (48%) reported having abused antibiotics, while about a third (35%) of the respondents reported sharing antibiotics with friends or loved ones in the past. There was no significant association between age, gender, and the medical students’ knowledge of antibiotic resistance (p > 0.05). However, they reported that they would like more education on antimicrobial use and resistance. The medical students in this study showed knowledge of antimicrobial resistance, but lacked comprehension of components of antimicrobial stewardship, including prevention of inappropriate use and classes of antibiotics. Therefore, steps need to be taken to prepare medical students for antimicrobial resistance and stewardship initiatives effectively.