The Need for Ongoing Antimicrobial Stewardship during the COVID-19 Pandemic and Actionable Recommendations.

The coronavirus disease (COVID-19) pandemic, which has significant impact on global health care delivery, occurs amid the ongoing global health crisis of antimicrobial resistance. Early data demonstrated that bacterial and fungal co-infection with COVID-19 remain low and indiscriminate use of antimicrobials during the pandemic may worsen antimicrobial resistance It is, therefore, essential to maintain the ongoing effort of antimicrobial stewardship activities in all sectors globally.

Improving Access to Antimicrobial Prescribing Guidelines in 4 African Countries: Development and Pilot Implementation of an App and Cross-Sectional Assessment of Attitudes and Behaviour Survey of Healthcare Workers and Patients.

Smartphone apps have proven to be an effective and acceptable resource for accessing information on antimicrobial prescribing. The purpose of the study is to highlight the development and implementation of a smartphone/mobile app (app) for antimicrobial prescribing guidelines (the Commonwealth Partnerships for Antimicrobial Stewardship-CwPAMS App) in Ghana, Tanzania, Uganda and Zambia and to evaluate patients' and healthcare providers' perspectives on the use of the App in one of the participating institutions. Two structured cross-sectional questionnaires containing Likert scale, multiple-choice, and open-ended questions were issued to patients and healthcare workers six months after the introduction of the app at one of the hospital sites. Metrics of the use of the app for a one-year period were also obtained. Download and use of the app peaked between September and November 2019 with pharmacists accounting for the profession that the most frequently accessed the app. More than half of the responding patients had a positive attitude to the use of the app by health professionals. Results also revealed that more than 80% of health care workers who had used the CwPAMS App were comfortable using a smartphone/mobile device on a ward round, considered the app very useful, and found it to improve their awareness of antimicrobial stewardship, including documentation of the indication and duration for antimicrobials on the drug chart. It also encouraged pharmacists and nurses to challenge inappropriate antimicrobial prescribing. Overall, our findings suggest that its use as a guide to antimicrobial prescribing sparked positive responses from patients and health professionals. Further studies will be useful in identifying the long-term consequences of the use of the CwPAMS App and scope to implement in other settings, in order to guide future innovations and wider use.

Public Hospital Pharmacists' Perceptions and Knowledge of Antibiotic Use and Resistance: A Multicenter Survey.

Antimicrobial Stewardship Program (ASP) has been implemented in major public hospitals in Malaysia, with pharmacists playing a key role in ensuring the appropriate use of antibiotics. This survey aimed to assess the practices, perceptions, and knowledge of public hospital pharmacists on antibiotic use and resistance. A cross-sectional survey involving pharmacists from six public hospitals in Penang was conducted using a self-administered validated questionnaire. The majority of pharmacists perceived that polypharmacy (92%, n = 270) and overuse of broad-spectrum antibiotics (85%, n = 252) can potentially induce resistance of microorganisms and that ensuring the rational use of antibiotics is a shared responsibility between clinicians and pharmacists (94%, n = 278). A large majority of the pharmacists think that formal training in infectious disease should be a pre-requisite for pharmacists in ASP (93%, n = 273). In terms of antibiotic selection, the availability of antibiotics in hospital (81%, n = 234) and patient's clinical condition (68%, n = 196) are more of a concern to the pharmacists. A total of 65% of the respondents (n = 192) demonstrated good levels of knowledge with a mean knowledge score of 10.1 out of 13 (95% CI: 9.95; 10.31). Pharmacists from the managerial level, ward pharmacy, in-patient, and medication therapy adherence clinic (MTAC) unit had better knowledge of antibiotics compared to pharmacists from other units (p < 0.001). Antibiotic knowledge gap had been identified among pharmacists in different work settings, and longer years of service does not warrant good antibiotic knowledge.