European medical students: a first multicentre study of knowledge, attitudes and perceptions of antibiotic prescribing and antibiotic resistance
European medical students: a first multicentre study of knowledge, attitudes and perceptions of antibiotic prescribing and antibiotic resistance
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DOI：
10.1093/jac/dkt440
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发表时间：
2014-03-01
影响因子：
5.2
通讯作者：
Nathwani, Dilip
中科院分区：
文献类型：
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作者：
Dyar, Oliver J.;Pulcini, Celine;Nathwani, Dilip
目的：了解医学生对抗生素处方和耐药性的知识和看法，为制定教育计划提供帮助。方法：邀请7所欧洲医学院的应届毕业生参加2012年的在线调查。结果：应答率为35%(338/961)。大多数学生(74%)希望获得更多关于选择抗生素治疗的教育。所有学校的学生在诊断感染时最有信心，在选择联合疗法、选择正确的剂量和给药间隔以及在诊断不确定的情况下不开处方方面最不自信。学生们认为，太多的处方和太多的广谱抗生素使用是导致耐药性的最重要因素；一些人(24%)认为糟糕的手部卫生根本不重要。大多数学生(92%)认为抵抗是一个全国性的问题。大多数人(66%)认为他们将开出的抗生素会导致耐药性，几乎所有人(98%)都认为耐药性在未来会成为更大的问题。大多数学生(83%)错误地认为耐甲氧西林金黄色葡萄球菌(MRSA)菌血症的发病率在过去十年里在他们的国家显著增加。在欧洲，与道路交通事故(死亡率约高2-3倍)和肺癌(死亡率约高10倍)相比，几乎没有人认识到抵抗的相对负担。结论：学生需要进一步了解抗生素处方的教育，并发现了缺乏信心的领域。学生们高估了目前耐药细菌的负担，并不知道在减少MRSA感染方面取得的成功。教育和管理方案可能受益于纳入更多的诊断不确定性病例，并突出预防耐甲氧西林金黄色葡萄球菌等成功案例，以此作为当前干预措施重要性的证据。
Objectives: To learn about medical students' knowledge of and perspectives on antibiotic prescribing and resistance, with the aim of helping to develop educational programmes.Methods: Final-year students at seven European medical schools were invited to participate in an online survey in 2012.Results: The response rate was 35% (338/961). Most students (74%) wanted more education on choosing antibiotic treatments. Students at all schools felt most confident in diagnosing an infection and least confident in choosing combination therapies, choosing the correct dose and interval of administration and not prescribing in cases of diagnostic uncertainty. Students felt that too many prescriptions and too much broad-spectrum antibiotic use were the most important contributors to resistance; some (24%) believed poor hand hygiene was not at all important. Most students (92%) believed that resistance is a national problem. Most (66%) felt that the antibiotics they would prescribe would contribute to resistance, and almost all (98%) felt that resistance would be a greater problem in the future. Most students (83%) incorrectly thought that rates of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia had significantly increased over the past decade in their countries. There was little appreciation of the relative burden of resistance in Europe compared with road traffic accidents (around two to three times greater mortality) and lung cancer (around 10 times greater mortality).Conclusions: Students wanted further education on antibiotic prescribing, and areas of lack of confidence were found. Students overestimated the current burden of resistant bacteria and were unaware of successes in reducing MRSA infections. Educational and stewardship programmes may benefit from including more cases of diagnostic uncertainty, and highlighting successes such as MRSA prevention, as evidence for the importance of current interventions.