Trainee doctors not adequately prepared to prescribe antibiotics‚ study finds

Trainee doctors are inadequately prepared to prescribe antibiotics‚ a survey of final-year students at three major medical schools has found.

A questionnaire filled in by 289 students at Wits‚ Free State and Cape Town medical schools found that only 33% felt confident about prescribing antibiotics.

The findings come after the World Health Organisation warned last month that 12 bacteria are poised to emerge as the “greatest threat to human health” because overprescribing means they are becoming resistant to antibiotics.

About 700‚000 people around the world are killed every year by drug-resistant infections‚ and it is estimated that the toll will be 10 million a year by 2050 if no action is taken.

The results of the South African survey have sparked a call in a South African Medical Journal editorial for “drastic educational measures”.

Adrian Brink from the UCT medical school and two University of Pretoria academics — Johan Schoeman (veterinary science) and George Muntingh (pharmacology) — say: “Existing education in SA medical schools may be augmented by standardisation‚ focusing on equipping young doctors with the necessary confidence and skills in appropriate antibiotic prescribing at an early stage of their careers.”

The seven scientists who did the research‚ which is also reported in the May edition of the journal‚ said knowledge levels among students were moderate to poor.

“This survey ... has exposed training gaps and raises a number of important concerns about the preparedness of our future antibiotic prescribers‚” writes the lead author‚ Sean Wasserman from UCT.

“Although formal pharmacology and microbiology lectures are included in medical school curricula‚ there appears to be a failure to translate this into clinical prescribing practice and a discordance between knowledge and practice.”

The effect of inadequate preparation at medical school‚ said Wasserman‚ “may translate into widespread antibiotic misuse and perpetuate antibiotic resistance. Our findings are concerning and serve as a call for intervention”.

The editorial said any new approach would need to include dentists‚ whose antibiotic prescriptions are thought to have rocketed in the past 20 years‚ and vets.

“The extensive non-therapeutic use of antibiotics in food animals ... raise serious concerns‚” say Brink‚ Schoeman and Muntingh.

“Moreover‚ the major increase in the use of antibiotics in companion animals and recent evidence of the reciprocal transfer of resistant pathogens between pets and their owners should prompt urgent attention to antibiotic stewardship.”


TMG Digital



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