Barker, Bronwyn-Combating Antimicrobial Resistance in Under-Resourced Hospital Settings (Dr. Jeffrey Pernica)

Combating Antimicrobial Resistance in Under-Resourced Hospital Settings

The spread of antimicrobial resistance amongst bacterial and fungal infections is a growing global concern. The effectiveness of international efforts to decelerate the spread vary according to the region. Under-resourced hospitals see a greater incidence of antimicrobial resistance and there is far less research and understanding on what widespread resistance is and the practitioners’ knowledge of resistance or prescription practices. Antibiograms are an important tool for curbing over-prescription rates that are frequently implemented in higher- and middle-income countries,  to various degrees of success. Antibiograms serve as a way of communicating the efficacy of different antimicrobials on strains of bacteria isolated in a specific region,  but they are often under-used. This thesis aims to investigate the prescribing practices of physicians in the Princess Marina Hospital of Botswana,  while analyzing frequency and effectiveness of antibiograms in that setting. A quantitative survey was distributed to all physicians in the paediatric ward of the hospital,  inquiring about the physician’s education and familiarity regarding antimicrobial resistance and antibiograms. The physicians were asked to respond to clinical vignettes using sample antibiograms. The survey has found that physicians are not well educated in antimicrobial resistance and antibiogram use,  and that it impacts their prescription practices. There needs to be a better understanding around the importance of ethical prescription patterns in terms of antimicrobial resistance and how to use an antibiogram. This study has implications for how physicians and microbiologists can combat the growing problem of antimicrobial resistance in under-resourced settings.