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A global investigation led by Monash University into antimicrobial knowledge in medicine, pharmacy, nursing, dentistry and veterinary undergraduate students has uncovered a need for better education across all five disciplines to curb the growing threat of antimicrobial resistance and its impact on planetary health.
Inappropriate use of antimicrobials (antibiotics, antivirals, antifungals and antiparasitics) can push the environment out of balance and cause unnecessary waste that can contaminate our soil, animals and waterways.
As such, antimicrobial stewardship is integral to planetary health education as it aims to prepare the future health care workforce to promote the responsible use of antimicrobials.
The study found that, to date, interdisciplinary planetary health education has primarily focused on inappropriate antimicrobial use alone, highlighting an urgent need for a far broader understanding of the multiple skills required to effectively combat antimicrobial resistance.
This includes an in-depth knowledge of things that can contribute to antimicrobial resistance such as inappropriate disposal, environmental contamination, understanding patterns of antimicrobial usage through various surveillance and auditing methods, false allergies and, most importantly, the role each health professional can contribute within a team dedicated to antimicrobial stewardship.
In this study, conducted by researchers from Monash’s Faculty of Pharmacy and Pharmaceutical Sciences and published in the journal BMC Medical Education, the team reviewed 144 research articles from a diverse range of countries with the goal of identifying gaps and trends in antimicrobial knowledge and, ultimately, helping inform planetary health curriculums and improve antimicrobial stewardship within health care settings around the world.
One of the study’s lead authors and Deputy Pharmacy Course Director at Monash’s Faculty of Pharmacy and Pharmaceutical Sciences, Dr. Angelina Lim, said antimicrobial stewardship in health care is multifaceted.
“While a solid understanding of inappropriate antimicrobial use is important in the fight against antimicrobial resistance, comprehension of other key factors, such as responsible disposing of medicines and ongoing surveillance methods, needs to be addressed in health care education if we are to combat the growing threat of antimicrobial resistance and its impact on both human and planetary health,” Dr. Lim said.
Of the 144 articles included in the review, the most represented countries were India and Pakistan, with medicine being the most represented discipline, followed by pharmacy and then dentistry. Overall, the review highlighted a need for more antimicrobial stewardship interprofessional education across all five disciplines, but particularly within nursing, veterinary and dentistry.
In addition to the need for more training and education in the field of appropriate antimicrobial prescribing, the study also found that students are more familiar with the term “antimicrobial resistance” compared to “antimicrobial stewardship” indicating the need for greater awareness in this area.
Lead author, Monash Faculty of Pharmacy and Pharmaceutical Sciences Ph.D. candidate and hospital pharmacist at Northern Health, Shahd Alzard, said she hopes this review will provide a strong foundation for health professional academics to instigate interprofessional antimicrobial stewardship innovations and programs.
“Further research is encouraged to develop a standardized definition of certain antimicrobial stewardship principles that expands beyond the scope of prescribing and encompasses the multiple factors jeopardizing the health of the planet as a result of antimicrobial resistance,” Alzard said.
“My hope is that we start to see a notable uptick in the implementation of antimicrobial stewardship education and training at the undergraduate level, at a time when knowledge and attitudes of students are still being shaped.”
Alzard and Dr. Lim have also recently collaborated with the Murdoch Children’s Research Institute to investigate opportunities and barriers to improving pediatric antimicrobial stewardship in community pharmacies.
“At the Faculty of Pharmacy and Pharmaceutical Sciences we want our future pharmacists to be able to practice planetary health principles in mind and, in turn, lead to better practices in the community. Our students have co-led a recently published project showing their passion for upskilling pharmacists in this area,” Dr. Lim concluded.
The timely study comes as world leaders prepare to gather in Azerbaijan from November 11–22 for the UN Climate Change Conference 2024, also known as COP29 or the Conference of Parties of the UN Framework Convention on Climate Change.
More information:
Shahd Alzard et al, A global investigation into antimicrobial knowledge in medicine, pharmacy, nursing, dentistry and veterinary undergraduate students: A scoping review to inform future planetary health multidisciplinary education, BMC Medical Education (2024). DOI: 10.1186/s12909-024-06253-w
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Global study reveals gaps in antimicrobial knowledge and planetary health education (2024, November 7)
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