4.5 Attitudes, perception and practice towards antibiotics use and its resistance
Around 70 to 85% of our respondents agree that “pharmaceutical companies should develop new antibiotic” and “government should give reward to these developments”. US Food and Drug Administration (FDA) summarized that “only one-tenth of new antibiotics being discovered in the last 35 years compared with the previous 35 years”.29 This slow development is most likely due to the inadequate financial support given to the pharmaceutical companies to carry out the research, hence, they have stopped the research progress and only aimed at promoting the sales of drugs. In consistent with the pipeline of new drug running dry, AR has limited the options available in treating the life-threatening infection caused by antibiotic-resistant bacteria. Therefore, it is crucial for the prescriber to be more mindful in selecting appropriate antibiotics to treat bacterial infections. During their undergraduate level, outcome-based education (OBE) can be implemented into their preclinical phase. This is to ensure the medical graduates are fit for practice and prescribing appropriate antibiotics.
Furthermore, according to a study done by Ab Halim et al., more than half of the respondents are expecting the doctor to prescribe antibiotics even if it is not necessary.11 Besides, Ab Rahman et al., also claimed that the presence of high antibiotics prescribing rate among the primary care settings (87%) and most of them were used to treat unnecessary conditions such as URTI (46.2%), cold and flu.15 It had been established that these unnecessary prescribing was most likely due to overly high expectations and pressure from patients or even due to financial incentives for the general practitioners. Similarly, the current study showed that almost all the respondents understood the antibiotics should only be given when necessary.
Further, more than half of our respondents disagree that medical experts will solve the problem of antibiotic resistance before it becomes too serious. Conversely, based on the WHO multi-country survey, 64% of them agreed with the statement above.27 This finding revealed that our respondents are less aware of their role in tackling with this issue. Perhaps, the prescriber should be nurtured with the sense of responsibility of stopping the emergence of antibiotic resistance as they play a major role in prescribing antibiotics.31 Instead of only increase the knowledge of antibiotic and its resistance among the students, it is also important to change their attitude and perception towards their role and responsibility in accordance with the development of AR.
Despite of the good overall theoretical knowledge, there are still a minority of the final year medical students who were practicing incorrect behaviours concerning the antibiotics consumption. In healthcare field, we shall not compromise even a single mistake because every action we take is concerning the safety of the patient. The undergraduate students are at the stage of the steppingstone whereby they need to be properly educated and well trained regarding the appropriate usage of antibiotics as they play a vital role in treating various illnesses in future days. Hence, a more comprehensive understanding of antibiotic resistance and the knowledge of the use and misuse of the antibiotics are absolutely inevitable for undergraduate medical students.