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 healthcare 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, the team reviewed 144 research articles from a diverse range of countries with the goal to identify gaps and trends in antimicrobial knowledge and, ultimately, help inform planetary health curriculums and improve antimicrobial stewardship within healthcare 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 healthcare 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 healthcare 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 PhD 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 standardised definition of certain antimicrobial stewardship principles that expands beyond the scope of prescribing and encompasses the multiple factors jeopardising the health of the planet as a result of antimicrobial resistance," Ms 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."
The full study, titled 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 has been published by BMC Medical Education and can be found here.
