Sulayyim, Hadi Jaber Al
(2024)
Antibiotic resistance during covid-19 pandemic and perspective of healthcare providers towards antibiotic resistance: a mixed-method study.
PhD thesis, Universiti Sains Malaysia.
Abstract
During the Novel coronavirus disease 2019 (COVID-19), there was an overuse
of antibiotics in hospitals. The improper use of antibiotics during COVID-19 has
increased the antibiotic resistance (AR), which was reported by multiple studies. The
main objective of this study was to study the AR during COVID-19 and perspective
of healthcare providers towards AR. This study employed a mixed method design
throughout two phases. Phase Ⅰ study (ⅰ): A retrospective cross-sectional study was
employed to identify patients who had positive AR bacteria before, during and after
COVID-19 as well as the bacterial isolates; Phase Ⅰ study (ⅱ): A cross sectional design
was employed to assess the knowledge, attitude, and practice (KAP) of healthcare
worker (HCWs) in Najran, Kingdom of Saudi Arabia (KSA); Phase Ⅱ study: A
qualitative multi-centre study was carried out in the KSA to explore the experience of
health commissioners toward AR during COVID-19. Results of Phase Ⅰ study (ⅰ)
showed the prevalence of Pan Drug Resistance (PDR) during COVID-19 pandemic
(85.7%) was higher as compared to the time before (0%) and after (14.3%), p= 0.001.
S. aureus showed a negligible resistance after pandemic, while the resistance Gramnegative
bacteria decreased during and after pandemic compared to the time before.
Results of Phase Ⅰ study (ⅱ) revealed poor knowledge, negative attitude and poor
practice of HCWs. The significantly associated factors with good knowledge were
nationality, cadre, qualification, and working place. Positive attitude was significantly
associated with cadre, qualification, and working place. Good practice was significantly associated with gender, cadre, qualification, and working place. In Phase
Ⅱ, seven themes emerged from data. Therefore, despite the AR increased globally
during COVID-19 pandemic, it dropped gradually in Najran region, KSA. Knowledge,
attitude and practice of HCWs in Najran, KSA regarding AR during pandemic need
improvement, whereas healthcare commissioners showed scientific and up to date
knowledge about the AR. Antibiotics’ prescription should be strictly implemented,
relying on the antimicrobial stewardship programs (ASP) and guidelines from the
world health organization (WHO) or ministry of health (MOH). Implementation of
effective educational and training programs are urgently needed. Findings of this study
could be used to inform policy and practice for governmental HCWs and public to
reduce the impact of pandemics on the AR.
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