What does antimicrobial stewardship look like where you are? Global narratives from participants in a massive open online course. Issue 1 (28th December 2021)

• Record Type: Journal Article
• Authors: Nampoothiri, Vrinda; Bonaconsa, Candice; Surendran, Surya; Mbamalu, Oluchi; Nambatya, Winnie; Ahabwe Babigumira, Peter; Ahmad, Raheelah; Castro-Sanchez, Enrique; Broom, Alex; Szymczak, Julia; Zingg, Walter; Gilchrist, Mark; Holmes, Alison; Mendelson, Marc; Singh, Sanjeev; McLeod, Monsey; Charani, Esmita
• Is Part Of: JAC-antimicrobial resistance. Volume 4:Issue 1(2022)
• Publication Date: 2021-12-28
• Subjects: Anti-infective agents -- Periodicals; Chemotherapy -- Periodicals; Drug resistance in microorganisms -- Periodicals; 616.9041
• DOI: 10.1093/jacamr/dlab186
• Languages: English
• ISSNs: 2632-1823

Abstract

Abstract: Background: Whilst antimicrobial stewardship (AMS) is being implemented globally, contextual differences exist. We describe how the use of a massive open online course (MOOC) platform provided an opportunity to gather diverse narratives on AMS from around the world. Methods: A free 3 week MOOC titled 'Tackling antimicrobial resistance: a social science approach' was launched in November 2019. Learners were asked specific questions about their experiences of AMS via 38 optional free-text prompts dispersed throughout the modules. Content analysis was used to identify key emerging themes from the learners' responses in the first three runs of the MOOC. Results: Between November 2019 and July 2020, 1464 learners enrolled from 114 countries. Overall, 199 individual learners provided a total of 1097 responses to the prompts. The diverse perspectives describe unique challenges present in different contexts including ill-defined roles for pharmacists and nurses in AMS; inadequate governance and policy inconsistencies in surveillance for antibiotic consumption and antimicrobial resistance (AMR) in some countries; lack of ownership of antibiotic decision-making and buy-in from different clinical specialties; and human resource and technological constraints. Patients' knowledge, experiences and perspectives were recognized as a valuable source of information that should be incorporated in AMS initiatives to overcome cultural barriers to the judicious use of antibiotics. Conclusions: Analysis of learner comments and reflections identified a range of enablers and barriers to AMS implementation across different healthcare economies. Common challenges to AMS implementation included the role of non-physician healthcare workers, resource limitations, gaps in knowledge of AMR, and patient engagement and involvement in AMS.