Knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Colombia: a cross-sectional descriptive study

Background This study was designed to describe the knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Medellín, Colombia. Methods A cross-sectional study was conducted among medical students from three universities from September to December 2018. The...

Full description

Autores:
Higuita Gutiérrez, Luis Felipe
Roncancio Villamil, Gustavo Eduardo
Jiménez Quiceno, Judy Natalia
Tipo de recurso:
Article of journal
Fecha de publicación:
2020
Institución:
Universidad Cooperativa de Colombia
Repositorio:
Repositorio UCC
Idioma:
OAI Identifier:
oai:repository.ucc.edu.co:20.500.12494/28570
Acceso en línea:
https://doi.org/10.1186/s12889-020-09971-0
https://hdl.handle.net/20.500.12494/28570
Palabra clave:
Medical students
Antibiotics
Antibiotic resistance
Colombia
Medical students
Antibiotics
Antibiotic resistance
Colombia
Rights
openAccess
License
Atribución
id COOPER2_cc8c2ca2718a3b8428f237116d671ecf
oai_identifier_str oai:repository.ucc.edu.co:20.500.12494/28570
network_acronym_str COOPER2
network_name_str Repositorio UCC
repository_id_str
dc.title.spa.fl_str_mv Knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Colombia: a cross-sectional descriptive study
title Knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Colombia: a cross-sectional descriptive study
spellingShingle Knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Colombia: a cross-sectional descriptive study
Medical students
Antibiotics
Antibiotic resistance
Colombia
Medical students
Antibiotics
Antibiotic resistance
Colombia
title_short Knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Colombia: a cross-sectional descriptive study
title_full Knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Colombia: a cross-sectional descriptive study
title_fullStr Knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Colombia: a cross-sectional descriptive study
title_full_unstemmed Knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Colombia: a cross-sectional descriptive study
title_sort Knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Colombia: a cross-sectional descriptive study
dc.creator.fl_str_mv Higuita Gutiérrez, Luis Felipe
Roncancio Villamil, Gustavo Eduardo
Jiménez Quiceno, Judy Natalia
dc.contributor.author.none.fl_str_mv Higuita Gutiérrez, Luis Felipe
Roncancio Villamil, Gustavo Eduardo
Jiménez Quiceno, Judy Natalia
dc.subject.spa.fl_str_mv Medical students
Antibiotics
Antibiotic resistance
Colombia
topic Medical students
Antibiotics
Antibiotic resistance
Colombia
Medical students
Antibiotics
Antibiotic resistance
Colombia
dc.subject.other.spa.fl_str_mv Medical students
Antibiotics
Antibiotic resistance
Colombia
description Background This study was designed to describe the knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Medellín, Colombia. Methods A cross-sectional study was conducted among medical students from three universities from September to December 2018. The sample size was calculated, the classrooms were visited, and those students who were willing to participate were invited to do so. The data collection instrument was constructed in three stages: i) the literature was systematically reviewed, ii) the items from the studies identified were extracted, and iii) item reduction was performed with exploratory factor analysis. Data were analyzed by calculating absolute and relative frequencies and means for quantitative variables. The indexes of knowledge, attitude, and practice were transformed to a scale from 0 (worst possible score) to 100. Comparisons were performed using the Mann-Whitney U test, Kruskall-Wallis H test, and linear regressions. Results Five hundred and thirty-two medical students were included with a response rate of 96%. Of the total participants, 49.1% reported having used antibiotics within the past year. Regarding knowledge, only 18.2% had heard of the term “antimicrobial stewardship” and 69.3% were aware that empiric antibiotic therapy contributes to antibiotic resistance. Regarding attitude, 11.6% considered that antibiotics should be discontinued as soon as symptoms disappear and 24.6% stated that it is better to prescribe broad-spectrum antibiotics to ensure that the patient is cured. Regarding practice, 28.5% recognized that resistance is a multifactorial problem, but they do not act on it because they consider that individual actions would have little impact. The adjusted linear regression showed that the variables associated with knowledge, attitude, and practice were socioeconomic status, training cycle, university, previous experience of research or education, the general perception of the training received, and antibiotic consumption. Conclusion Knowledge, attitude, and practice differ widely depending on the university, training cycle, and socioeconomic status, and a significant proportion of students consider that the standard of training received at the university on antibiotics and bacterial resistance is poor or mediocre. These findings show that there is a need to strengthen the medical students’ curriculum on antibiotics, mechanisms of antibiotic resistance, and the prudent use of antibiotics as an important strategy to combat problem-resistant public health, primarily in endemic countries.
publishDate 2020
dc.date.accessioned.none.fl_str_mv 2020-12-16T19:10:39Z
dc.date.available.none.fl_str_mv 2020-12-16T19:10:39Z
dc.date.issued.none.fl_str_mv 2020-12-04
dc.type.none.fl_str_mv Artículo
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_2df8fbb1
dc.type.coar.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
dc.type.coarversion.none.fl_str_mv http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.driver.none.fl_str_mv info:eu-repo/semantics/article
dc.type.version.none.fl_str_mv info:eu-repo/semantics/publishedVersion
format http://purl.org/coar/resource_type/c_6501
status_str publishedVersion
dc.identifier.issn.spa.fl_str_mv 14712458
dc.identifier.uri.spa.fl_str_mv https://doi.org/10.1186/s12889-020-09971-0
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/20.500.12494/28570
dc.identifier.bibliographicCitation.spa.fl_str_mv Higuita-Gutiérrez, L.F., Roncancio Villamil, G.E. & Jiménez Quiceno, J.N. (2020). Knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Colombia: a cross-sectional descriptive study. BMC Public Health 20, 1861. https://doi.org/10.1186/s12889-020-09971-0
identifier_str_mv 14712458
Higuita-Gutiérrez, L.F., Roncancio Villamil, G.E. & Jiménez Quiceno, J.N. (2020). Knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Colombia: a cross-sectional descriptive study. BMC Public Health 20, 1861. https://doi.org/10.1186/s12889-020-09971-0
url https://doi.org/10.1186/s12889-020-09971-0
https://hdl.handle.net/20.500.12494/28570
dc.relation.isversionof.spa.fl_str_mv https://link.springer.com/article/10.1186/s12889-020-09971-0#citeas
dc.relation.ispartofjournal.spa.fl_str_mv BMC Public Health
dc.relation.references.spa.fl_str_mv 1. Abera B, Kibret M, Mulu W. Knowledge and beliefs on antimicrobial resistance among physicians and nurses in hospitals in Amhara region, Ethiopia. BMC Pharmacol Toxicol. 2014;15:26.
2. Grigoryan L, Haaijer-Ruskamp FM, Burgerhof JGM, Mechtler R, Deschepper R, Tambic-Andrasevic A, et al. Self-medication with antimicrobial drugs in Europe. Emerg Infect Dis. 2006;12:452–9.
3. Cole A. GPs feel pressurised to prescribe unnecessary antibiotics, survey finds. BMJ. 2014;349:g5238.
4. Bell M. Antibiotic misuse: a global crisis. JAMA Intern Med. 2014;174:1920–1.
5. Marshall BM, Levy SB. Food animals and antimicrobials: impacts on human health. Clin Microbiol Rev. 2011;24:718–33.
6. Årdal C, Outterson K, Hoffman SJ, Ghafur A, Sharland M, Ranganathan N, et al. International cooperation to improve access to and sustain effectiveness of antimicrobials. Lancet. 2016;387:296–307.
7. Khan AKA, Banu G, Reshma KK. Antibiotic resistance and usage-a survey on the knowledge, attitude, perceptions and practices among the medical students of a southern Indian teaching hospital. J Clin Diagn Res. 2013;7:1613–6. https://doi.org/10.7860/JCDR/2013/6290.3230.
8. Bai Y, Wang S, Bai J, Gong Y, Lu Z. Factors associated with doctors’ knowledge on antibiotic use in China. Sci Rep. 2016;6:23429. https://doi.org/10.1038/srep23429.
9. Shapiro DJ, Hicks LA, Pavia AT, Hersh AL. Antibiotic prescribing for adults in ambulatory care in the USA, 2007-09. J Antimicrob Chemother. 2014;69:234–40.
10. Yang K, Wu D, Tan F, Shi S, Guo X, Min Q, et al. Attitudes and perceptions regarding antimicrobial use and resistance among medical students in Central China. SpringerPlus. 2016;5:1779.
11. Scaioli G, Gualano MR, Gili R, Masucci S, Bert F, Siliquini R. Antibiotic use: a cross-sectional survey assessing the knowledge, attitudes and practices amongst students of a school of medicine in Italy. PLoS One. 2015;10:e0122476.
12. World Health Organization. WHO Global Strategy for Containment of Antimicrobial Resistance. 2001 http://www.who.int/drugresistance/SpGlobal2.pdf. Accessed 17 June 2016.
13. Abbo LM, Cosgrove SE, Pottinger PS, Pereyra M, Sinkowitz-Cochran R, Srinivasan A, et al. Medical students’ perceptions and knowledge about antimicrobial stewardship: how are we educating our future prescribers? Clin Infect Dis. 2013;57:631–8.
14. Pulcini C, Wencker F, Frimodt-Møller N, Kern WV, Nathwani D, Rodríguez-Baño J, et al. European survey on principles of prudent antibiotic prescribing teaching in undergraduate students. Clin Microbiol Infect. 2015;21:354–61.
15. Thriemer K, Katuala Y, Batoko B, Alworonga J-P, Devlieger H, Van Geet C, et al. Antibiotic prescribing in DR Congo: a knowledge, attitude and practice survey among medical doctors and students. PLoS One. 2013;8:e55495.
16. Ovalle MV, Saavedra SY, González MN, Hidalgo AM, Duarte C, Beltrán M. Results of the national surveillance of antimicrobial resistance of Enterobacteriaceae and Gram negative bacilli in health care-associated infections in Colombia, 2012-2014. Biomedica. 2017;37(4):473–85. https://doi.org/10.7705/biomedica.v34i2.3432.
17. Vanegas JM, Cienfuegos AV, Ocampo AM, López L, del Corral H, Roncancio G, et al. Similar frequencies of Pseudomonas aeruginosa isolates producing KPC and VIM carbapenemases in diverse genetic clones at tertiary-care hospitals in Medellín, Colombia. J Clin Microbiol. 2014;52:3978–86.
18. Ocampo AM, Chen L, Cienfuegos AV, Roncancio G, Chavda KD, Kreiswirth BN, et al. A two-year surveillance in five Colombian tertiary care hospitals reveals high frequency of non-CG258 clones of carbapenem-resistant Klebsiella pneumoniae with distinct clinical characteristics. Antimicrob Agents Chemother. 2016;60:332–42.
19. Villalobos AP, Barrero LI, Rivera SM, Ovalle MV, Valera D. Surveillance of healthcare associated infections, bacterial resistance and antibiotic consumption in high-complexity hospitals in Colombia, 2011. Biomedica. 2014;34(Suppl 1):67–80.
20. Hernández Ayazo H, Sierra Merlano RM. Medical training in Colombia. Educación Médica. 2018;19(1):31–5. https://doi.org/10.1016/j.edumed.2018.03.006.
21. Sarahroodi S, Arzi A, Sawalba AF, Ashtarinezhad A. Antibiotiotics self-medication among southern Iranian university students. Int J Pharmacol. 2010;6:48–52.
22. Mahajan DM, Dudhgaonkar DS, Deshmukh DS. A questionnaire based survey on the knowledge, attitude and practises about antimicrobial resistance and usage among the second year MBBS students of a teaching tertiary care hospital in Central India. Int J Pharmacol Res. 2014;4:175–9.
23. Ahmad A, Khan MU, Patel I, Maharaj S, Pandey S, Dhingra S. Knowledge, attitude and practice of B.Sc. Pharmacy students about antibiotics in Trinidad and Tobago. J Res Pharm Pract. 2015;4:37–41.
24. Justo JA, Gauthier TP, Scheetz MH, Chahine EB, Bookstaver PB, Gallagher JC, et al. Knowledge and attitudes of doctor of pharmacy students regarding the appropriate use of antimicrobials. Clin Infect Dis. 2014;59(Suppl 3):S162–9.
25. Fejza A, Kryeziu Z, Kadrija K, Musa M. Pharmacy students' knowledge and attitudes about antibiotics in Kosovo. Pharm Pract (Granada). 2016;14(1):715. https://doi.org/10.18549/PharmPract.2016.01.715.
26. López-Vázquez P, Vázquez-Lago JM, Gonzalez-Gonzalez C, Piñeiro-Lamas M, López-Durán A, Herdeiro MT, et al. Development and validation of the knowledge and attitudes regarding antibiotics and resistance (KAAR-11) questionnaire for primary care physicians. J Antimicrob Chemother. 2016;71:2972–9.
27. Courtenay M, Lim R, Castro-Sanchez E, Deslandes R, Hodson K, Morris G, et al. Development of consensus-based national antimicrobial stewardship competencies for UK undergraduate healthcare professional education. J Hosp Infect. 2018;100:245–56.
28. Huang Y, Gu J, Zhang M, Ren Z, Yang W, Chen Y, et al. Knowledge, attitude and practice of antibiotics: a questionnaire study among 2500 Chinese students. BMC Med Educ. 2013;13:163.
29. Srinivasan A, Song X, Richards A, Sinkowitz-Cochran R, Cardo D, Rand C. A survey of knowledge, attitudes, and beliefs of house staff physicians from various specialties concerning antimicrobial use and resistance. Arch Intern Med. 2004;164:1451–6.
30. Chang-Ro L, Jung HL, Lin-Woo K, Byeong CJ, Sang HL. Educational effectiveness, target, and content for prudent antibiotic use. Biomed Res Int. 2015;2015. https://doi.org/10.1155/2015/214021.
31. Vacca CP, Niño CY, Reveiz L. Antibiotics sale restriction in pharmacies in Bogotá, Colombia: descriptive study. Rev Panam Public Health. 2011;30:586–91.
32. Kristiansson C, Grape M, Gotuzzo E, Samalvides F, Chauca J, Larsson M, et al. Socioeconomic factors and antibiotic use in relation to antimicrobial resistance in the Amazonian area of Peru. Scand J Infect Dis. 2009;41:303–12.
33. Jensen JN, Bjerrum L, Boel J, Jarløv JO, Arpi M. Parents’ socioeconomic factors related to high antibiotic prescribing in primary health care among children aged 0–6 years in the Capital Region of Denmark. Scand J Prim Health Care. 2016;34:274–81.
34. Harakeh S, Almatrafi M, Ungapen H, Hammad R, Olayan F, Hakim R, et al. Perceptions of medical students towards antibiotic prescribing for upper respiratory tract infections in Saudi Arabia. BMJ Open Respir Res. 2015;2:e000078.
35. Shehadeh M, Suaifan G, Darwish RM, Wazaify M, Zaru L, Alja'fari S. Knowledge, attitudes and behavior regarding antibiotics use and misuse among adults in the community of Jordan. A pilot study. Saudi Pharm J. 2012;20:125–33.
36. Gérvas J. Antibiotic resistance, a public health problem. Primary Health Care. 2000;25:589–96.
37. Vacca CP, Niño CY, Reveiz L. Restriction of antibiotic sales in pharmacies in Bogotá, Colombia: a descriptive study. Rev Panam Salud Publica. 2011;30(6):586–91.
dc.rights.license.none.fl_str_mv Atribución
dc.rights.accessrights.none.fl_str_mv info:eu-repo/semantics/openAccess
dc.rights.coar.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
rights_invalid_str_mv Atribución
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.format.extent.spa.fl_str_mv 12
dc.coverage.temporal.spa.fl_str_mv 20
dc.publisher.spa.fl_str_mv Universidad Cooperativa de Colombia, Facultad de Ciencias de la Salud, Medicina, Medellín y Envigado
Biomed Central
dc.publisher.program.spa.fl_str_mv Medicina
dc.publisher.place.spa.fl_str_mv Medellín
institution Universidad Cooperativa de Colombia
bitstream.url.fl_str_mv https://repository.ucc.edu.co/bitstreams/175262ef-818f-46dc-b0f4-b5e1b1791452/download
https://repository.ucc.edu.co/bitstreams/56f7e33a-ace0-416c-82e9-4fdda013462c/download
https://repository.ucc.edu.co/bitstreams/cb1de8f3-9b9b-4b00-8d96-0cd5f79fd692/download
https://repository.ucc.edu.co/bitstreams/8dcbeb96-d355-4f39-b1ad-9606321fc428/download
bitstream.checksum.fl_str_mv 673f6b47b3709a30559114bbaea215d9
3bce4f7ab09dfc588f126e1e36e98a45
0c37feb52b873f02137f25db2dbdd753
ebde70c9dc16a017fee166801fca25f6
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
MD5
repository.name.fl_str_mv Repositorio Institucional Universidad Cooperativa de Colombia
repository.mail.fl_str_mv bdigital@metabiblioteca.com
_version_ 1814247343391768576
spelling Higuita Gutiérrez, Luis FelipeRoncancio Villamil, Gustavo EduardoJiménez Quiceno, Judy Natalia202020-12-16T19:10:39Z2020-12-16T19:10:39Z2020-12-0414712458https://doi.org/10.1186/s12889-020-09971-0https://hdl.handle.net/20.500.12494/28570Higuita-Gutiérrez, L.F., Roncancio Villamil, G.E. & Jiménez Quiceno, J.N. (2020). Knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Colombia: a cross-sectional descriptive study. BMC Public Health 20, 1861. https://doi.org/10.1186/s12889-020-09971-0Background This study was designed to describe the knowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Medellín, Colombia. Methods A cross-sectional study was conducted among medical students from three universities from September to December 2018. The sample size was calculated, the classrooms were visited, and those students who were willing to participate were invited to do so. The data collection instrument was constructed in three stages: i) the literature was systematically reviewed, ii) the items from the studies identified were extracted, and iii) item reduction was performed with exploratory factor analysis. Data were analyzed by calculating absolute and relative frequencies and means for quantitative variables. The indexes of knowledge, attitude, and practice were transformed to a scale from 0 (worst possible score) to 100. Comparisons were performed using the Mann-Whitney U test, Kruskall-Wallis H test, and linear regressions. Results Five hundred and thirty-two medical students were included with a response rate of 96%. Of the total participants, 49.1% reported having used antibiotics within the past year. Regarding knowledge, only 18.2% had heard of the term “antimicrobial stewardship” and 69.3% were aware that empiric antibiotic therapy contributes to antibiotic resistance. Regarding attitude, 11.6% considered that antibiotics should be discontinued as soon as symptoms disappear and 24.6% stated that it is better to prescribe broad-spectrum antibiotics to ensure that the patient is cured. Regarding practice, 28.5% recognized that resistance is a multifactorial problem, but they do not act on it because they consider that individual actions would have little impact. The adjusted linear regression showed that the variables associated with knowledge, attitude, and practice were socioeconomic status, training cycle, university, previous experience of research or education, the general perception of the training received, and antibiotic consumption. Conclusion Knowledge, attitude, and practice differ widely depending on the university, training cycle, and socioeconomic status, and a significant proportion of students consider that the standard of training received at the university on antibiotics and bacterial resistance is poor or mediocre. These findings show that there is a need to strengthen the medical students’ curriculum on antibiotics, mechanisms of antibiotic resistance, and the prudent use of antibiotics as an important strategy to combat problem-resistant public health, primarily in endemic countries.https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001501791https://orcid.org/0000-0003-1361-3124https://scienti.minciencias.gov.co/gruplac/jsp/visualiza/visualizagr.jsp?nro=00000000011355luis.higuita@campusucc.edu.coroncancio@gmail.comjnatalia.jimenez@udea.edu.co12Universidad Cooperativa de Colombia, Facultad de Ciencias de la Salud, Medicina, Medellín y EnvigadoBiomed CentralMedicinaMedellínhttps://link.springer.com/article/10.1186/s12889-020-09971-0#citeasBMC Public Health1. Abera B, Kibret M, Mulu W. Knowledge and beliefs on antimicrobial resistance among physicians and nurses in hospitals in Amhara region, Ethiopia. BMC Pharmacol Toxicol. 2014;15:26.2. Grigoryan L, Haaijer-Ruskamp FM, Burgerhof JGM, Mechtler R, Deschepper R, Tambic-Andrasevic A, et al. Self-medication with antimicrobial drugs in Europe. Emerg Infect Dis. 2006;12:452–9.3. Cole A. GPs feel pressurised to prescribe unnecessary antibiotics, survey finds. BMJ. 2014;349:g5238.4. Bell M. Antibiotic misuse: a global crisis. JAMA Intern Med. 2014;174:1920–1.5. Marshall BM, Levy SB. Food animals and antimicrobials: impacts on human health. Clin Microbiol Rev. 2011;24:718–33.6. Årdal C, Outterson K, Hoffman SJ, Ghafur A, Sharland M, Ranganathan N, et al. International cooperation to improve access to and sustain effectiveness of antimicrobials. Lancet. 2016;387:296–307.7. Khan AKA, Banu G, Reshma KK. Antibiotic resistance and usage-a survey on the knowledge, attitude, perceptions and practices among the medical students of a southern Indian teaching hospital. J Clin Diagn Res. 2013;7:1613–6. https://doi.org/10.7860/JCDR/2013/6290.3230.8. Bai Y, Wang S, Bai J, Gong Y, Lu Z. Factors associated with doctors’ knowledge on antibiotic use in China. Sci Rep. 2016;6:23429. https://doi.org/10.1038/srep23429.9. Shapiro DJ, Hicks LA, Pavia AT, Hersh AL. Antibiotic prescribing for adults in ambulatory care in the USA, 2007-09. J Antimicrob Chemother. 2014;69:234–40.10. Yang K, Wu D, Tan F, Shi S, Guo X, Min Q, et al. Attitudes and perceptions regarding antimicrobial use and resistance among medical students in Central China. SpringerPlus. 2016;5:1779.11. Scaioli G, Gualano MR, Gili R, Masucci S, Bert F, Siliquini R. Antibiotic use: a cross-sectional survey assessing the knowledge, attitudes and practices amongst students of a school of medicine in Italy. PLoS One. 2015;10:e0122476.12. World Health Organization. WHO Global Strategy for Containment of Antimicrobial Resistance. 2001 http://www.who.int/drugresistance/SpGlobal2.pdf. Accessed 17 June 2016.13. Abbo LM, Cosgrove SE, Pottinger PS, Pereyra M, Sinkowitz-Cochran R, Srinivasan A, et al. Medical students’ perceptions and knowledge about antimicrobial stewardship: how are we educating our future prescribers? Clin Infect Dis. 2013;57:631–8.14. Pulcini C, Wencker F, Frimodt-Møller N, Kern WV, Nathwani D, Rodríguez-Baño J, et al. European survey on principles of prudent antibiotic prescribing teaching in undergraduate students. Clin Microbiol Infect. 2015;21:354–61.15. Thriemer K, Katuala Y, Batoko B, Alworonga J-P, Devlieger H, Van Geet C, et al. Antibiotic prescribing in DR Congo: a knowledge, attitude and practice survey among medical doctors and students. PLoS One. 2013;8:e55495.16. Ovalle MV, Saavedra SY, González MN, Hidalgo AM, Duarte C, Beltrán M. Results of the national surveillance of antimicrobial resistance of Enterobacteriaceae and Gram negative bacilli in health care-associated infections in Colombia, 2012-2014. Biomedica. 2017;37(4):473–85. https://doi.org/10.7705/biomedica.v34i2.3432.17. Vanegas JM, Cienfuegos AV, Ocampo AM, López L, del Corral H, Roncancio G, et al. Similar frequencies of Pseudomonas aeruginosa isolates producing KPC and VIM carbapenemases in diverse genetic clones at tertiary-care hospitals in Medellín, Colombia. J Clin Microbiol. 2014;52:3978–86.18. Ocampo AM, Chen L, Cienfuegos AV, Roncancio G, Chavda KD, Kreiswirth BN, et al. A two-year surveillance in five Colombian tertiary care hospitals reveals high frequency of non-CG258 clones of carbapenem-resistant Klebsiella pneumoniae with distinct clinical characteristics. Antimicrob Agents Chemother. 2016;60:332–42.19. Villalobos AP, Barrero LI, Rivera SM, Ovalle MV, Valera D. Surveillance of healthcare associated infections, bacterial resistance and antibiotic consumption in high-complexity hospitals in Colombia, 2011. Biomedica. 2014;34(Suppl 1):67–80.20. Hernández Ayazo H, Sierra Merlano RM. Medical training in Colombia. Educación Médica. 2018;19(1):31–5. https://doi.org/10.1016/j.edumed.2018.03.006.21. Sarahroodi S, Arzi A, Sawalba AF, Ashtarinezhad A. Antibiotiotics self-medication among southern Iranian university students. Int J Pharmacol. 2010;6:48–52.22. Mahajan DM, Dudhgaonkar DS, Deshmukh DS. A questionnaire based survey on the knowledge, attitude and practises about antimicrobial resistance and usage among the second year MBBS students of a teaching tertiary care hospital in Central India. Int J Pharmacol Res. 2014;4:175–9.23. Ahmad A, Khan MU, Patel I, Maharaj S, Pandey S, Dhingra S. Knowledge, attitude and practice of B.Sc. Pharmacy students about antibiotics in Trinidad and Tobago. J Res Pharm Pract. 2015;4:37–41.24. Justo JA, Gauthier TP, Scheetz MH, Chahine EB, Bookstaver PB, Gallagher JC, et al. Knowledge and attitudes of doctor of pharmacy students regarding the appropriate use of antimicrobials. Clin Infect Dis. 2014;59(Suppl 3):S162–9.25. Fejza A, Kryeziu Z, Kadrija K, Musa M. Pharmacy students' knowledge and attitudes about antibiotics in Kosovo. Pharm Pract (Granada). 2016;14(1):715. https://doi.org/10.18549/PharmPract.2016.01.715.26. López-Vázquez P, Vázquez-Lago JM, Gonzalez-Gonzalez C, Piñeiro-Lamas M, López-Durán A, Herdeiro MT, et al. Development and validation of the knowledge and attitudes regarding antibiotics and resistance (KAAR-11) questionnaire for primary care physicians. J Antimicrob Chemother. 2016;71:2972–9.27. Courtenay M, Lim R, Castro-Sanchez E, Deslandes R, Hodson K, Morris G, et al. Development of consensus-based national antimicrobial stewardship competencies for UK undergraduate healthcare professional education. J Hosp Infect. 2018;100:245–56.28. Huang Y, Gu J, Zhang M, Ren Z, Yang W, Chen Y, et al. Knowledge, attitude and practice of antibiotics: a questionnaire study among 2500 Chinese students. BMC Med Educ. 2013;13:163.29. Srinivasan A, Song X, Richards A, Sinkowitz-Cochran R, Cardo D, Rand C. A survey of knowledge, attitudes, and beliefs of house staff physicians from various specialties concerning antimicrobial use and resistance. Arch Intern Med. 2004;164:1451–6.30. Chang-Ro L, Jung HL, Lin-Woo K, Byeong CJ, Sang HL. Educational effectiveness, target, and content for prudent antibiotic use. Biomed Res Int. 2015;2015. https://doi.org/10.1155/2015/214021.31. Vacca CP, Niño CY, Reveiz L. Antibiotics sale restriction in pharmacies in Bogotá, Colombia: descriptive study. Rev Panam Public Health. 2011;30:586–91.32. Kristiansson C, Grape M, Gotuzzo E, Samalvides F, Chauca J, Larsson M, et al. Socioeconomic factors and antibiotic use in relation to antimicrobial resistance in the Amazonian area of Peru. Scand J Infect Dis. 2009;41:303–12.33. Jensen JN, Bjerrum L, Boel J, Jarløv JO, Arpi M. Parents’ socioeconomic factors related to high antibiotic prescribing in primary health care among children aged 0–6 years in the Capital Region of Denmark. Scand J Prim Health Care. 2016;34:274–81.34. Harakeh S, Almatrafi M, Ungapen H, Hammad R, Olayan F, Hakim R, et al. Perceptions of medical students towards antibiotic prescribing for upper respiratory tract infections in Saudi Arabia. BMJ Open Respir Res. 2015;2:e000078.35. Shehadeh M, Suaifan G, Darwish RM, Wazaify M, Zaru L, Alja'fari S. Knowledge, attitudes and behavior regarding antibiotics use and misuse among adults in the community of Jordan. A pilot study. Saudi Pharm J. 2012;20:125–33.36. Gérvas J. Antibiotic resistance, a public health problem. Primary Health Care. 2000;25:589–96.37. Vacca CP, Niño CY, Reveiz L. Restriction of antibiotic sales in pharmacies in Bogotá, Colombia: a descriptive study. Rev Panam Salud Publica. 2011;30(6):586–91.Medical studentsAntibioticsAntibiotic resistanceColombiaMedical studentsAntibioticsAntibiotic resistanceColombiaKnowledge, attitude, and practice regarding antibiotic use and resistance among medical students in Colombia: a cross-sectional descriptive studyArtículohttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1http://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionAtribucióninfo:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2PublicationORIGINAL2020-Higuita-Gutiérrez,Roncancio,Jiménez_KnowledgeAttitudeAndPractice.pdf2020-Higuita-Gutiérrez,Roncancio,Jiménez_KnowledgeAttitudeAndPractice.pdfArtículoapplication/pdf1549593https://repository.ucc.edu.co/bitstreams/175262ef-818f-46dc-b0f4-b5e1b1791452/download673f6b47b3709a30559114bbaea215d9MD51LICENSElicense.txtlicense.txttext/plain; charset=utf-84334https://repository.ucc.edu.co/bitstreams/56f7e33a-ace0-416c-82e9-4fdda013462c/download3bce4f7ab09dfc588f126e1e36e98a45MD52THUMBNAIL2020-Higuita-Gutiérrez,Roncancio,Jiménez_KnowledgeAttitudeAndPractice.pdf.jpg2020-Higuita-Gutiérrez,Roncancio,Jiménez_KnowledgeAttitudeAndPractice.pdf.jpgGenerated Thumbnailimage/jpeg5366https://repository.ucc.edu.co/bitstreams/cb1de8f3-9b9b-4b00-8d96-0cd5f79fd692/download0c37feb52b873f02137f25db2dbdd753MD53TEXT2020-Higuita-Gutiérrez,Roncancio,Jiménez_KnowledgeAttitudeAndPractice.pdf.txt2020-Higuita-Gutiérrez,Roncancio,Jiménez_KnowledgeAttitudeAndPractice.pdf.txtExtracted texttext/plain51880https://repository.ucc.edu.co/bitstreams/8dcbeb96-d355-4f39-b1ad-9606321fc428/downloadebde70c9dc16a017fee166801fca25f6MD5420.500.12494/28570oai:repository.ucc.edu.co:20.500.12494/285702024-08-10 22:42:21.62restrictedhttps://repository.ucc.edu.coRepositorio Institucional Universidad Cooperativa de Colombiabdigital@metabiblioteca.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