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.

backgroundInappropriate use of antimicrobials can push the environment out of balance, and cause unnecessary waste that can contaminate our soil, animals and waterways. Health professional education is committed to preparing students for antimicrobial stewardship (AMS) and supporting planetary health, but a more multidisciplinary action is needed to curb the expansion of antimicrobial resistance (AMR). The aim of this scoping review is to showcase the current antimicrobial knowledge of undergraduate students across the disciplines of medicine, pharmacy, nursing, dentistry and veterinary. This will consequently showcase the gaps and trends across the different disciplines and countries to help inform planetary health multidisciplinary undergraduate curriculums.

methodsA search of the existing literature published prior to December 2023 was conducted using CINAHL, EMBASE, MEDLINE, SCOPUS, and ERIC databases. Studies were excluded if they included postgraduate students or discussed the knowledge, attitude and practice (KAP) of students towards antimicrobial prescribing, AMR and AMS related to a specific learning activity.

resultsA total of 144 articles were included. The most represented countries were India and Pakistan accounting for 17% and 8% of the studies, respectively. Single-disciplinary research accounted for approximately 80% of the studies. Medicine was the most represented discipline in both single-disciplinary and multidisciplinary research, appearing in approximately 62% of the studies, followed by pharmacy appearing in approximately 30% of the studies and dentistry appearing in approximately 18% of the studies. Three major priority themes were identified: students are more familiar with the term AMR compared to AMS; inappropriate use of antimicrobials is seen as the main driver of AMR; and the need for more training and education in the field of appropriate antimicrobial prescribing, AMR and AMS.

conclusionThis review has highlighted that there is a need for more AMS interprofessional education (IPE) activities in all five disciplines, and especially within the disciplines of nursing, veterinary and dentistry, as shown by a lack of multidisciplinary research in this area. Most of the knowledge assessments have just touched the surface of AMS and focused on inappropriate antimicrobial use alone. Interdisciplinary planetary health education needs to go beyond these skills and broaden the understanding of other factors that can contribute to AMR such as inappropriate disposal, environmental contamination, monitoring and surveillance, one health, false allergies, and more importantly, how each health professional can contribute to a team.