Level of self-confidence among nurse practitioners in rural public health facilities regarding antimicrobial stewardship programs.

Background: Nurse practitioners, especially in remote rural areas in low- and middle-income countries, initiate treatment for numerous conditions including therapy against infections. For a sustained and meaningful reduction in antimicrobial resistance, nurse practitioners should confidently play a greater role as stewards of antibiotic therapy. Therefore, this study investigated the self-confidence level, perceptions, and professional development needs of nurse practitioners as stewards of antibiotic therapy in remote countryside areas in KwaZulu-Natal, South Africa. Methods: Data collection took place at six healthcare facilities in rural areas in KwaZulu-Natal, South Africa. Questionnaires, with open-ended and 5-point Likert-scale-based items, were distributed to nurse practitioners employed, ie, participants, at the research sites. Results: One hundred and thirty (n = 130) participants filled and returned questionnaires; 31% (n = 41) and 69% (n = 89) were males and females, respectively. Over 64% (n = 83) of nurse practitioners were not aware of the extent of inappropriate utilization of antibiotics in South Africa, with a median of 3 (interquartile range (IQR 2-3). Over 70% (n = 91) of participants knew that inappropriate utilization of antimicrobials was harmful to patients, with a median of 4 (IQR 3-5). Only 30% (n = 39) of participants felt confident enough to play a meaningful role as stewards of antimicrobial therapy. Conclusions: There is a need for continuous professional development programs on antimicrobial stewardship to enhance self-confidence among nurse practitioners in rural areas.