Healthcare commissioners’ experience with antibiotic resistance during the COVID-19 pandemic in Saudi Arabia: a qualitative study

ABSTRACT

Introduction

The occurrence of antibiotic resistance (AR) has become a critical issue during the Novel coronavirus disease 2019 (COVID-19) pandemic. This study explores the experiences of healthcare commissioners with AR during the COVID-19 pandemic, identifies challenges, and provides recommendations for combating AR during pandemics.

Methods

This qualitative study was multi-centered and used a phenomenological approach. Semi-structured interviews were conducted between December 2022 and January 2023 among 11 health commissioners using video calls.

Results

Seven themes emerged from the data, including knowledge of AR and its consequences, the antibiotic prescription system, the future of AR and potential contributory factors, the impact of COVID-19 on AR and their relationship, the experience of AR during the COVID-19 pandemic in healthcare facilities, barriers that prevent the misuse of antibiotics during pandemics, and recommendations regarding antibiotic resistance during pandemics.

Conclusion

The findings of this study could be used to inform policy and practice for government healthcare workers (HCWs) and the public. Furthermore, this study identified the main challenges of AR during the pandemic, and the recommendations of health commissioners were provided accordingly. Such recommendations could be beneficial on a national and international scale to reduce the impact of future pandemics on AR.

Abbreviations

COVID-19: Novel coronavirus disease 2019; AR: Antibiotic Resistance; IPC: Infection prevention and control; MDRO: multi-drug resistant organism; ASP: Antimicrobial Stewardship Program; HCW: Healthcare worker; KSA: Kingdom of Saudi Arabia; WHO: World Health Organization; MOH: Ministry of Health; MOEWA: Ministry of Environment, Water, and Agriculture; AMR: Antimicrobial Resistance; PHCC: Primary Healthcare Center

KEYWORDS:

• Health commissioners
• perspective
• antibiotic resistance
• COVID-19
• pandemic

Ethics approval

This study was approved by the Human Research Ethical Committee of Universiti Sains Malaysia (JEPeM Code USM/JEPeM/22040202) and the Institutional Review Board at the General Directorate of Health Affairs (IRB Log Number 2022-23E).

Acknowledgements

We are thankful to all the study participants.

Availability of data and material

Support data for the findings of this study are available and can be obtained from the corresponding author upon reasonable request.

Consent for publication

Not applicable.

Competing interests

The authors declare no conflict of interest.

Author contributions

Conceptualization, H.A.S., N.A.G., and A.A.H; methodology, H.A.S., N.A.G., R.I., and A.A.H.; Transcribing and formal analysis, H.J.A. and N.A.G; writingـــoriginal draft preparation, H.A.S.; writing – review and editing, H.A.S., N.A.G., R.I., and A.A.H.; visualization, H.J.A.; supervision, N.A.G, R.I.; project administration, H.J.A., N.A.G, A.A.H. All authors have read and agreed to the published version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research received no external funding.

Notes on contributors

Hadi Jaber Al Sulayyim

Hadi Jaber Al Sualyyim is a PhD candidate, at the School of Health Sciences, Universiti Sains Malaysia. His research interest is in antimicrobial resistance and hospital infection.

Rohani Ismail

Dr Rohani Ismail is a lecturer at the School of Health Sciences, Universiti Sains Malaysia. Her research interest is in mixed method study, and women and adolescent health.

Abdullah Al Hamid

Dr Abdullah Al Hamid is an Assistant professor at College of Clinical Pharmacy, Department of Pharmacy Practice, King Faisal University, Saudi Arabia. His research interest areas are mediation safety, patient safety, clinical pharmacy and healthcare system improvement. Dr Abdullah has a track record of publications in these areas and working for both academic and clinical organizations.

Noraini Abdul Ghafar

Dr Noraini Abdul Ghafar is lecturer in Epidemiology and Biostatistics at the School of Health Sciences, Universiti Sains Malayasia. Her research interest are epidemiology of infectious and non-infectious disease, disease modelling, and disease prevention.