Gamified interventions to improve the knowledge, awareness and practice on rational use of antibiotics among school children in Mysuru, South India to curb the growing antimicrobial resistance (AMR).

IntroductionAntimicrobial resistance (AMR) is a global problem. Its important to create awareness of the rational use of antibiotics to curb AMR. ObjectiveTo improve the awareness of the rational use of antibiotics through innovative games for High School Students. DesignProspective interventional study SettingTwelve High Schools in the city of Mysuru, South India. Participants2195 Students between 13 and 16 years. InterventionInnovative gamified interventions to educate on the rational use of antibiotics. Use of antibiotics only in bacterial infections of the respiratory tract, gut, urinary tract and skin was introduced through black blackboard. An animated video was shown on the effects of irrational antibiotic use. Situations in which antibiotics can be avoided in respiratory infections and gastroenteritis were taught through Bucketing the Ball and Monkeying with Donkey games. Pre-test and Post-test questionnaires were administered and evaluated. Main outcome measuresTo assess the improvement in awareness of the rational use of antibiotics. ResultsAfter the intervention, knowledge of the use of antibiotics only for bacterial infections improved from 11.5% to 82.5% and ill-effects of antibiotics improved from 2.5% to 82.5%. Awareness of when not to use and when to use antibiotics for respiratory infections and gastroenteritis improved from 5.1% to 96.77%, awareness of better use of antibiotics for urinary and skin infections improved from 19.6% to 90.38% and not buying antibiotics directly from the pharmacy without prescription, and completing the antibiotic course improved from 20.3% to 91.92%. p-value < 0.05 for all components. ConclusionsAwareness of the rational use of antibiotics is very poor among the general public. The need of the hour is to create awareness not only among healthcare providers but also among the general public. Innovative gamified interventions create better and long-lasting awareness of this. Strength and Limitations of the studyO_LIThe strength was using gamified interventions to create knowledge and awareness about rational use of antibiotics. C_LIO_LIThe limitation is, awareness about adverse effects of antibiotics could not be converted to gamified intervention, and it was shown as an animated video since adverse effects of antibiotics include long term complications. C_LIO_LIThough the students may not be able to remember in the long run the difference between viral and bacterial infections, they will definitely be able to remember that not all respiratory tract infections and gastro enteritis require antibiotics and henceforth they will not pressurize the physicians to prescribe antibiotics. C_LI Limitation