Knowledge and Perception of Pharmacy Interns in Ghana on Antimicrobial Use, Resistance, and Stewardship: A Cross-Sectional Study

Background and Aims: Antimicrobial resistance (AMR) is a global health crisis, particularly predominant in low- and middle-income countries. Pharmacists play a crucial role in combating AMR, especially through antimicrobial stewardship (AMS) initiatives. In Ghana, the training of pharmacists includes a mandatory 1-year internship before licensure, aimed at ensuring that graduates are well-prepared to deliver high-quality pharmaceutical care. However, the extent to which this training equips interns to address AMR, especially through AMS, remains unclear. This study aimed to determine the knowledge and perceptions of pharmacy interns in Ghana on antimicrobial use (AMU), AMR, and AMS to identify gaps or deficiencies in their training. Methods: A cross-sectional study was conducted among 195 pharmacy interns who had just sat for the Ghana Pharmacy Professional Qualifying Examination (GPPQE). A questionnaire adapted from previously published studies was used to collect data. Data were analyzed descriptively using Google Sheets. Knowledge scores were categorized using Bloom's cut-off criteria: a score of ≥ 80% was considered “good,” while < 80% was classified as “moderate to poor.”. Results: Most interns had received training on AMU (92.3%), AMR (90.3%), and AMS (81.5%). Good knowledge levels were observed for AMU (65.6%) and AMR (58.9%); however, only 43.1% demonstrated good AMS knowledge. Despite 92.3% of interns perceiving the quantity and quality of their knowledge to be good, only 58.0% strongly agreed they had received sufficient training, and 64.6% expressed a desire for further education on AMU, AMR, and AMS, reflecting awareness of training gaps. Conclusion: Although most interns received training, there were critical knowledge gaps present, particularly in AMS. While interns held positive perceptions of their stewardship roles, a gap exists between their self-assessed knowledge and objective knowledge performance, especially regarding AMS. Reviewing internship training objectives and harmonizing AMS education across training institutions is recommended to ensure that pharmacy graduates are well prepared for their stewardship roles in practice.