KNOWLEDGE, ATTITUDE AND PRACTICES ON ANTIBIOTIC USE AND RESISTANCE AMONG DOCTORS IN B.P. KOIRALA INSTITUTE OF HEALTH SCIENCES
Background: Assessment of knowledge, attitudes and practices (KAP) of antibiotic prescription among doctors may help in developing guidelines to improve antibiotics use and decrease resistance.
Aims and objectives: Our aim was to evaluate KAP regarding antibiotic use and its resistance among doctors.
Materials and Methods: A cross sectional, questionnaire based study was conducted among the doctors of B.P. Koirala Institute of Health Sciences, Dharan, Nepal between January-March 2016 and their KAP regarding antibiotic use and resistance was assessed by using a five point Likert scale. The data were analyzed by calculating percentage and frequency.
Results: Almost half of the doctors (50.2%) used to prescribe antibiotics more than once daily. Nearly two thirds of the doctors (65.3%) received antibiotic education at a formal lecture on ward rounds. Most of the doctors (87.4%) agreed that antimicrobials are overused. One hundred thirty four doctors (42.3%) agreed that patientsâ€™ demands for antibiotics contribute to its overuse. Nearly two third doctors (70.7%) believed that locally developed antimicrobial guidelines would be more useful. Most of the respondents (89.9%) wanted more ongoing education on antibiotic use and its resistance.
Conclusions: Our study reveals that antibiotics are overused and patientsâ€™ demand contribute to this. Locally developed antimicrobial guidelines would be more useful. More CME on antibiotic use and its resistance should be conducted to enhance the awareness among doctors.
Keywords: Antibiotics; Attitude; Antimicrobial drug resistance; Knowledge.
2. Spellberg B, Guidos R, Gilber D, Bradley J, Boucher HW, Scheld WM et al. The epidemic of antibiotic-resistant infections: A call to action for the medical community from the Infectious Diseases Society of America. Clin Infect Dis. 2008; 46:155-164.
3. Antimicrobial resistanceâ€”global report on surveillance. World Health Organization, 2014, Geneva [cited 2015 October 15]. Available from: http://www.who.int/drugresistance/documents/surveillancereport/en/
4. Phelps CE. Bug/drug resistance. Med Care. 1988; 27(2):194â€“203.
5. Antibiotic resistance threats in the United States. CDC, 2013, USA [cited 2015 October 15]. Available from: http://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf
6. Holmes AH, Sharland M. The Chennai Declaration: Indiaâ€™s landmark national commitment to antibiotic stewardship demonstrates that â€˜truth alone triumphsâ€™. J Antimicrob Chemother. 2013; 50:71-3.
7. Hayashi Y, Davis L, Paterson DL. Why canâ€™t I prescribe that antibiotic? The role of antimicrobial stewardship programmes in modern medicine. Intern Med J. 2009; 39:636-8.
8. Shlaes DM, Gerding DN, John JF, Craig WA, Bornstein DL, Duncan RA et al. SHEA position paper: Society for Healthcare Epidemiology of America and Infectious Diseases Society of America Joint Committee on the prevention of antimicrobial resistance: Guidelines for the prevention of antimicrobial resistance in hospitals. Infection Control and Hosp Epidemiol. 1997; 18:275-91.
9. Srinivasan A, Song X, Richards A, Sinkowitz-Cochran R, Cardo D, Rand C. A survey of knowledge, attitudes and beliefs of house staff physicians from various specialties concerning antimicrobial use and resistance. Arch Intern Med. 2004; 164:1451-56.
10. Cabana MD, Rand CS, Powe NR et al. Why donâ€™t physicians follow clinical practice guidelines? a framework for improvement. JAMA. 1999; 282:1458-65.
11. Okeke I. Poverty and root causes of resistance in developing countries. In: Sosa A, Byarugaba D, Amabile-Cuevas C, Hsueh P, Kariuki S et al., eds. Antimicrobial resistance in developing countries. First edition, New York; Springer; 2010; p. 27-36.
12. Wester CW, Durairaj L, Evans AT, Schwartz DN, Husain S, Martinez E. Antibiotic resistance: a survey of physician perceptions. Arch Intern Med. 2002; 162:2210-16.
13. Katuala Y, Batoko B, Alworonga JP, Devlieger H, et al. Antibiotic Prescribing in DR Congo: A Knowledge, Attitude and Practice Survey among Medical Doctors and Students. PLoS One. 2013; 8(2):e55495.
14. Thriemer K, Katuala Y, Batoko B, Alworonga JP, Devlieger H, Van Geet C et al. Antibiotic prescribing in DR Congo: a knowledge, attitude and practice survey among medical doctors and students. PLoS One. 2013; 8(2):e55495.
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