Knowledge, attitude and practicing behaviour regarding antimicrobial use and awareness of antimicrobial resistance among clinicians
DOI:
https://doi.org/10.18203/2320-6012.ijrms20223636Keywords:
Antimicrobial use, Antimicrobial awareness and resistance, Knowledge, Attitude, Practicing behaviourAbstract
Background: Antimicrobials' irrational use is leading to antimicrobial resistance. This situation has become a public health care issue and must be tackled by clinicians. The awareness about antimicrobial resistance and proper usage by patients must be looked after by clinicians. Hence, the present study was taken to determine the knowledge, attitude, and practicing behaviour regarding antimicrobial use and awareness of antimicrobial resistance among clinicians.
Methods: The study was conducted on clinicians in a tertiary care hospital. A standardized questionnaire was distributed to 110 participants and ethical approval was taken before the study. Data was analyzed using SPSS software. For data comparisons, chi-square tests were used. P≤0.05*, considered significant.
Results: The study showed a majority in the 25-34 years of age group with male predominance. Many belonged to the 1-0 years of practicing group and the majority were physicians. The antibiotic resistance subject was highly relevant to clinicians, according to them awareness can be spread by proper and precise intake of antibiotics by patients. The relationship between the predominant age group and years of practice revealed good knowledge (χ2=56.703, p=0.01), fair attitude (χ2=69.556, p=0.01), and good practicing behavior (χ2=43.047, p=0.01).
Conclusions: Clinicians were aware of antimicrobial resistance issue globally but irrelevant in their own practice. Patient awareness campaigns and educational programs need to be conducted. Lack of time and patient interest are the barriers to be overcome to spread awareness. The prescribing of antimicrobials should be in a controlled way with the implementation of ethical principles for better patients' health safety.
References
Fair RJ, Tor Y. Antibiotics and bacterial resistance in the 21st century. Perspect Medicin Chem. 2014;6:25–64.
Rajni E, Rathi P, Malik M, Mittal S, Mamoria VP. Impact of Hospital Acquired Infection and Antibiotic Resistance Awareness Campaign on Knowledge Attitude and Practices of Medical Undergraduates in a Tertiary Care Teaching Hospital, India. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. 2020;14(09):23–7.
Founou RC, Founou LL, Essack SY. Clinical and economic impact of antibiotic resistance in developing countries: A systematic review and meta-analysis. PLoS One. 2017;12(12):1-18.
Laxminarayan R, Chaudhury RR. Antibiotic Resistance in India: Drivers and Opportunities for Action. PLoS Med. 2016;13(3):1–7.
Ganesh Kumar S, Adithan C, Harish BN, Sujatha S, Roy G, Malini A. Antimicrobial resistance in India: A review. J Nat Sci Biol Med. 2013;4(2):286–98.
Uchil RR, Kohli GS, Katekhaye VM, Swami OC. Strategies to combat antimicrobial resistance. Journal of Clinical and Diagnostic Research. 2014;8(7):1–4.
Mucklow J, Bollington L, Maxwell S. Assessing prescribing competence. Br J Clin Pharmacol. 2012;74(4):632-39.
Ryan C, Ross S, Davey P, Duncan EM, Francis JJ, Fielding S, et al. Prevalence and causes of prescribing errors: The PRescribing Outcomes for Trainee Doctors Engaged in Clinical Training (PROTECT) study. PLoS One. 2014;9(1):1–9.
Sadasivam K, Chinnasami B, Ramraj B, Karthick N, Saravanan A. Knowledge, attitude and practice of paramedical staff towards antibiotic usage and its resistance. Biomedical and Pharmacology Journal. 2016;9(1):337–43.
Ranjalkar J, Chandy S. India’s National Action Plan for antimicrobial resistance – An overview of the context, status, and way ahead. J Family Med Prim Care. 2019;8(6):1828–34.
Ventola CL. The antibiotic resistance crisis: causes and threats. P & T Journal. 2015;40(4):277–83.
Laxminarayan R, Duse A, Wattal C, Zaidi AKM, Wertheim HFL, Sumpradit N, et al. Antibiotic resistance-the need for global solutions. Lancet Infect Dis. 2013;13(12):128–42.
Lee CR, Lee JH, Kang LW, Jeong BC, Lee SH. Educational effectiveness, target, and content for prudent antibiotic use. Biomed Res Int. 2015;2015:1–13.
Tahoon MA, Khalil MM, Hammad E, Morad WS, awad SM, Ezzat S. The effect of educational intervention on healthcare providers’ knowledge, attitude, & practice towards antimicrobial stewardship program at, National Liver Institute, Egypt. Egyptian Liver Journal. 2020;10(1):1–7.
Chatterjee S, Hazra A, Chakraverty R, Shafiq N, Pathak A, Trivedi N, et al. Knowledge, attitude, and practice survey on antimicrobial use and resistance among Indian clinicians: A multicentric, cross-sectional study. Perspect Clin Res. 2022;13(2):99–105.
García C, Llamocca LP, García K, Jiménez A, Samalvides F, Gotuzzo E, et al. Knowledge, attitudes and practice survey about antimicrobial resistance and prescribing among physicians in a hospital setting in Lima, Peru. BMC Clin Pharmacol. 2011;11:1–8.
Cheoun ML, Heo J, Kim WH. Antimicrobial resistance: kap of healthcare professionals at a tertiary-level hospital in Nepal. Int J Environ Res Public Health. 2021;18(19):1–13.
K. NT, Hazra P, Padma L. A cross-sectional observational study on knowledge, attitude and practices about indiscriminate use of antibiotics and antibiotic resistance among medical doctors at Sapthagiri Hospital, Bangalore. Int J Basic Clin Pharmacol. 2019;8(12):2609–13.
Strich JR, Palmore TN. Preventing Transmission of Multidrug-Resistant Pathogens in the Intensive Care Unit. Infect Dis Clin North Am. 2017;31(3):535–50.
Parveen S, Garzon-Orjuela N, Amin D, McHugh P, Vellinga A. Public Health Interventions to Improve Antimicrobial Resistance Awareness and Behavioural Change Associated with Antimicrobial Use: A Systematic Review Exploring the Use of Social Media. 2022;11(669):1-18.
Barlow G. Clinical challenges in antimicrobial resistance. Nat Microbiol. 2018;3(3):256–60.
Doron S, Davidson LE. Antimicrobial stewardship. Mayo Clin Proc. 2011;86(11):1113–23.
Mathai E, Allegranzi B, Kilpatrick C, Pittet D. Prevention and control of health care-associated infections through improved hand hygiene. Indian J Med Microbiol. 2010;28(2):100–6.
Hand washing: A modest measure—with big effects. BMJ. 1999;318(7185):686.
Demoz GT, Kasahun GG, Hagazy K, Woldu G, Wahdey S, Tadesse DB, et al. Prescribing pattern of antibiotics using who prescribing indicators among inpatients in Ethiopia: A need for antibiotic stewardship program. Infect Drug Resist. 2020;13:2783–94.
Chen X, Fu F. Social learning of prescribing behavior can promote population optimum of antibiotic use. Front Phys. 2018;6(DEC):1–9.
Davey P, Pagliari C, Hayes A. The patient’s role in the spread and control of bacterial resistance to antibiotics. Clinical Microbiology and Infection. 2002;8(SUPPL.2):43–68.
Llor C, Moragas A, Cots JM. Implementation of the delayed antibiotic prescribing strategy. Prospective observation study in primary care. Revista Espanola de Quimioterapia. 2022;35(2):213–7.
Bashir A, Garba I, Aliero AA, Kibiya A, Abubakar MH, Ntulume I, et al. Superbugs-related prolonged admissions in three tertiary hospitals, Kano State, Nigeria. Pan Afr Med J. 2019;32:166.
Llor C, Bjerrum L. Antimicrobial resistance: Risk associated with antibiotic overuse and initiatives to reduce the problem. Ther Adv Drug Saf. 2014;5(6):229–41.
Hurley HJ, Knepper BC, Price CS, Mehler PS, Burman WJ, Jenkins TC. Avoidable antibiotic exposure for uncomplicated skin and soft tissue infections in the ambulatory care setting. American Journal of Medicine. 2013;126(12):1099–106.
Leekha S, Terrell CL, Edson RS. General principles of antimicrobial therapy. Mayo Clin Proc. 2011;86(2):156–67.
Lambregts M, Rump B, Ropers F, Sijbom M, Petrignani M, Visser L, et al. Antimicrobial guidelines in clinical practice: Incorporating the ethical perspective. JAC Antimicrob Resist. 2021;3(2):1–9.
Meena DK, Jayanthi M. Monitoring Antibiotic Use in Public Health Care Facilities of South Indian Union Territory: A Step to Promote Rational Use of Antibiotics. Cureus. 2021;13(10):18431.
Porter G, Kotwani A, Bhullar L, Joshi J. Over-the-counter sales of antibiotics for human use in India: The challenges and opportunities for regulation. Med Law Int. 2021;21(2):147–73.
Chan AHY, Horne R, Lycett H, Raebel E, Guitart J, Wildman E, et al. Changing Patient and Public Beliefs About Antimicrobials and Antimicrobial Resistance (AMR) Using a Brief Digital Intervention. Front Pharmacol. 2021;12:608971.