Predictors of antibiotic prescriptions: a knowledge, attitude and practice survey among physicians in tertiary hospitals in Nigeria

Autor: Abdulrazaq G. Habib, Emmanuel Effa, Garba Iliyasu, Juliet Ijeoma Mmerem, Shamsudin Aliyu, Dimie Ogoina, Farouq Muhammad Dayyab, Vivian Kwaghe, Mukhtar A Adeiza, Zaiyad Garba Habib, Daniel Otokpa, Dalhat Mahmood, Akan A. Otu, Stella Rotifa, Olukemi Adekanmbi, Iorhen Ephram Akase, Abisoye Oyeyemi, Uche S. Unigwe, Micheal Iroezindu
Rok vydání: 2021
Předmět:
0301 basic medicine
Microbiology (medical)
Antibiotic prescriptions
Adult
Male
medicine.medical_specialty
Health Knowledge
Attitudes
Practice
Adolescent
030106 microbiology
Nigeria
Inappropriate Prescribing
Infectious and parasitic diseases
RC109-216
Antimicrobial stewardship
Logistic regression
Antimicrobial resistance
Likert scale
Tertiary Care Centers
03 medical and health sciences
Young Adult
0302 clinical medicine
Physicians
Surveys and Questionnaires
Drug Resistance
Bacterial
medicine
Humans
Pharmacology (medical)
030212 general & internal medicine
Medical prescription
Practice Patterns
Physicians'
Response rate (survey)
business.industry
Research
Public Health
Environmental and Occupational Health
Middle Aged
Inappropriate Prescriptions
Checklist
Anti-Bacterial Agents
Infectious Diseases
Cross-Sectional Studies
Family medicine
Scale (social sciences)
KAP
Female
business
Zdroj: Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control, Vol 10, Iss 1, Pp 1-17 (2021)
Popis: BackgroundAs part of the Global Action Plan against antimicrobial resistance (AMR), countries are required to generate local evidence to inform context-specific implementation of national action plans against AMR (NAPAR). We aimed to evaluate the knowledge, attitude, and practice (KAP) regarding antibiotic prescriptions (APR) and AMR among physicians in tertiary hospitals in Nigeria, and to determine predictors of KAP of APR and AMR.MethodsIn this cross-sectional study, we enrolled physicians practicing in tertiary hospitals from all six geopolitical zones of Nigeria. Implementation of an antimicrobial stewardship programmes (ASP) by each selected hospital were assessed using a 12 item ASP checklist. We used a structured self-administered questionnaire to assess the KAP of APR and AMR. Frequency of prescriptions of 18 different antibiotics in the prior 6 months was assessed using a Likert’s scale. KAP and prescription (Pr) scores were classified as good (score ≥ 80%) or average/poor (score ResultsA total of 1324 physicians out of 1778 (74% response rate) practicing in 12 tertiary hospitals in 11 states across all six geopolitical zones participated in the study. None of the participating hospitals had a formal ASP programme and majority did not implement antimicrobial stewardship strategies. The median KAPPr scores were 71.1%, 77%, 75% and 53.3%, for the knowledge, attitude, practice, and prescription components, respectively. Only 22.3%, 40.3%, 31.6% and 31.7% of study respondents had good KAPPr, respectively. All respondents had prescribed one or more antibiotics in the prior 6 months, mostly Amoxicillin-clavulanate (98%), fluoroquinolones (97%), and ceftriaxone (96.8%). About 68% of respondents had prescribed antibiotics from the World Health Organization reserve group. Prior AMR training, professional rank, department, and hospital of practice were independently associated with good KAPPr.ConclusionsOur study suggests gaps in knowledge and attitude of APR and AMR with inappropriate prescriptions of antibiotics among physicians practicing in tertiary hospitals in Nigeria. Nigeria’s NAPAR should also target establishment and improvement of ASP in hospitals and address institutional, educational, and professional factors that may influence emergence of AMR in Nigeria.
Databáze: OpenAIRE
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