Knowledge, attitudes and practice survey about antimicrobial resistance and prescribing among physicians in a tertiary care teaching hospital in Eastern India

Abhishek Ghosh, Tirthankar Deb, Sanjana Ghosh


Background: Antimicrobial resistance is a worldwide problem. Reduction in antimicrobial use is necessary to limit this problem. This can be addressed through changes in prescribing behaviour. Information about the driving forces behind antimicrobial prescription can be obtained by KAP (knowledge, attitudes and practice) surveys.

Methods: A self-administered 37 item questionnaire was distributed among doctors of different departments of College of Medicine & JNM Hospital, Kalyani. It focused on their awareness about the current status of antimicrobial resistance, sources of information and training about use of Antimicrobials, confidence, factors influencing decisions and appropriateness of potential interventions.

Results: All doctors agreed that antimicrobial resistance is a problem in India and also in their daily practice. Doctors were lacking on the aspect of regular educational activities regarding appropriate use of antimicrobials, which they felt extremely important. Also many of them were unaware about the hospital formularies, current susceptibility pattern of common pathogens. Majority said that a local guideline would be more useful than the international one.

Conclusions: This survey identified topics to address in the containment of antimicrobials resistance like dissemination of information about local antimicrobial resistance rates, the revision and dissemination of local guidelines, and emphasization on regular educational activities among physicians.


Antimicrobials, Resistance, Knowledge, Practice, Physicians

Full Text:



Levy SB. The challenge of antibiotic resistance. Sci Am. 1998;278:46-53.

Okeke IN, Laxminarayan R, Bhutta ZA, Duse AG, Jenkins P, O’Brien TF, Pablos-Mendez A, Klugman KP. Antimicrobial resistance in developing countries. Part I: recent trends and current status. Lancet Infect Dis. 2005;5(8):481-93.

Okeke IN: Poverty and root causes of resistance in developing countries. In antimicrobial resistance in developing countries. 1st edition. Edited by: Sosa AB, DK; Amabile-Cuevas, CF; Hsueh, PR; Kariuki, S; Okeke. IN New York: Springer;2010:27-36.

Costelloe C, Metcalfe C, Lovering A, Mant D, Hay AD. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ. 2010;340:c2096.

Shanthi M, Sekar U. Multi-drug resistant Pseudomonas aeruginosa and Acinetobacter baumannii infections among hospitalized patients: risk factors and outcomes. J Assoc Physicians India. 2009,57:636,8-40,5.

Guerra CM, Pereira CA, Neves Neto AR, Cardo DM, Correa L. Physicians’ perceptions, beliefs, attitudes, and knowledge concerning antimicrobial resistance in a Brazilian teaching hospital. Infect Control Hosp Epidemiol. 2007,28(12):1411-4.

Pulcini C, Williams F, Molinari N, Davey P, Nathwani D. Junior doctors’ knowledge and perceptions of antibiotic resistance and prescribing: a survey in France and Scotland. Clin Microbiol Infect. 2011,17(1):80-7.

Ganguly NK, Arora NK, Chandy SJ, Fairoze MN, Gill JP, Gupta U, et al. Rationalizing antibiotic use to limit antibiotic resistance in India. Indian J Med Res. 2011;134:281-94.

Al Khaja KA, Sequeira RP, Damanhori AH, Ismaeel AY, Handu SS. Antimicrobial prescribing trends in primary care: implications for health policy in Bahrain. Pharmacoepidemiol Drug Saf. 2008;17:389-96.

Aggarwal S, Mathew J, Singh H, Sharma V. Attitude and perception of junior resident doctors’ regarding antibiotic resistance - A pilot study, J Acute Dis. 2014; 2014:6-9

García C, Llamocca LP, Garcia K, et al. Knowledge, attitudes and practice survey about antimicrobial resistance and prescribing among physicians in a hospital setting in Lima, Peru. BMC Clin Pharmacol. 2011,11:8.

Vesga O AM, Salazar BE, Rodriguez CA, Zuluaga AF. Generic vancomycin products fail in vivo despite being pharmaceutical equivalents of the innovator. Antimicrob agents chemother. 2010,54(8):3271-9.

Rodriguez CA, Agudelo M, Zuluaga AF, Vesga O: In vitro and in vivo comparison of the anti-staphylococcal efficacy of generic products and the innovator of oxacillin. BMC Infect Dis. 2010,10:153.

Nweihed L ML, Martin A: Influencia de los padres en la prescripcion de antibioticos hecha por los pediatras. Arch Venez Pueric Pediatr. 2002,65:21-7.