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
Keywords:Antimicrobial resistance, Antibiotic stewardship, Rational prescribing
Background: WHO defines Antimicrobial resistance (AMR) as “the ability of a microorganism to stop an antimicrobial from working against it”. The Global burden includes increased morbidity, prolonged illness and a higher mortality rate, along with economic burden. The cause can be tracked down to irrational usage of antibiotics and lack of awareness of rational prescribing practices.
Methodology: A cross-sectional questionnaire-based observational study was carried out using a standard pre-validated questionnaire, which was administered to all the medical doctors present in their respective departments during the study period, exploring their knowledge regarding rational antibiotic usage, their attitudes and awareness towards AMR. Informed consent from the participants was obtained verbally, and confidentiality assured. The collected data was analyzed as per descriptive statistics.
Results: Majority of doctors (91.3%) have a good knowledge and agree that indiscriminate use of antibiotics leads to antimicrobial resistance. 96.12% of doctors identify it as a global issue but only 85.5% consider it a problem in their hospital. Doctors (78%) have a positive attitude and do not prefer to prescribe an antibiotic for minor illnesses, but only 40% think it might contribute to antimicrobial resistance.
Conclusion: Our study has demonstrated that doctors have a good knowledge about the emerging problem of antimicrobial resistance, however a minor percentage of doctors fail to acknowledge this at the level of their own hospital. Regular updates on the local antimicrobial resistance rates & antibiotic stewardship might help to control the global issue of AMR.
World Health Day 2011-Antibiotic resistance: No action today, no cure tomorrow. Available at: http://www.who.int/world-health-day/2011/en/ Accessed: 11 August 2018.
Kumar SG, Adithan C, Harish BN, Sujatha S, Roy G, Malini A. Antimicrobial resistance in India: A review. J Nat Sc Biol Med. 2013;4:286-91.
World Health Organization, editor. Antimicrobial resistance: global report on surveillance. Geneva, Switzerland: World Health Organization. 2014:232 .
Ghosh A, Deb T, Ghosh S. Knowledge, attitudes and practice survey about antimicrobial resistance and prescribing among physicians in a tertiary care teaching hospital in Eastern India. Int J Basic Clin Pharmacol. 2016;5:180-7.
World Health Organization, editor. The evolving threat of antimicrobial resistance: options for action. Geneva, Switzerland: World Health Organization. 2012:119.
Padmanabha TS, Nandini T, Manu G, Madhav Savkar, Ravi M. Knowledge, attitude and practices of antibiotic usage among the medical undergraduates of a tertiary care teaching hospital: an observational cross-sectional study. Int J Basic Clin Pharmacol. December 2016; 5(6):2432-7.
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.
Shanthi M, Sekar U. Multi-drug Resistant Pseudomonas aeruginosa and Acinetobacter baumannii infections among hospitalized patients: risk factors and outcomes. JAPI. 2009;57:636, 638-45.
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;6-9.
Bala R, Singh H, Kaur K, P Girish, Kohli K. Knowledge and attitude towards antimicrobial self-medication usage: a cross sectional study among medical and nursing students. Int J Basic Clin Pharmacol. 2013;2:428-32.
Khan AA, Banu GK. Antibiotic Resistance and Usage-A Survey on the Knowledge, Attitude, Perceptions and Practices among the Medical Students of a Southern Indian Teaching Hospital. J Clini Diagnostic Res. 2013;7(8):1613-6.
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. Archi Internal Med. 2004;164(13):1451-6.