DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20201173

A study of knowledge, attitude and practice on use of antibiotics and its resistance among the doctors and interns at urban tertiary care hospital: an interventional study

Manjusha Kalyani, Anand Janagond, Nimble Koshy, Roshy Cheriyan, M. G. Keshannanvar, Mallappa Shalavadi, Chandrashekhar V. Mangannavar

Abstract


Background: Infections due to resistant micro-organisms considerably increase the mortality rate, treatment cost, disease spread and duration of illness. The development of antibiotic resistance (AMR) is increasing steadily increasing over the last 10-15 years, which is a real threat to disease management. Many studies states that about 20-50% of antibiotic use unnecessary so decreasing the use of antibiotics is the first step to curb the AMR.

Methods: A questionnaire based prospective interventional study among the doctors. Systemic random sampling was applied. The pre tested structured questionnaire was used. Data’s were summarised in the excel sheet, analysed by proportions, percentages and other statistical methods like Student t test, Fisher test and Chi square test were used to check the association. The p>0.05 was considered as significant.

Results: Out of 200 doctors, preliminary screening of 170 was included in the study and finally 156 participants were actively selected for analysis of results. Out of 156 participants, 55.1% were MBBS Intern and 44.9% were doctors. High significance (p=0.0001) were found between pre and post knowledge, attitude and practice of doctors.

Conclusions: Further modes of studies have to perform to identify the determinants of attitude behaviour and motivation that lead people to use and misuse antibiotics. For effective outcome many more qualitative and quantitative studies are required. In addition, health care system should follow proper regulation and prescription policy as well as controls for prescription of antibiotic drugs.


Keywords


Antibiotic resistance, Attitude, Knowledge, Practice, Prescription, Systemic random sampling

Full Text:

PDF

References


Coast J, Smith R, Miller M. Superbugs: should antimicrobial resistance be included as a coast in economic evaluation? Health economic.1996;5:217-26.

Quavi A, Zageal-Maurer S, Mariano N, Urban C, Rosenburg C, Burns J, et al. Increased mortality associated with a clonal outbreak of Ceftaxidime-rersistant Klebsiella pneumomise: a case- control study. Infect control Hospital Epidemol. 2005;26:23-8.

Okeke IN, Laxminarayan R, Bhutta ZA, Duse AG, Jenkins P, O’Brien TF, et al. Antimicrobial resisitance in developing countries. Part I; Recent trends and current status. Lancet Infect Dis. 2005;5(8):481-93.

Norrby SR, Nord CE, Finch R. Lack of development of new antimicrobial drugs: A potential serious threat to public health. Lancet Infect Dis. 2005;5(2):115-9.

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.

Dellit TH, Owens RC, McGowan JE Jr, Gerding DN, Weinstein RA, Burke JP, et al, infectious disease society of America and the society for healthcare and epedemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 2007:44:159-77.

Pulcini C, Cua E, Lieutier F, Landraud L, Dellamonica P, Roger PM. Antibiotic misuse: a prospective clinical audit in a French university hospital. Eur J Clin Microbiol Infect Dis. 2007;26:277-80.

Stephenson J. CDC campaign targets antimicrobial resistance in hospitals. JAMA. 2002;287:2351-2.

World health organization. Prevention and containment of antimicrobial resistance. Available at: http://www.searo.who.int/entity/antimicrobial_resistance/sea_cd_273.pdf?ua=1. Accessed 15 February 2016.

Directorate general of health service. National policy for containment of antimicrobial resistance India. Available at: http://www.ncdc.gov.in/ writereaddata/ linkimages/amr_policy1600931343.pdf. Accessed 15 February 2016.

Dellit TH, Owens RC, McGowan JE Jr, Gerding DN, Weinstein RA, Burke JP, et al. Infectious Disease Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 2007;44:159-77.

Wester CW, Durairaj L, Evans AT, Schwartz DN, Husain S, Martinez E. Antibiotic resistance: A survey of Physician perception. Arch Med. 2002;162:2210-6.

Wester CW, Durairaj L, Evans AT, Schwartz DN, Husain S, Martinez E. Antibiotic resistance: a survey of physician perceptions. Arch Intern Med. 2002;162:2210-6.

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. Arch Intern Med. 2004;164:1451-6.

Pulcini C1, Williams F, Molinari N, Davey P, Nathwani D. Junior doctors’ knowledge and perception of antibiotic resistance and prescribing: a survey in France and Scotland. Clin Microbiol Infect. 2011;17:80-7.

Pulcini C, Cua E, Lieutier F, Landraud L, Dellamonica P, Roger PM. Antibiotic misuse: a prospective clinical audit in a French university hospital. Eur J Clin Microbiol Infect Dis. 2007;26:277-80.

Bruce J, MacKenzie FM, Cookson B, Mollison J, Van der Meer JW, Krcmery V, et al. Antibiotic stewardship and consumption: findings from a pan-European hospital study. J Antimicrob Chemother. 2009;64(4):853-60.

Bharani KY, Sekhar S, Hanumanth N, Palaparthi L. A KAP study regarding antimicrobial resistance among medical students in South India. IOSR J Dent Med Sci. 2015;14(4):110-3.