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Taborda JCM, Guzmán JCM, Higuita-Gutiérrez LF. Understanding antibiotic knowledge, attitudes, and practices: a cross-sectional study in physicians from a Colombian region, 2023. BMC Med Educ 2024; 24:380. [PMID: 38589913 PMCID: PMC11000393 DOI: 10.1186/s12909-024-05354-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Antibiotic resistance has been identified as a global health threat. Knowledge, attitudes, and inappropriate prescription practices of antibiotics by physicians play a crucial role in this problem. In Colombia, research addressing this issue is scarce. METHODS A cross-sectional study involving 258 physicians was conducted. A scale with questions on sociodemographic aspects, level of education, satisfaction with antibiotic education received, and knowledge, attitudes, and practices was administered. The scale was designed for each item to be analyzed individually or as a total score ranging from 0 to 100 (0 being the lowest and 100 the highest). RESULTS 31.5% of physicians rated the education received on antibiotics as fair to poor. The knowledge score was 80.1 (IQR 70.5-87.5); however, 25.2% agreed to some extent that amoxicillin is useful in treating most respiratory infections, and 15% agreed that antibiotics are effective in treating upper respiratory infections. Attitudes scored 80.2 (IQR 75.0-86.5), with 99% stating that bacterial resistance is a public health problem in Colombia, but only 56.9% considering it a problem affecting their daily practice. Practices scored 75.5 (IQR 68.8-81.2), and 71.7% affirmed that if they refuse to prescribe antibiotics to a patient who does not need them, the patient can easily obtain them from another physician. General practitioners were found to have lower scores in all three indices evaluated. CONCLUSION The study reveals enduring misconceptions and concerning practices in antibiotic prescription, particularly among general practitioners. Enhancing knowledge necessitates the implementation of continuous medical education programs that focus on updated antibiotic guidelines, and resistance patterns. Fostering positive attitudes requires a culture of trust and collaboration among healthcare professionals. Practical enhancements can be realized through the establishment of evidence-based prescribing guidelines and the integration of regular feedback mechanisms. Moreover, advocating for the inclusion of antimicrobial stewardship principles in medical curricula is crucial, emphasizing the significance of responsible antibiotic use early in medical education.
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Affiliation(s)
| | | | - Luis Felipe Higuita-Gutiérrez
- Facultad de medicina, Universidad Cooperativa de Colombia, Medellín, Colombia.
- Escuela de microbiología, Universidad de Antioquia, Medellín, Colombia.
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Khan FU, Mallhi TH, Khan FU, Hayat K, Rehman A, Shah S, Khan Z, Khan YH, Ahmad T, Gudi SK, Karataş Y, Fang Y. Evaluation of Consumers Perspective on the Consumption of Antibiotics, Antibiotic Resistance, and Recommendations to Improve the Rational use of Antibiotics: An Exploratory Qualitative Study From Post-Conflicted Region of Pakistan. Front Pharmacol 2022; 13:881243. [PMID: 35662689 PMCID: PMC9159815 DOI: 10.3389/fphar.2022.881243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/25/2022] [Indexed: 01/07/2023] Open
Abstract
Background: Antibiotics misuse is a global challenge, and the situation is likely to deteriorate in conflict zones with insufficient health services. The misuse of antibiotics is not only associated with antimicrobial resistance but may also lead to serious consequences. This study was aimed to investigate the knowledge, attitude, and practices on antibiotic consumption, antibiotic resistance (ABR), and related suggestions among residents of conflicted zones in Pakistan. Methods: Semi-structured interviews were conducted at community pharmacies between June 2020 and January 2021. The primary findings were ascertained through thematic content analysis. Themes, sub-themes, and categories were drawn from the final analysis. Data analysis was carried out in six steps from getting to know the data to final report development. Results: A total of 20 consumers were interviewed with a mean interview duration of 25.4 min. The average age of participants was 35.1 years, and most of them were males. ABR was unfamiliar to the participants. Most of the participants understood the term "antibiotics," but they did not know how to use them properly. The participants were unable to distinguish between bacterial and viral illnesses. Thirteen participants believed that antibiotics have a faster effect than any other drug. Most of the participants perceived that every antibiotic could cause diarrhea, and pharmacy staff sometimes prefer other medicines such as multivitamins. Consumer practices regarding antibiotic usage and ABR were found to be poor. Most participants recommended that health officials must ensure qualified staff at pharmacies with strict regulations. Five participants said that a leaflet with antibiotic instructions in Urdu (national language) is usually beneficial, especially when making solutions from powder. Conclusions: This study underscored poor knowledge, attitude, and practices among residents of conflicted zones towards antibiotics and ABR. Low literacy rate, unavailability of healthcare facilities, absence of pharmacists at community pharmacies, and uncontrolled sales of antibiotics are some factors attributed to serious hazards, ABR, and irrational use of drugs.
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Affiliation(s)
- Faiz Ullah Khan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi’an, China
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
| | - Farman Ullah Khan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi’an, China
| | - Khezar Hayat
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi’an, China
- Institute of Pharmaceutical Sciences, the University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Asim.Ur Rehman
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | - Shahid Shah
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Zakir Khan
- Institute of Health Sciences, Department of Pharmacology, Faculty of Medicine, Cukurova University, Adana, Turkey
- Pharmacovigilance Specialist, Balcali Hospital, Faculty of Medicines, Cukurova University, Adana, Turkey
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia
| | - Tawseef Ahmad
- Department of Pharmacy, COMSATS University Islamabad, Abbottabad Campus, Abbottabad, Pakistan
| | - Sai Krishna Gudi
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Yusuf Karataş
- Institute of Health Sciences, Department of Pharmacology, Faculty of Medicine, Cukurova University, Adana, Turkey
- Pharmacovigilance Specialist, Balcali Hospital, Faculty of Medicines, Cukurova University, Adana, Turkey
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an, China
- Shaanxi Center for Health Reform and Development Research, Xi’an, China
- Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science and Technology Innovation Harbor, Xi’an, China
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Ashraf S, Ashraf S, Ashraf M, Imran MA, Choudhary ZA, Hafsa HT, Awais AB, Kalsoom L, Farooq I, Habib Z, Ashraf S, Iqbal QUA, Ghufran M, Sherazi SSH, Akram MK, Akmal R, Rafique S, Nawaz K, Safdar Z, Siddique UN, Hassan M, Arshad S, Virk AR, Ashraf M, Saboor QA, Humayun A, Izhar M. Knowledge, attitude, and practice of clinicians about antimicrobial stewardship and resistance among hospitals of Pakistan: a multicenter cross-sectional study. Environ Sci Pollut Res Int 2022; 29:8382-8392. [PMID: 34490566 PMCID: PMC8421064 DOI: 10.1007/s11356-021-16178-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/23/2021] [Indexed: 06/13/2023]
Abstract
Considering that antimicrobial resistance (AMR) is a global challenge, there is a dire need to assess the knowledge, attitude, and practice (KAP) of clinicians in AMR endemic countries. The current multicenter, cross-sectional study aimed at highlighting gaps in antimicrobial (AM) stewardship and AMR among practicing doctors working in public tertiary care teaching hospitals of Lahore, Pakistan. A KAP survey, based on a self-administered questionnaire containing 45 questions, was distributed among 336 clinicians in 6 randomly selected hospitals. Overall, 92% of the clinicians considered AMR as a worldwide problem but only 66% disagreed that cold and flu symptoms require antibiotics. Moreover, around 68% of the doctors felt confident about their practice in AM but still, 96% felt the need to get more knowledge about AM drugs. The need for refresher courses on rational antibiotic use was expressed by 84% of the participants. The main contributing factors considered for AMR by the doctors included excessive AM usage in the medical profession (87.1%) and multiple antibiotics per prescription (76.4%). Pharmacologically, AM spectrum was accurately chosen by 1.4% for Ampicillin, 0.003% for Erythromycin and 0% for Levofloxacin. Clinically, more than 50% of the clinicians used miscellaneous AM for empirical therapy of respiratory tract infection and cholecystitis. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 25. It is concluded that the knowledge of clinicians is relatively poor for AM spectrum and drugs of choice for certain infections. However, the clinicians are aware of their shortcomings and desire for improvement.
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Affiliation(s)
- Sohaib Ashraf
- Department of Cardiology, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan.
| | - Shoaib Ashraf
- Department of Pathobiology, Riphah International University, Lahore, Pakistan.
| | - Moneeb Ashraf
- Department of Pharmacology, King Edward Medical University, Mayo Hospital, Lahore, Pakistan.
| | - Muhammad Ahmad Imran
- Department of Microbiology, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan.
| | - Zawar Ahmad Choudhary
- Department of Internal Medicine, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Hadiqa Tul Hafsa
- Department of Microbiology, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Abeer Bin Awais
- Department of Internal Medicine, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Larab Kalsoom
- Department of Internal Medicine, Services Institute of Medical Sciences, Lahore, Pakistan
| | - Iqra Farooq
- Department of Pediatrics Surgery, Children Hospital and Institute of Child Health, Lahore, Pakistan
| | - Zaighum Habib
- Department of Orthopedics, Tehsil Head Quarter, Ferozwala, Shaikhupura, Pakistan
| | - Sidra Ashraf
- Department of Biochemistry, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Qurrat Ul Ain Iqbal
- Department of Internal Medicine, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Muhammad Ghufran
- Medico Cirujano, ESACHS (Empresa de Servico Externo de la Asociacion Chilena de Seguridad), Punta Arenas, Chile
| | - Syed Sami Hussain Sherazi
- Department of Pharmacology and Toxicology, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Muhammad Kiwan Akram
- Department of Nutrition, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Rutaba Akmal
- Department of Community Medicine, Sahara Medical College, Narowal, Pakistan
| | - Sundas Rafique
- Department of Internal Medicine, Mayo Hospital, Lahore, Pakistan
| | - Khawar Nawaz
- Department of Pediatrics, Sunny Downstate/Kings Country Medical Center, New York, NY, USA
| | - Zartasha Safdar
- Department of Pharmacology and Toxicology, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Uzma Nasim Siddique
- Department of Internal Medicine, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Muhammad Hassan
- Department of Internal Medicine, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Shahroze Arshad
- Department of Internal Medicine, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Abdul Rehman Virk
- Department of Internal Medicine, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Muhammad Ashraf
- Department of Pharmacology and Toxicology, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Qazi Abdul Saboor
- Department of Cardiology, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
| | - Ayesha Humayun
- Department of Community Medicine, Shaikh Khalifa Bin Zayed Al-Nahyan Medical and Dental College, Lahore, Pakistan
| | - Mateen Izhar
- Department of Microbiology, Shaikh Zayed Post-Graduate Medical Complex, Lahore, Pakistan
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Karasneh RA, Al-Azzam SI, Ababneh MA, Basheti IA, Al-Azzeh O, Al Sharie S, Conway BR, Aldeyab MA. Exploring Information Available to and Used by Physicians on Antibiotic Use and Antibiotic Resistance in Jordan. Antibiotics (Basel) 2021; 10:963. [PMID: 34439013 PMCID: PMC8389019 DOI: 10.3390/antibiotics10080963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 11/16/2022] Open
Abstract
Evidence based information sources for physicians are needed for informed antibiotic prescribing practices. The aim of this study was to explore physicians' preferred sources of information and evaluate physicians' awareness of available information and initiatives on prudent antibiotic prescribing in Jordan. A cross-sectional study was conducted utilizing an online questionnaire and included physicians (n = 409) from all sectors and specialties in Jordan. Published guidelines (31.8%), the workplace (25.7%), colleagues or peers (20.0%), group or conference training (18.3%), and the medical professional body (18.1%) were the main sources of information about avoiding unnecessary antibiotic prescribing, with the influence of these sources on changing prescribers' views being 34.7%, 17.1%, 11%, 13.4%, and 7.6%, respectively. One-third of physicians (33.7%) reported no knowledge of any initiatives on antibiotic awareness and resistance. Regarding awareness of national action plans on antimicrobial resistance, 10.5%, 34%, and 55.5% of physicians were aware, unaware, and unsure of the presence of any national action plans, respectively. Physicians showed interest in receiving more information on resistance to antibiotics (58.9%), how to use antibiotics (42.2%), medical conditions for which antibiotics are used (41.3%), prescribing of antibiotics (35.2%), and links between the health of humans, animals, and the environment (19.8%). The findings can inform interventions needed to design effective antimicrobial stewardship, enabling physicians to prescribe antibiotics appropriately.
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Affiliation(s)
- Reema A. Karasneh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan;
| | - Sayer I. Al-Azzam
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan; (S.I.A.-A.); (M.A.A.)
| | - Mera A. Ababneh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan; (S.I.A.-A.); (M.A.A.)
| | - Iman A. Basheti
- Faculty of Pharmacy, Applied Sciences Private University, Amman 11931, Jordan;
| | - Ola Al-Azzeh
- Department of Pharmacy Practice, College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia;
| | - Sarah Al Sharie
- Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan;
| | - Barbara R. Conway
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK;
- Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Mamoon A. Aldeyab
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK;
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