Knowledge, Attitudes and Practices of Resident Physicians About Antibiotic Resistance - A Comparative Study of Two Departments At A Tertiary Care Hospital
DOI:
https://doi.org/10.51253/pafmj.v76i2.8477Keywords:
antibiotic resistance, attitudes, physicians, practicesAbstract
Objective: To compare the knowledge, attitude, and practices of resident physicians from Department of Surgery with Department of Medicine, about antibiotic resistance (AER) and to determine if better knowledge leads to better attitudes and practices.
Study Design: Analytical cross-sectional study.
Place and Duration of Study: Departments of Surgery and Medicine, Pak Emirates Military Hospital (PEMH), Rawalpindi, Pakistan, from Jul to Dec 2021.
Methodology: A validated questionnaire exploring knowledge, attitudes and practices (KAP) regarding antibiotic resistance (AR) was administered to 61 resident physicians from Department of Medicine and 55 residents from Department of Surgery, at PEMH, Rawalpindi, Pakistan. All responses were collected and analyzed using Statistical Package for Social Sciences (SPSS) version 25.
Results: The average scores of physicians from Department of Medicine were 29.84±3.36, 28± 1.66 and 41.80±3.40 in the knowledge, attitude and practice domains respectively, while they were 26.5± 2.12, 25.42± 2.63 and 37.98±3.45 respectively in the domains of knowledge, attitude and practice for physicians from Department of Surgery. An association was found between the score of knowledge with attitude and practice with Pearson correlation coefficient of 0.31 and 0.33 respectively, however, no correlation was found between year of training and KAP scores.
Conclusion: Medicine residents outperformed Surgery residents in antibiotic resistance knowledge (29.84±3.36 vs. 26.5±2.12), attitude (28.00±1.66 vs. 25.42±2.63), and practice (41.80±3.40 vs. 37.98±3.45) scores. Higher knowledge correlated with better attitudes (r=0.31) and practices (r=0.33), independent of training year. Targeted training, especially for surgeons, is recommended to enhance stewardship.
Downloads
References
1. Aslam B, Wang W, Arshad MI, Khurshid M, Muzammil S, Rasool MH, et al. Antibiotic resistance: a rundown of a global crisis. Infect Drug Resist 2018; 11: 1645-1658. https://doi.org/10.2147/IDR.S173867
2. Ain NU, Iftikhar A, Bukhari SS, Abrar S, Hussain S, Haider MH, et al. High frequency and molecular epidemiology of metallo-β-lactamase-producing gram-negative bacilli in a tertiary care hospital in Lahore, Pakistan. Antimicrob Resist Infect Control 2018; 7:128.
https://doi.org/10.1186/s13756-018-0417-y
3. Braun SD, Jamil B, Syed MA, Abbasi SA, Weiß D, Slickers P, et al. Prevalence of carbapenemase-producing organisms at the Kidney Center of Rawalpindi (Pakistan) and evaluation of an advanced molecular microarray-based carbapenemase assay. Future Microbiol 2018; 13: 1225-1246. https://doi.org/10.2217/fmb-2018-0082
4. Di Gennaro F, Marotta C, Amicone M, Bavaro DF, Bernaudo F, Frisicale EM, et al. Italian young doctors' knowledge, attitudes and practices on antibiotic use and resistance: a national cross-sectional survey. J Glob Antimicrob Resist 2020; 23: 167-173.
https://doi.org/10.1016/j.jgar.2020.08.022
5. Nair M, Tripathi S, Mazumdar S, Mahajan R, Harshana A, Pereira A, et al. Knowledge, attitudes, and practices related to antibiotic use in Paschim Bardhaman District: a survey of healthcare providers in West Bengal, India. PLoS One 2019; 14: e0217818.
https://doi.org/10.1371/journal.pone.0217818
6. Cheoun ML, Heo J, Kim WH. Antimicrobial resistance: KAP of healthcare professionals at a tertiary-level hospital in Nepal. Int J Environ Res Public Health 2021; 18: 10062. https://doi.org/10.3390/ijerph181910062
7. Shahid A, Iftikhar F, Arshad MK, Javed Z, Sufyan M, Ghuman RS, et al. Knowledge and attitude of physicians about antimicrobial resistance and their prescribing practices in Services Hospital, Lahore, Pakistan. J Pak Med Assoc 2017; 67: 968-973.
8. Ahmed H, Bhimani S, Khanum I, Khan A, Khetpal A, Abbas MA, et al. Knowledge, attitude and perception survey of doctors regarding antibiotic use and resistance in Karachi, Pakistan. J Pak Med Assoc 2020; 70:1023-1028. https://doi.org/10.5455/JPMA.6239
9. World Health Assembly. Global action plan on antimicrobial resistance. WHA68.7. WHO; 2015.
10. McCullough AR, Rathbone J, Parekh S, Hoffmann TC, Del Mar CB. Not in my backyard: a systematic review of clinicians' knowledge and beliefs about antibiotic resistance. J Antimicrob Chemother 2015; 70: 2465-2473.
https://doi.org/10.1093/jac/dkv164
11. Teixeira Rodrigues A, Roque F, Falcão A, Figueiras A, Herdeiro MT. Understanding physician antibiotic prescribing behaviour: a systematic review of qualitative studies. Int J Antimicrob Agents 2013; 41: 203-212.
https://doi.org/10.1016/j.ijantimicag.2012.09.003
12. Thakolkaran N, Shetty AV, D'Souza NDR, Shetty AK. Antibiotic prescribing knowledge, attitudes, and practice among physicians in teaching hospitals in South India. J Family Med Prim Care 2017; 6: 526-532. https://doi.org/10.4103/2249-4863.222057
13. Mangi AA, Ghoto MA, Dayo A, Ali A, Memon N, Juno AAA, et al. Evaluation of the irrational use of antibiotics and correlation of economical constraints to antibiotic resistance. Isra Med J 2017; 9: 106-110.
14. Basharat S, Kumar R, Mushtaq M, Mohsin M. Understanding regarding antibiotic resistance among healthcare professionals in government sector of Tehsil Gujar Khan. Pak J Public Health 2020; 9: 144-148.
15. Fathi I, Sameh O, Abu-Ollo M, Naguib A, Alaa-Eldin R, Ghoneim D, et al. Knowledge, attitudes, and beliefs regarding antimicrobial therapy and resistance among physicians in Alexandria University Teaching Hospitals and the associated prescription habits. Microb Drug Resist 2017; 23: 71-78.
https://doi.org/10.1089/mdr.2015.0279
16. Ogoina D, Iliyasu G, Kwaghe V, Otu A, Akase IE, Adekanmbi O, et al. Predictors of antibiotic prescriptions: a knowledge, attitude and practice survey among physicians in tertiary hospitals in Nigeria. Antimicrob Resist Infect Control 2021; 10:73.
https://doi.org/10.1186/s13756-021-00940-9
17. Chaw PS, Schlinkmann MKM, Raupach-Rosin H, Karch A, Pletz MW, Huebner J, et al. Knowledge, attitude and practice of Gambian health practitioners towards antibiotic prescribing and microbiological testing: a cross-sectional survey. Trans R Soc Trop Med Hyg 2017; 111: 117-124.
https://doi.org/10.1093/trstmh/trx027
18. Liu C, Liu C, Wang D, Zhang X. Knowledge, attitudes and intentions to prescribe antibiotics: a structural equation modeling study of primary care institutions in Hubei, China. Int J Environ Res Public Health 2019; 16: 2385.
https://doi.org/10.3390/ijerph16132385
19. Roque F, Herdeiro MT, Soares S, Teixeira Rodrigues A, Breitenfeld L, Figueiras A. Educational interventions to improve prescription and dispensing of antibiotics: a systematic review. BMC Public Health 2014; 14: 1276.
https://doi.org/10.1186/1471-2458-14-1276
20. Egwuenu A, Olayinka B, Apeji Y, Abayomi O, Olayinka A, Obasanya J, et al. A systematic review on antibiotic use in humans in Nigeria. In: Pan African Medical Journal Conference Proceedings. 2018.
21. Dyar OJ, Beović B, Vlahović-Palčevski V, Verheij T, Pulcini C. How can we improve antibiotic prescribing in primary care? Expert Rev Anti Infect Ther 2016; 14: 403-413.
https://doi.org/10.1586/14787210.2016.1152066
22. Liu C, Liu C, Wang D, Zhang X. Intrinsic and external determinants of antibiotic prescribing: a multi-level path analysis of primary care prescriptions in Hubei, China. Antimicrob Resist Infect Control 2019; 8: 132. https://doi.org/10.1186/s13756-019-0579-z
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Sidra Riaz, Shazia Nisar, Abdur Rahim Palwa, Farrukh Saeed, Abdul Rehman Arshad, Mehmood Hussain

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.





