Knowledge, attitude, and practice of antibiotics use among primary healthcare physicians, Ministry of Health, Jeddah

Background: Overuse of antibiotics is considered a major public health problem on a global level and leads to existence and spread of antibiotic-resistant bacterial strains in all settings. Objectives: To explore the knowledge, attitude, and practice of primary healthcare physicians regarding antibiotic use. Methods: A cross-sectional study was conducted at a random sample of primary healthcare centers (PHCCs), belonging to Ministry of Health, in the city of Jeddah, Saudi Arabia. All primary healthcare physicians working at chosen PHCCs were recruited. A self-administered questionnaire was used for data collection. It includes five sections; socio-demographic characteristics of physicians, 11 statements to assess knowledge about antibiotic use, 6 statements to assess attitude toward antibiotic use, 6 statements concerning practice of antibiotic prescription, and 12 statements about factors influencing antibiotic prescription. Results: The study included 163 primary care physicians. The age of 58.9% ranged between 31 and 40 years. Approximately two-thirds of them were females (64.4%), and majority were Saudi nationals (98.8%). History of attending training courses in antibiotic use and resistance was reported by 47.9% of the physicians. The median (Interquartile range) of knowledge score percentage was 63.64 (45.45-81.82). It was abnormally distributed (p-value of Shapiro-Wilk test was 0.001). Physicians who reported previous attendance of courses in antibiotic use and resistance were more knowledgeable regarding antibiotics use and resistance compared to those who did not attend such courses (Mean ranks were 91.04 and 73.70, respectively (p = 0.018)). Most of the physicians agreed that taking antibiotics as prescribed minimize its side effects (81.6%), and taking antibiotics without rationale indication increase its side effects (81%). Male physicians were more likely than females to agree that use of antibiotics in case of viral infection prevents secondary bacterial infection (27.6% versus 10.5%), P < 0.001. Majority of the participants would increase antibiotic prescription in cases of purulent discharge (83.5%) and to prevent complications (71.1%). Conclusion: Knowledge and practice of primary healthcare physicians in Jeddah city regarding antibiotics use and resistance needs improvement. However their attitude toward them was acceptable. Improvement of their knowledge and continuous monitoring of their practice in this regard are warranted.