Predictors of antibiotic prescriptions: a knowledge, attitude and practice survey among physicians in tertiary hospitals in Nigeria

被引：26

作者：

Ogoina, Dimie ^{[1
]}

Iliyasu, Garba ^{[2
]}

Kwaghe, Vivian ^{[3
]}

Otu, Akan ^{[4
]}

Akase, Iorhen Ephram ^{[5
]}

Adekanmbi, Olukemi ^{[6
]}

Mahmood, Dalhat ^{[7
]}

Iroezindu, Micheal ^{[8
]}

Aliyu, Shamsudin ^{[9
]}

Oyeyemi, Abisoye Sunday ^{[10
]}

Rotifa, Stella ^{[11
]}

Adeiza, Mukhtar Abdulmajid ^{[12
]}

Unigwe, Uche Sonny ^{[8
]}

Mmerem, Juliet Ijeoma ^{[8
]}

Dayyab, Farouq Muhammad ^{[13
,14
]}

Habib, Zaiyad Garba ^{[3
]}

Otokpa, Daniel ^{[4
]}

Effa, Emmanuel ^{[4
]}

Habib, Abdulrazaq Garba ^{[2
]}

机构：

[1] Niger Delta Univ, Teaching Hosp, Dimie Ogoina Infect Dis Unit, Dept Internal Med, Yenagoa, Bayelsa State, Nigeria

[2] Aminu Kano Univ, Dept Internal Med, Infect Dis Unit, Teaching Hosp, Kano, Nigeria

[3] Univ Abuja Teaching Hosp, Dept Internal Med, Infect Dis Unit, Abuja, Gwagwadala, Nigeria

[4] Univ Calabar, Coll Med Sci, Dept Internal Med, Calabar, Cross River Sta, Nigeria

[5] Lagos State Univ, Dept Internal Med, Teaching Hosp, Lagos, Nigeria

[6] Univ Ibadan, Dept Med, Univ Coll Hosp, Ibadan, Oyo State, Nigeria

[7] African Field Epidemiol Network AFENET, Nigeria Ctr Dis Control NCDC, Abuja, Nigeria

[8] Univ Nigeria, Teaching Hosp Ituku, Dept Med, Ituku, Enugu State, Nigeria

[9] Ahmadu Bello Univ, Dept Med Microbiol, Teaching Hosp, Zaria, Kaduna State, Nigeria

[10] Niger Delta Univ, Dept Community Med, Teaching Hosp, Okolobiri, Bayelsa State, Nigeria

[11] Fed Med Ctr Yenagoa, Dept Community Med, Yenagoa, Bayelsa State, Nigeria

[12] Ahmadu Bello Univ, Dept Internal Med, Teaching Hosp, Zaria, Kaduna State, Nigeria

[13] Infect Dis Hosp, Kano, Nigeria

[14] Fed Med Ctr, Dept Med, Nguru, Yobe State, Nigeria

来源：

ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL | 2021年 / 10卷 / 01期

关键词：

Antimicrobial resistance; KAP; Antibiotic prescriptions; Antimicrobial stewardship; Nigeria; ANTIMICROBIAL STEWARDSHIP; DETERMINANTS; PERCEPTIONS; RESISTANCE; COUNTRIES; BEHAVIOR;

D O I：

10.1186/s13756-021-00940-9

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background As part of the Global Action Plan against antimicrobial resistance (AMR), countries are required to generate local evidence to inform context-specific implementation of national action plans against AMR (NAPAR). We aimed to evaluate the knowledge, attitude, and practice (KAP) regarding antibiotic prescriptions (APR) and AMR among physicians in tertiary hospitals in Nigeria, and to determine predictors of KAP of APR and AMR. Methods In this cross-sectional study, we enrolled physicians practicing in tertiary hospitals from all six geopolitical zones of Nigeria. Implementation of an antimicrobial stewardship programmes (ASP) by each selected hospital were assessed using a 12 item ASP checklist. We used a structured self-administered questionnaire to assess the KAP of APR and AMR. Frequency of prescriptions of 18 different antibiotics in the prior 6 months was assessed using a Likert's scale. KAP and prescription (Pr) scores were classified as good (score >= 80%) or average/poor (score < 80%). Independent predictors of good knowledge, attitude, and practice (KAPPr) were ascertained using an unconditional logistic regression model. Results A total of 1324 physicians out of 1778 (74% response rate) practicing in 12 tertiary hospitals in 11 states across all six geopolitical zones participated in the study. None of the participating hospitals had a formal ASP programme and majority did not implement antimicrobial stewardship strategies. The median KAPPr scores were 71.1%, 77%, 75% and 53.3%, for the knowledge, attitude, practice, and prescription components, respectively. Only 22.3%, 40.3%, 31.6% and 31.7% of study respondents had good KAPPr, respectively. All respondents had prescribed one or more antibiotics in the prior 6 months, mostly Amoxicillin-clavulanate (98%), fluoroquinolones (97%), and ceftriaxone (96.8%). About 68% of respondents had prescribed antibiotics from the World Health Organization reserve group. Prior AMR training, professional rank, department, and hospital of practice were independently associated with good KAPPr. Conclusions Our study suggests gaps in knowledge and attitude of APR and AMR with inappropriate prescriptions of antibiotics among physicians practicing in tertiary hospitals in Nigeria. Nigeria's NAPAR should also target establishment and improvement of ASP in hospitals and address institutional, educational, and professional factors that may influence emergence of AMR in Nigeria.

引用

页数：17

共 60 条

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