Awareness Regarding Antimicrobial Resistance and Antibiotic Prescribing Behavior among Physicians: Results from a Nationwide Cross-Sectional Survey in India

Author:

Mittal Niti1,Goel Parul2,Goel Kapil3,Sharma Rashmi4,Nath Bhola5,Singh Surjit6ORCID,Thangaraju Pugazhenthan7,Mittal Rakesh1,Kahkasha Kahkasha8,Mithra Prasanna9ORCID,Sahu Rajesh10,Priyadarshini Raman P.11,Sharma Nikita12,Pala Star13,Rohilla Suneel Kumar1,Kaushal Jyoti1,Sah Sanjit14,Rustagi Sarvesh15,Sah Ranjit16ORCID,Barboza Joshuan J.17ORCID

Affiliation:

1. Department of Pharmacology, Pt. B. D. Sharma Postgraduate Institute of Medical Sciences, Rohtak 124001, India

2. Department of Biochemistry, Shri Atal Bihari Vajpayee Government Medical College, Chhainsa, Faridabad 121004, India

3. Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India

4. Department of Community Medicine, GMERS Medical College Sola, Ahmedabad 380060, India

5. Department of Community and Family Medicine, All India Institute of Medical Sciences, Raebareli 229405, India

6. Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur 342001, India

7. Department of Pharmacology, All India Institute of Medical Sciences, Raipur 492010, India

8. Department of Biochemistry, All India Institute of Medical Sciences, Deoghar 814152, India

9. Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal 575001, India

10. Department of Community Medicine, Armed Forces Medical College, Pune 411040, India

11. Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Karaikal 609602, India

12. Department of Community and Family Medicine, All India Institute of Medical Sciences, Bilaspur 174037, India

13. Department of Community Medicine, NEIGRIHMS, Shillong 793018, India

14. Global Consortium for Public Health and Research, Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha 442001, India

15. School of Applied and Life Sciences, Uttaranchal University, Dehradun 248007, India

16. Tribhuvan University Teaching Hospital, Kathmandu 46000, Nepal

17. School of Medicine, César Vallejo University, Trujillo 13007, Peru

Abstract

(1) Background: Understanding the physicians’ knowledge, attitudes, and antimicrobial prescribing behavior is a crucial step towards designing strategies for the optimal use of these agents. (2) Methods: A cross-sectional online survey was conducted among clinicians across India between May and July 2022 using a self-administered questionnaire in English comprising 35 questions pertaining to demographic characteristics, knowledge, attitude, and practices domains. (3) Results: A total of 544 responses were received from 710 physicians contacted. Sixty percent of participants were males, with mean age of 34.7 years. Mean ± Standard Deviation scores for knowledge, attitude, and practices domains were 8 ± 1.6, 20.2 ± 3.5, and 15.3 ± 2.1, respectively. Higher scores were associated with basic [odds ratio (95% Confidence Interval), p value: 2.95 (1.21, 7.2), 0.02], medical and allied sciences [2.71 (1.09, 6.67), 0.03], and central zone [3.75 (1.39, 10.12), 0.009]. A substantial proportion of dissatisfactory responses were found regarding hospital antibiograms, antibiotics effective against anaerobes, WHO AWaRe (access, watch, and reserve) classification of antibiotics, and the role of infection prevention and control (IPC) measures in the containment of antimicrobial resistance (AMR). (4) Conclusions: There is a need to sensitize and educate clinicians on various issues related to antimicrobial use, such as antibiograms, double anaerobic cover, IPC practices, and guideline-based recommendations, to curb the AMR pandemic.

Publisher

MDPI AG

Subject

Pharmacology (medical),Infectious Diseases,Microbiology (medical),General Pharmacology, Toxicology and Pharmaceutics,Biochemistry,Microbiology

Reference51 articles.

1. Antimicrobial Resistance Collaborators (2022). Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. Lancet, 399, 629–655.

2. World Health Organization (2023, February 03). WHO’s First Global Report on Antibiotic Resistance Reveals Serious, Worldwide Threat to Public Health. Available online: http://www.who.int/mediacentre/news/releases/2014/amr-report/en/.

3. NDM-1 (New Delhi metallo beta lactamase-1) producing Gram-negative bacilli: Emergence and clinical implications;Fomda;Indian J. Med. Res.,2014

4. Global increase and geographic convergence in antibiotic consumption between 2000 and 2015;Klein;Proc. Natl. Acad. Sci. USA,2018

5. WHO (2022, December 03). Global Action Plan on Antimicrobial Resistance. Available online: https://apps.who.int/iris/handle/10665/193736.

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