Antibiotic Use and Resistance Among Prescribers: Current Status of Knowledge, Attitude, and Practice in Egypt

Abstract

Introduction

The problem of antimicrobial resistance (AMR) is rising worldwide. One of the most significant factors influencing antimicrobial resistance in low- and middle-income countries is the lack of the skills and knowledge of health care providers for proper antimicrobial use.

Aim

To identify knowledge, characterize practices and describe the attitude of Egyptian prescribers towards antibiotic use.

Methods

A self-administered validated questionnaire was distributed among Egyptian prescribers.

Results

Five hundred Egyptian physicians responded to the questionnaire, 113 (22.6%) reported having Antibiotic Stewardship Program (ASP) at their workplace, 99 (19.8%) use international antibiotic guidelines as the main source for prescribing activity, 358 (71.6%) recorded adequate knowledge. Elder prescribers and those who work in private or university hospitals were significantly more knowledgeable (p=0.031 and 0.001, respectively). Forty-seven (9.4%) showed a positive attitude towards proper antibiotic prescription. The type of work institution; primary health clinics and private, or university hospital and the specialty are significantly associated with a positive attitude (p=0.009 and 0.015, respectively). Seventy-eight (15.6%) expressed a proper antibiotic prescription practice. Elder age, more experienced and trained prescribers showed more proper practice. The implementation of ASP and using proper sources of information were significantly associated with proper practice (p=0.012 and 0.008, respectively).

Conclusion

Egyptian prescribers have a good level of knowledge about antibiotics. However, low rates of positive attitude and proper practice towards the problem of AMR and ASP are recorded.

Keywords:

• antibiotics
• resistance
• stewardship
• prescribers
• multidrug resistance
• low- and middle-income countries

Acknowledgments

We acknowledge the help in data collection offered by Dr. Weam Mohammed, director of Infection prevention and control department, health Affairs directorate, BeniSuef, Egypt; Dr. Heba Kasem Ahmed, Director of Infection Prevention and Control Department, Health Affairs Directorate, Cairo, Egypt; Dr. Mona Abdel–Galeel, head of infection control team, El-Mahala General Hospital Gharbia, Egypt; Dr. Hanan Sayed Abd El-Razek, Director of infection prevention and control department, Health affairs directorate, Minya, Egypt; Dr. Omnia Sameh Habib, Infection Prevention and control consultant, Boulak El-Dakroor General Hospital, Giza, Egypt; Dr. Mai Ezz El-Din Abo Samra, Infection control manager, Health care authority, Universal Health Insurance, Port Said Branch Port Said, Egypt. Dr. Ahmed Sayed Mosa, Director of Infection Prevention and Control department, Health Affairs directorate,  Assiut, Egypt.

Disclosure

The authors report no conflicts of interest in this work.