Addressing antimicrobial resistance in Nigerian hospitals: exploring physicians prescribing behavior, knowledge, and perception of antimicrobial resistance and stewardship programs

ABSTRACT

Introduction

We assessed the knowledge of, attitude toward antimicrobial resistance (AMR) and practice of antimicrobial stewardship (AMS) among physicians in Nigeria to provide future guidance to the Nigerian National Action Plan for AMR.

Methods

A descriptive cross-sectional questionnaire-based study explored the physicians’ self-reported practice of antibiotic prescribing, knowledge, attitude, and practice of AMR and components of ASPs.

Results

The majority (217; 67.2%) of respondents prescribed antibiotics daily in their clinical practice AMR was recognized as a global and local problem by 308 (95.4%) and 262 (81.1%) respondents, respectively. Only 91 (28.2%) of respondents have ever heard of antibiotic stewardship. The median AMR knowledge score was 40 (19–45)out of 45while that for ASP was 46.0(32–57) out of 60. There was significant statistical difference between the ASP median scores among the medical specialties category (P value <0.0001) More respondents had good knowledge of AMR than ASPs (82.7% versus 36.5%; p < 0.0001).

Conclusion

Respondents in this study were more knowledgeable about AMR than AMS and its core components.

KEYWORDS:

• Antibiotic stewardship
• rational use of antimicrobials
• inappropriate use of antimicrobials
• antibiotic prescription
• tertiary healthcare facilities
• Nigeria

Article highlights

• Inappropriate prescribing and use of antibiotics are major causes of antimicrobial resistance (AMR) worldwide especially in LMICs where poor regulation of access exists.

• Antimicrobial stewardship programs are sub-optimal where available in Nigeria potentially compounding the problem of antimicrobial resistance.

• This study assessed the antibiotic prescribing habits, knowledge, attitude, and practice of Nigerian physicians about AMR and antimicrobial stewardship programs (ASP)

• Slightly more than half (55.5%) of respondents routinely sent samples to the laboratory before commencing antibiotic treatment.

• A comparison with the proportion of respondents with good AMR and ASP knowledge clearly showed that more respondents had good knowledge of AMR than ASP (82.7% versus 36.5%; p <.0001).

• There was a statistically significant difference in the knowledge score for ASP among physicians working in internal medicine and surgical specialties (surgery and obstetrics and gynaecology).

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.