A national survey of the knowledge, attitudes and prescribing practices of doctors regarding antibiotic resistance in a Caribbean country

Antimicrob Resist Infect Control. 2018 Feb 15:7:23. doi: 10.1186/s13756-018-0315-3. eCollection 2018.

Abstract

Background: Antibiotic resistance (ABR) is a serious threat that requires coordinated global intervention to prevent its spread. There is limited data from the English-speaking Caribbean.

Methods: As part of a national programme to address antibiotic resistance in Jamaica, a survey of the knowledge, attitudes and antibiotic prescribing practices of Jamaican physicians was conducted using a 32-item self-administered questionnaire.

Results: Of the eight hundred physicians targeted, 87% responded. The majority thought the problem of resistance very important globally (82%), less nationally (73%) and even less (53%) in personal practices. Hospital physicians were more likely to consider antibiotic resistance important in their practice compared to those in outpatient practice or both (p < 0.001). Composite knowledge scores were generated and considered good if scored > 80%, average if 60-79% and poor if < 60%. Most had good knowledge of factors preventing resistance (83%) and resistance inducing potential of specific antibiotics (59%), but only average knowledge of factors contributing to resistance (57%). Knowledge of preventative factors was highest in females (p = 0.004), those with postgraduate training (p = 0.001) and those > four years post graduation (p = 0.03). Empiric therapy was often directed by international guidelines and cultures were not routinely done. Limited laboratory and human resources were identified as challenges.

Conclusion: Physicians in this study were aware of the problem of ABR, but downplayed its significance nationally and personally. These results will guide a national antibiotic stewardship programme.

Keywords: Antibiotic; Attitudes; Knowledge; Practices; Prescribing; Resistance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / standards
  • Anti-Bacterial Agents / therapeutic use
  • Antimicrobial Stewardship* / standards
  • Attitude
  • Attitude of Health Personnel*
  • Caribbean Region
  • Cross-Sectional Studies
  • Drug Prescriptions
  • Drug Resistance, Microbial*
  • Education, Medical
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Hospitals
  • Humans
  • Jamaica
  • Male
  • Physicians / psychology*
  • Practice Patterns, Physicians'
  • Surveys and Questionnaires

Substances

  • Anti-Bacterial Agents