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

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 a...

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Autores principales: Ogoina, Dimie, Iliyasu, Garba, Kwaghe, Vivian, Otu, Akan, Akase, Iorhen Ephram, Adekanmbi, Olukemi, Mahmood, Dalhat, Iroezindu, Micheal, Aliyu, Shamsudin, Oyeyemi, Abisoye Sunday, Rotifa, Stella, Adeiza, Mukhtar Abdulmajid, Unigwe, Uche Sonny, Mmerem, Juliet Ijeoma, Dayyab, Farouq Muhammad, Habib, Zaiyad Garba, Otokpa, Daniel, Effa, Emmanuel, Habib, Abdulrazaq Garba
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8086089/
https://www.ncbi.nlm.nih.gov/pubmed/33931108
http://dx.doi.org/10.1186/s13756-021-00940-9
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author Ogoina, Dimie
Iliyasu, Garba
Kwaghe, Vivian
Otu, Akan
Akase, Iorhen Ephram
Adekanmbi, Olukemi
Mahmood, Dalhat
Iroezindu, Micheal
Aliyu, Shamsudin
Oyeyemi, Abisoye Sunday
Rotifa, Stella
Adeiza, Mukhtar Abdulmajid
Unigwe, Uche Sonny
Mmerem, Juliet Ijeoma
Dayyab, Farouq Muhammad
Habib, Zaiyad Garba
Otokpa, Daniel
Effa, Emmanuel
Habib, Abdulrazaq Garba
author_facet Ogoina, Dimie
Iliyasu, Garba
Kwaghe, Vivian
Otu, Akan
Akase, Iorhen Ephram
Adekanmbi, Olukemi
Mahmood, Dalhat
Iroezindu, Micheal
Aliyu, Shamsudin
Oyeyemi, Abisoye Sunday
Rotifa, Stella
Adeiza, Mukhtar Abdulmajid
Unigwe, Uche Sonny
Mmerem, Juliet Ijeoma
Dayyab, Farouq Muhammad
Habib, Zaiyad Garba
Otokpa, Daniel
Effa, Emmanuel
Habib, Abdulrazaq Garba
author_sort Ogoina, Dimie
collection PubMed
description 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.
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spelling pubmed-80860892021-04-30 Predictors of antibiotic prescriptions: a knowledge, attitude and practice survey among physicians in tertiary hospitals in Nigeria Ogoina, Dimie Iliyasu, Garba Kwaghe, Vivian Otu, Akan Akase, Iorhen Ephram Adekanmbi, Olukemi Mahmood, Dalhat Iroezindu, Micheal Aliyu, Shamsudin Oyeyemi, Abisoye Sunday Rotifa, Stella Adeiza, Mukhtar Abdulmajid Unigwe, Uche Sonny Mmerem, Juliet Ijeoma Dayyab, Farouq Muhammad Habib, Zaiyad Garba Otokpa, Daniel Effa, Emmanuel Habib, Abdulrazaq Garba Antimicrob Resist Infect Control Research 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. BioMed Central 2021-04-30 /pmc/articles/PMC8086089/ /pubmed/33931108 http://dx.doi.org/10.1186/s13756-021-00940-9 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Ogoina, Dimie
Iliyasu, Garba
Kwaghe, Vivian
Otu, Akan
Akase, Iorhen Ephram
Adekanmbi, Olukemi
Mahmood, Dalhat
Iroezindu, Micheal
Aliyu, Shamsudin
Oyeyemi, Abisoye Sunday
Rotifa, Stella
Adeiza, Mukhtar Abdulmajid
Unigwe, Uche Sonny
Mmerem, Juliet Ijeoma
Dayyab, Farouq Muhammad
Habib, Zaiyad Garba
Otokpa, Daniel
Effa, Emmanuel
Habib, Abdulrazaq Garba
Predictors of antibiotic prescriptions: a knowledge, attitude and practice survey among physicians in tertiary hospitals in Nigeria
title Predictors of antibiotic prescriptions: a knowledge, attitude and practice survey among physicians in tertiary hospitals in Nigeria
title_full Predictors of antibiotic prescriptions: a knowledge, attitude and practice survey among physicians in tertiary hospitals in Nigeria
title_fullStr Predictors of antibiotic prescriptions: a knowledge, attitude and practice survey among physicians in tertiary hospitals in Nigeria
title_full_unstemmed Predictors of antibiotic prescriptions: a knowledge, attitude and practice survey among physicians in tertiary hospitals in Nigeria
title_short Predictors of antibiotic prescriptions: a knowledge, attitude and practice survey among physicians in tertiary hospitals in Nigeria
title_sort predictors of antibiotic prescriptions: a knowledge, attitude and practice survey among physicians in tertiary hospitals in nigeria
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8086089/
https://www.ncbi.nlm.nih.gov/pubmed/33931108
http://dx.doi.org/10.1186/s13756-021-00940-9
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