Knowledge, attitude, and practice survey on antimicrobial use and resistance among Indian clinicians: A multicentric, cross-sectional study
Suparna Chatterjee1, Avijit Hazra1, Raja Chakraverty1, Nusrat Shafiq2, Ashish Pathak3, Niyati Trivedi4, Balakrishnan Sadasivam5, Ashish Kumar Kakkar2, Ratinder Jhaj5, Rajni Kaul6, Nilima Kshirsagar6
1 Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
2 Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
3 Department of Paediatrics, R. D. Gardi Medical College, Ujjain, India; Department of Women and Children’s Health, International Maternal and Child Health Unit, Uppsala University, Uppsala; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
4 Department of Pharmacology, Government Medical College, Baroda, Gujarat, India
5 Department of Pharmacology, All India Institute of Medical Science, Bhopal, Madhya Pradesh, India
6 Indian Council of Medical Research, New Delhi, India
Institute of Postgraduate Medical Education and Research, 244B, AJC Bose Road, Kolkata - 700 020, West Bengal
Source of Support: None, Conflict of Interest: None
Purpose: This multicentric questionnaire-based study was undertaken to address the lack of systematic background data on the knowledge, attitudes, and practices among Indian physicians related to antimicrobial use and resistance.
Materials and Methods: A validated structured study questionnaire was used for capturing respondent particulars, antimicrobial prescribing habits, knowledge of antimicrobial resistance (AMR), ways of choosing and learning about antibiotics, agreement or disagreement with certain perceptions regarding antibiotics, selection of antibiotics in specific settings, and suggestions regarding rationalizing antimicrobial use in the practice setting. Summary statistical analysis of the pooled data was done.
Results: Five hundred and six respondents with a mean (standard deviation) age of 31.4 (8.71) years participated in the study. Three hundred and twenty-seven were medical and 179 surgical discipline clinicians. Overall, the theoretical knowledge about antimicrobials was satisfactory, but areas of concern were noted in the attitude and practice domains. A substantial proportion of participants failed to identify the correct choice of antibiotics in the case-based scenarios. 38.33% reported not attending a single continuing medical education on antimicrobials during the past year. Statistically significant differences were not observed in the KAP quotient scores between medical and surgical discipline respondents.
Conclusions: Despite satisfactory background knowledge regarding the rational use of antimicrobials and AMR patterns, there are discrepancies in the physicians' prescribing attitude and thus strengthen the case for instituting specific interventions to improve antimicrobial prescribing.