KNOWLEDGE, ATTITUDES AND PRACTICES OF ANTIBIOTICS PRESCRIPTION AMONG RESIDENT DOCTORS IN AHMADU BELLO UNIVERSITY TEACHING HOSPITAL (ABUTH) ZARIA, NIGERIA
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ABSTRACT
Background: Assessment of the knowledge, attitudes and practice of resident doctors and medical officers in ABUTH Zaria, on antibiotics prescription in order to develop interventions to improve antimicrobial resistance. Methods: A total of 309 respondents was surveyed using a 30 stem questionnaire which was distributed to residents doctors and medical officers in ABUTH Zaria, Results: A total of 251 (81.3%) responded to the survey from 17 different departments which was grouped into six specialties, only 106 (42.2%) of the respondents indicated they had worked in infectious disease unit (IDU), 212 (84.5%) acknowledged they were aware of rational drug use (RDU), while 233 (92.8%) indicated they were aware of national drug formulary (NDF), of those who knew about NDF, only 101 (40.2%) routinely use NDF to aid their prescription. Majority 200 (79.7%) of the respondents do not know the hospital antimicrobial susceptibility pattern. Even though 204 (98.8%) of the respondents indicated they had prescribed antibiotics in the past six months, 123 (49.2%) admitted prescribing greater than five antibiotics in the past seven days pre survey. Many 161 (64.7%) of the respondents believed it is the responsibility of the doctors to explain to patients how to take the antibiotics prescribed, this show a significant relationship between designations of respondents, (χ2 , p=0.038). Majority 232 (92.8%) of the respondents acknowledged antibiotics resistance as a national problem, 213 (85.2%) indicated it as a problem in their clinical practice, while 197 (79.1%) believe it is a problem in the hospital. The knowledge that antibiotics resistance is a problem in the hospital is influenced by the level of residency training, which shows a significant relationship (χ 2 , p=0.003). Only 32 viii (13.6%) and 26 (10.4%) of respondents have the knowledge of WHO prevalence of inappropriate antibiotics use and Methicillin resistance Staphylococcus aureus (MRSA), a significant relationship was found with respect to level of training (designation) of respondents, (χ 2 , p=0.035). Four factors were considered as potential cause of antibiotics resistance, too low dose of antibiotics prescription, too many broad spectrum of antibiotics prescription, too long duration of antibiotics. A significant relationship (χ 2 , p=0.022) was found between respondents designation and their perception of long duration of antibiotics usage as an important cause of antibiotics resistance. Respondents indicate educational session on prescription and availability of local or national guideline as most helpful in improving antibiotics prescription. Speaking to pharmaceutical representative and restriction of prescription of all antibiotics were considered as unhelpful in improving antibiotics prescription. Conclusions: This study revealed the respondents have some knowledge on some of the important causes of resistance to antibiotics, that the hospital do not have an antibiogram for antibiotics sensitivity, and that a formal education on antibiotics prescription is required. These data provides helpful information for the design of strategies to optimize adherence to good antibiotics prescription.
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