Physicians' antibiotics prescribing patterns for common diseases and knowledge on antimicrobial resistance: A descriptive cross-sectional study

Abstract

PURPOSE: This study was conducted to assess the Knowledge, Attitude, and Practice (KAP) of patients or their caregivers, and prescribers of antibiotics toward antimicrobial resistance in Bangladesh. METHOD: This was a mixed-method research study. Data were collected from pre-determined study areas using a sample survey of 583 respondents, 11 Focus Group Discussions (FGDs), 11 Key-Informant Interviews (KIIs), and 11 In-depth Interviews (IDIs). A scale of 11 points was used to measure attitudes. RESULTS: About 59% of the respondents (patients or carers) were between 1 to 20 years old. The difference of age of patients by sex was found statistically significant at .001 level (x2 = 39.82, def. = 8; Cramer's V = .49). About 25.7% of the respondents visited an MBBS doctor and 8.1% visited a BDS dentist, and 66.2% went to traditional healers and the pharmacy. Men take more antibiotics for treatment purposes compared to their female counterparts. The difference between men and women, with regard to the treatment of common diseases, was found to be statistically significant. (X2= 29.82; Cramer's V= .41, def. = 7; Sig; P= < .02). Usually, new graduate doctors and traditional healers prescribe antibiotics of longer duration. The duration of prescriptions for antibiotics and type of the physician was found statistically significant (x2= 19.22; Cramer's V= .28, def. = 8; Sig; P= < .02). Physicians prescribed common antibiotics for upper respiratory tract infections (26%), cold and fever (21%), diarrhea (12%), STDs (9%), HTN (8%), UTIs (7.5%), diabetes (5%), and lower respiratory infections (4%). Cephalosporin (31.4%), macrolides (27.6%), quinolones (17.8%), metronidazole (13%), and penicillin (10.10%) were used. About 65.8% of the caregivers did not have any knowledge about antimicrobial resistance and the negative effects of the overuse of antibiotics. CONCLUSION: The majority of the respondents had poor knowledge of antimicrobial resistance and the negative effects of the overuse of antibiotics. A community-based awareness program was found important to create awareness of antimicrobial resistance and the negative effects of the overuse of antibiotics.