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

一项针对加勒比海某国医生关于抗生素耐药性的知识、态度和处方行为的全国性调查

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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.

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