Physicians' Knowledge and Perception of Antimicrobial Resistance: A Survey in Khartoum State Hospital Settings

Abstract

Aims: To assess physicians' knowledge and perception regarding antimicrobial resistance and current antibiotic practices at the three main hospitals at Khartoum State-Sudan. Study Design: A cross- sectional survey. Place and Duration of Study: Physicians from the three main Khartoum state teaching hospitals (Khartoum, Omdurman and Khartoum North) had been surveyed between October 2011 and March 2012. Methodology: A total of 350 Physicians identified from different departmental specialties were interviewed using a 40 item, self-administered questionnaire. Results: Of physicians surveyed 38.0% considered antibiotic resistance were very important in their hospitals, 41.7% nationally and 44.3% globally. The majority of respondents (47.5%) perceived the problem of antibiotic resistance as sever problem in their hospitals. Factors identified as important in producing resistance include, widespread antibiotic use (54.3%), poor access to local antibiograms (47.4%), inappropriate course duration (46.3%), and inappropriate empiric choice (44.9%).The respondents were less likely to perceive patient's demand and role of pharmaceutical companies' promotion of antibiotics as very important factors (19.1% and 18.3% respectively).The intervention considered very useful by the largest percentage of physicians was "educational programs" (45.7%) followed by "updating about local antibiotic resistance pattern" (37.4%) and "access to current antibiogram" (35.2%). Antibiotic restriction programs were regarded as less helpful. Knowledge of resistance organisms and resistance-prone antibiotics was poor. Conclusion: Although physicians were aware of the antibiotic resistance, their perceptions about its importance, its causes and potential solutions are often contradictory and variable. These contradictory perspectives present challenges that must be overcome if we are to successfully address the mounting problem of antibiotic resistance.