Knowledge, attitudes and practices relating to antibiotic use and resistance among prescribers from public primary healthcare facilities in Harare, Zimbabwe.
AMR
antibiotic resistance
antibiotic use
outpatients
Journal
Wellcome open research
ISSN: 2398-502X
Titre abrégé: Wellcome Open Res
Pays: England
ID NLM: 101696457
Informations de publication
Date de publication:
2021
2021
Historique:
accepted:
26
04
2022
medline:
29
4
2022
pubmed:
29
4
2022
entrez:
2
10
2023
Statut:
epublish
Résumé
Background Overuse of antibiotics is one of the main drivers for antimicrobial resistance (AMR). Globally, most antibiotics are prescribed in the outpatient setting. This survey aimed to explore attitudes and practices with regards to microbiology tests, AMR and antibiotic prescribing among healthcare providers at public primary health clinics in Harare, Zimbabwe. Methods This cross-sectional survey was conducted in nine primary health clinics located in low-income suburbs of Harare between October and December 2020. In Zimbabwe, primary health clinics provide nurse-led outpatient care for acute and chronic illnesses. Healthcare providers who independently prescribe antibiotics and order diagnostic tests were invited to participate. The survey used self-administered questionnaires. A five-point Likert scale was used to determine attitudes and beliefs. Results A total of 91 healthcare providers agreed to participate in the survey. The majority of participants (62/91, 68%) had more than 10 years of work experience. Most participants reported that they consider AMR as a global (75/91, 82%) and/or national (81/91, 89%) problem, while 52/91 (57%) considered AMR to be a problem in their healthcare facilities. A fifth of participants (20/91, 22%) were unsure if AMR was a problem in their clinics. Participants felt that availability of national guidelines (89/89, 100%), training sessions on antibiotic prescribing (89/89, 100%) and regular audit and feedback on prescribing (82/88, 93%) were helpful interventions to improve prescribing. Conclusions These findings support the need for increased availability of data on AMR and antibiotic use in primary care. Educational interventions, regular audit and feedback, and access to practice guidelines may be useful to limit overuse of antibiotics.
Identifiants
pubmed: 37780956
doi: 10.12688/wellcomeopenres.16657.2
pmc: PMC10534082
doi:
Banques de données
Dryad
['10.5061/dryad.66t1g1k1s']
Types de publication
Journal Article
Langues
eng
Pagination
72Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Informations de copyright
Copyright: © 2022 Olaru ID et al.
Déclaration de conflit d'intérêts
No competing interests were disclosed.
Références
J Antimicrob Chemother. 2007 Apr;59(4):718-26
pubmed: 17337511
J Infect. 2019 Jan;78(1):8-18
pubmed: 29981773
Lancet Infect Dis. 2019 Sep;19(9):930
pubmed: 31478515
Antimicrob Resist Infect Control. 2022 Mar 3;11(1):44
pubmed: 35241171
Glob Health Action. 2019;12(1):1639388
pubmed: 31339473
Proc Natl Acad Sci U S A. 2018 Apr 10;115(15):E3463-E3470
pubmed: 29581252
J Antimicrob Chemother. 2015 Sep;70(9):2465-73
pubmed: 26093375
JAMA. 2016 May 3;315(17):1864-73
pubmed: 27139059
Wellcome Open Res. 2022 Apr 29;6:72
pubmed: 37780956
BMC Pharmacol Toxicol. 2014 May 19;15:26
pubmed: 24887310
Soc Sci Med. 2021 Mar;272:113594
pubmed: 33529937
J Antimicrob Chemother. 2019 Sep 1;74(9):2803-2809
pubmed: 31169902
BMJ Glob Health. 2021 Nov;6(11):
pubmed: 34836911
Clin Microbiol Infect. 2011 Jan;17(1):80-7
pubmed: 20132254
PLoS Med. 2020 Jun 16;17(6):e1003139
pubmed: 32544153
BMC Public Health. 2019 May 10;19(Suppl 3):498
pubmed: 32326918
J Chemother. 2020 Dec;32(8):456-459
pubmed: 32114964
PLoS One. 2013;8(2):e55495
pubmed: 23441152
Lancet Infect Dis. 2020 Feb;20(2):179-187
pubmed: 31843383
PLoS One. 2017 Apr 14;12(4):e0174566
pubmed: 28410366
Lancet. 2016 Jan 9;387(10014):176-87
pubmed: 26603922
S Afr Med J. 2018 Aug 28;108(9):763-771
pubmed: 30182902
Clin Infect Dis. 2006 Feb 1;42(3):377-82
pubmed: 16392084
BMJ Open. 2020 Jul 21;10(7):e035632
pubmed: 32699131
Wellcome Open Res. 2020 Jun 12;5:140
pubmed: 33088923
J Clin Pharm Ther. 2018 Feb;43(1):59-64
pubmed: 28833324