Antibiotic knowledge and prescribing practices of doctors working in tertiary hospitals in Johannesburg

Norsworthy, Stacey
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Antimicrobial resistance currently poses an increasing public health risk worldwide. Antimicrobial stewardship has a large role to play in minimising further development of antimicrobial resistance and protecting the future use of antimicrobial agents. Health care workers are an important target for implementation of this stewardship. This study aimed to evaluate the antimicrobial knowledge and prescribing practices of doctors working in tertiary hospitals in Johannesburg. Information collected included questions on antimicrobial knowledge. prescription choice for specific infections, perceptions regarding antimicrobial resistance and factors influencing antimicrobial prescription. This was a cross sectional study using a self-administered questionnaire. Doctors of all levels of qualification within the Department of Internal Medicine working in Helen Joseph Hospital (HJH), Chris Hani Baragwanath Academic Hospital (CHBAH) and Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) were invited to participate. A total of 108 medical doctors participated. Only 56% said they were confident in their prescription practices. Fewer than half (47%) had received education between 1-3 times on this topic within the last year, while 15% said they had not received any education. The majority of participants scored between 33-67% on antimicrobial knowledge questions regarding specific infections. Three quarters of respondents agreed that antimicrobials are over prescribed in South Africa and 94% responded that they are overprescribed worldwide. Almost every participant (98%) indicated that they would like more teaching on this topic. The doctors who participated in this study prescribe antimicrobial agents on a regular basis, but a large portion are not confident in their knowledge to do so. Theoretical questions identified gaps in knowledge regarding treatment of common infectious diseases across all levels of qualification. While the doctors acknowledged antimicrobial resistance as a local and international problem, they indicated that they would like further teaching on the topic. Antimicrobial stewardship teaching rounds would be an excellent way to implement this
A research report submitted in partial fulfilment of the requirements for the degree of Master of Medicine in the branch of Internal Medicine to the Faculty of Science, University of the Witwatersrand, Johannesburg, 2020