Evidence map›Paper›PMID 33931108›Full record

ArticleAntimicrobial resistance and infection control2021

Predictors of antibiotic prescriptions: a knowledge, attitude and practice survey among physicians in tertiary hospitals in Nigeria.

Dimie Ogoina, Garba Iliyasu, Vivian Kwaghe, Akan Otu, Iorhen Ephram Akase, Olukemi Adekanmbi, Dalhat Mahmood, Micheal Iroezindu, Shamsudin Aliyu, Abisoye Sunday Oyeyemi and 9 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Antimicrobial resistance and infection control, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Dimie OgoinaDimie Ogoina Infectious Disease Unit, Department of Internal Medicine, Niger Delta University/Niger Delta University Teaching Hospital, Yenagoa, Bayelsa State, Nigeria. dimieogoina@gmail.com.ORCID 0000-0002-2098-6300
Garba IliyasuInfectious Disease Unit, Department of Internal Medicine, Aminu Kano University Teaching Hospital, Kano, Nigeria.
Vivian KwagheInfectious Disease Unit, Department of Internal Medicine, University of Abuja Teaching Hospital, Abuja, Gwagwadala, Nigeria.
Akan OtuDepartment of Internal Medicine, College of Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.
Iorhen Ephram AkaseDepartment of Internal Medicine, Lagos State University Teaching Hospital, Lagos, Nigeria.
Olukemi AdekanmbiDepartment of Medicine, University College Hospital/University of Ibadan, Ibadan, Oyo State, Nigeria.
Dalhat MahmoodNigeria Centre for Disease Control (NCDC), African Field Epidemiology Network (AFENET), Abuja, Nigeria.
Micheal IroezinduDepartment of Medicine, University of Nigeria Teaching Hospital Ituku/Ozalla Enugu, Ituku, Enugu State, Nigeria.
Shamsudin AliyuDepartment of Medical Microbiology, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria.
Abisoye Sunday OyeyemiDepartment of Community Medicine, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria.
Stella RotifaDepartment of Community Medicine, Federal Medical Centre Yenagoa, Yenagoa, Bayelsa State, Nigeria.
Mukhtar Abdulmajid AdeizaDepartment of Internal Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria.
Uche Sonny UnigweDepartment of Medicine, University of Nigeria Teaching Hospital Ituku/Ozalla Enugu, Ituku, Enugu State, Nigeria.
Juliet Ijeoma MmeremDepartment of Medicine, University of Nigeria Teaching Hospital Ituku/Ozalla Enugu, Ituku, Enugu State, Nigeria.
Farouq Muhammad DayyabInfectious Disease Hospital, Kano, Nigeria.
Zaiyad Garba HabibInfectious Disease Unit, Department of Internal Medicine, University of Abuja Teaching Hospital, Abuja, Gwagwadala, Nigeria.
Daniel OtokpaDepartment of Internal Medicine, College of Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.
Emmanuel EffaDepartment of Internal Medicine, College of Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria.
Abdulrazaq Garba HabibInfectious Disease Unit, Department of Internal Medicine, Aminu Kano University Teaching Hospital, Kano, Nigeria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs part of the Global Action Plan against antimicrobial resistance (AMR), countries are required to generate local evidence to inform context-specific implementation of national action plans against AMR (NAPAR). We aimed to evaluate the knowledge, attitude, and practice (KAP) regarding antibiotic prescriptions (APR) and AMR among physicians in tertiary hospitals in Nigeria, and to determine predictors of KAP of APR and AMR.

methodsIn this cross-sectional study, we enrolled physicians practicing in tertiary hospitals from all six geopolitical zones of Nigeria. Implementation of an antimicrobial stewardship programmes (ASP) by each selected hospital were assessed using a 12 item ASP checklist. We used a structured self-administered questionnaire to assess the KAP of APR and AMR. Frequency of prescriptions of 18 different antibiotics in the prior 6 months was assessed using a Likert's scale. KAP and prescription (Pr) scores were classified as good (score ≥ 80%) or average/poor (score < 80%). Independent predictors of good knowledge, attitude, and practice (KAPPr) were ascertained using an unconditional logistic regression model.

resultsA total of 1324 physicians out of 1778 (74% response rate) practicing in 12 tertiary hospitals in 11 states across all six geopolitical zones participated in the study. None of the participating hospitals had a formal ASP programme and majority did not implement antimicrobial stewardship strategies. The median KAPPr scores were 71.1%, 77%, 75% and 53.3%, for the knowledge, attitude, practice, and prescription components, respectively. Only 22.3%, 40.3%, 31.6% and 31.7% of study respondents had good KAPPr, respectively. All respondents had prescribed one or more antibiotics in the prior 6 months, mostly Amoxicillin-clavulanate (98%), fluoroquinolones (97%), and ceftriaxone (96.8%). About 68% of respondents had prescribed antibiotics from the World Health Organization reserve group. Prior AMR training, professional rank, department, and hospital of practice were independently associated with good KAPPr.

conclusionsOur study suggests gaps in knowledge and attitude of APR and AMR with inappropriate prescriptions of antibiotics among physicians practicing in tertiary hospitals in Nigeria. Nigeria's NAPAR should also target establishment and improvement of ASP in hospitals and address institutional, educational, and professional factors that may influence emergence of AMR in Nigeria.

Indexed as

Health Knowledge, Attitudes, PracticePractice Patterns, Physicians'AdolescentAdultAnti-Bacterial AgentsAntimicrobial StewardshipCross-Sectional StudiesDrug Resistance, BacterialFemaleHumansInappropriate PrescribingMaleMiddle AgedNigeriaPhysiciansSurveys and QuestionnairesAnti-Bacterial AgentsAntibiotic prescriptionsAntimicrobial resistanceAntimicrobial stewardshipKAPNigeria

Identifiers

PMID33931108
PMCPMC8086089

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.