ArticleBMJ open2022
Perceptions, views and practices regarding antibiotic prescribing and stewardship among hospital physicians in Jakarta, Indonesia: a questionnaire-based survey.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 17 citations in OpenAlex.
- Factors influencing antimicrobial stewardship implementation in healthcare facilities in four countries of Southeast Asia: a mixed-methods study (2022-23).The Lancet regional health. Southeast Asia · 2026Article
- Multilevel barriers to antimicrobial stewardship in tertiary care hospitals: A comparative systematic scoping review of high-income versus low-/middle-income countries evidence mapped by study design and healthcare professionals.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Specialty and age-based differences in awareness and attitudes towards antibiotic stewardship: a cross-sectional online survey on Japanese clinic physicians.BMC infectious diseases · 2025Article
- Development and validation of a psychometric scale for assessing pharmacy students' perceptions and attitudes toward antimicrobial resistance and antimicrobial stewardship in Indonesia: the PATARAS study.BMC medical education · 2025Article
- Antibiotic prescription practices and knowledge of its rational use among medical personnel in areas of Vidarbha: Are we equipped enough for rational use of medicines?Journal of family medicine and primary care · 2025Article
- Doctors' perceptions of antimicrobial resistance in the Northern West Bank, Palestine: a qualitative study.JAC-antimicrobial resistance · 2025Article
- Antimicrobial prescription KAP among physicians in primary care institutions in Southwest China.PloS one · 2025Article
- Primary care and specialist physicians' prescribing preferences for concurrent probiotic-antibiotic therapy: a multinational clinical practice survey across 13 countries.Frontiers in medicine · 2025Article
- Barriers, facilitators, perceptions and impact of interventions in implementing antimicrobial stewardship programs in hospitals of low-middle and middle countries: a scoping review.Antimicrobial resistance and infection control · 2024Article
- Inappropriate antibiotic prescribing and its determinants among outpatient children in 3 low- and middle-income countries: A multicentric community-based cohort study.PLoS medicine · 2023Article
- Antimicrobial resistance and antimicrobial stewardship in South Africa: a survey of healthcare workers in academic and nonacademic hospitals.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Assessment of antimicrobial prescribing practice, knowledge, and culture in three teaching hospitals.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2022Article
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Authors and funding
13 authors at 7 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAntibiotic overuse is one of the main drivers of antimicrobial resistance (AMR), especially in low-income and middle-income countries. This study aimed to understand the perceptions and views towards AMR, antibiotic prescribing practice and antimicrobial stewardship (AMS) among hospital physicians in Jakarta, Indonesia.
designCross-sectional, self-administered questionnaire-based survey, with descriptive statistics, exploratory factor analysis (EFA) to identify distinct underlying constructs in the dataset, and multivariable linear regression of factor scores to analyse physician subgroups.
settingSix public and private acute-care hospitals in Jakarta in 2019.
participants1007 of 1896 (53.1% response rate) antibiotic prescribing physicians.
resultsPhysicians acknowledged the significance of AMR and contributing factors, rational antibiotic prescribing, and purpose and usefulness of AMS. However, this conflicted with reported suboptimal local hospital practices, such as room cleaning, hand hygiene and staff education, and views regarding antibiotic decision making. These included insufficiently applying AMS principles and utilising microbiology, lack of confidence in prescribing decisions and defensive prescribing due to pervasive diagnostic uncertainty, fear of patient deterioration or because patients insisted. EFA identified six latent factors (overall Crohnbach's α=0.85): awareness of AMS activities; awareness of AMS purpose; views regarding rational antibiotic prescribing; confidence in antibiotic prescribing decisions; perception of AMR as a significant problem; and immediate actions to contain AMR. Factor scores differed across hospitals, departments, work experience and medical hierarchy.
conclusionsAMS implementation in Indonesian hospitals is challenged by institutional, contextual and diagnostic vulnerabilities, resulting in externalising AMR instead of recognising it as a local problem. Appropriate recognition of the contextual determinants of antibiotic prescribing decision making will be critical to change physicians' attitudes and develop context-specific AMS interventions.
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