Specialty and age-based differences in awareness and attitudes towards antibiotic stewardship: a cross-sectional online survey on Japanese clinic physicians.

Yoshiaki Gu, An Dang Do, Yumiko Fujitomo, Fumio Ohtake

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Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 citing paper in PubMed.

Distribution and associated factors of psychological dimensions related to antimicrobial resistance countermeasures among hospital staff in Japan: an exploratory cross-sectional study.JAC-antimicrobial resistance · 2026
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4 authors.

Yoshiaki GuDepartment of Infectious Diseases, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-ku, 113-8510, Tokyo, Japan. yogu.cid@tmd.ac.jp.

An Dang DoDepartment of Infectious Diseases, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-ku, 113-8510, Tokyo, Japan.

Yumiko FujitomoAMR Clinical Reference Center, National Center for Global Health and Medicine, Japan Institute for Health Security, 1-21-1 Toyama, Shinjuku-ku, 162-8655, Tokyo, Japan.

Fumio OhtakeCenter for Infectious Disease Education and Research, Osaka University, 1- 10 Yamadaoka, 565-0871, Osaka, Suita, Osaka, Japan.

Funding

Japan Society for the Promotion of Science 20H05632

6 · The paper itself

Abstract

backgroundAntimicrobial resistance (AMR) is a critical global health issue, with inconsistent adherence to antimicrobial stewardship contributing to its worsening. This study aims to assess physicians' awareness and attitudes towards AMR and appropriate antimicrobial use across different medical specialties in Japan.

methodsAn online cross-sectional survey was conducted from January 31 to February 5, 2024, among 280 physicians from three specialties (internal medicine, pediatrics, and otorhinolaryngology) who were working in outpatient clinics in Japan. Participants were asked about their familiarity with the National Action Plan (NAP) on AMR and the manuals of Ministry of Health and Labor Welfare (MHLW) on prudent antimicrobial use. Their opinions on AMR facts and antibiotic use were also surveyed using five-point Likert scales. Data were analyzed using descriptive statistics, multilevel mixed-effects ordered logistic regression and generalized linear models to examine factors influencing NAP/manuals adherence.

resultsMost respondents were male (85%) and predominantly aged 50 and above (73.9%), Familiarity with the AMR Action Plan varied, with 36.4% of respondents reported understanding its content, while 37.5% only knew its name. Similarly, 27.1% of respondents used the MHLW manuals, whereas 48.6% were aware of them but did not use them. Internal medicine physicians showed the highest adherence to antimicrobial stewardship and most concern about AMR facts, while pediatricians demonstrated the highest adherence to MHLW manuals (AOR = 2.4, p = 0.000 compared to internal medicine doctors). Otorhinolaryngologists reported higher awareness of NAP (AOR = 2.6, p = 0.006 compared to internal medicine doctors) but had the lowest adherence to NAP and MHLW manuals. Younger physicians (< 50 years) were more proactive in addressing AMR and adhering to antimicrobial stewardship than older physicians. Messages emphasizing the prevention of drug resistance and societal impacts of AMR were most associated with positive attitudes from physicians in outpatient clinics.

conclusionsThis study highlights significant variability in AMR awareness and adherence across specialties and age groups. Internal medicine physicians showed the highest adherence, while pediatricians were the most familiar with AMR manuals. Otorhinolaryngologists demonstrated strong awareness but lower adherence. Targeted educational interventions, particularly focusing on older physicians and specific specialties, are needed to improve antimicrobial use and combat the growing threat of resistance.

Indexed as

Antimicrobial StewardshipAttitude of Health PersonnelHealth Knowledge, Attitudes, PracticePhysiciansAdultAgedAge FactorsAnti-Bacterial AgentsCross-Sectional StudiesEast Asian PeopleFemaleHumansJapanMaleMiddle AgedSurveys and QuestionnairesAnti-Bacterial AgentsAntimicrobial resistance (AMR)Antimicrobial stewardshipHealth educationInfectious disease controlPhysician awareness

Identifiers

PMID41023885

DOI10.1186/s12879-025-11583-1

PMCPMC12481877

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LicenceCC BY-NC-ND

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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.