Healthcare providers’ knowledge, attitudes and practices toward antimicrobial resistance and antibiotic use at a tertiary care hospital in Southwest Ethiopia

Abstract

The growing burden of antimicrobial resistance (AMR) is strongly linked to the inappropriate use of antibiotics. Improving the knowledge, attitude and practices of healthcare providers (HCPs) toward AMR and antibiotic use is essential in combating AMR. Therefore, this study aimed to assess healthcare providers’ knowledge, attitudes and practices toward AMR and antibiotic use at Jimma University Medical Center, a tertiary care hospital in Southwest Ethiopia. A cross-sectional study was carried out at Jimma University Medical Center in Southwest Ethiopia from August to November 2023. Data were collected from 328 HCPs across seven clinical wards using a semi-structured, self-administered questionnaire. Forty-one participants who reported that antibiotic prescribing or dispensing was not part of their duties were excluded from the practice-related analysis. Data were entered using EpiData version 3.1 and analysed by SPSS version 26.0. Out of 328 respondents, 83.8% (275) demonstrated good knowledge and 77.4% (254) exhibited a positive attitude toward AMR and antibiotic use. However, only 36.6% (105/287) of those included in the practice analysis reported good antibiotic use practices. Regarding inappropriate prescribing, 28.5% (82/287) admitted to often or always prescribing antibiotics for colds or sore throats, and 20.6% (59/287) reported dispensing antibiotics without a prescription frequently (always or often). Adherence to standard treatment guidelines was reported as frequent (always or often) by 61.7% (177/287) of participants, whereas 33.4% (96/287) did so sometimes or rarely. Nearly half (50.9%, 146/287) had not received any training and a significant proportion (72.5%, 208/287) had not attended any continuing professional development (CPD) activities related to AMR and antibiotic use. HCPs who had participated in training (AOR = 1.9, 95% CI: 1.0–3.5; p = 0.02) or CPD (AOR = 2.1, 95% CI: 1.0–4.2; p = 0.03) were significantly more likely to exhibit good practices. Although most healthcare providers demonstrated good knowledge and a positive attitude toward antimicrobial resistance and antibiotic use, their actual practice was inadequate. Strengthening antimicrobial stewardship requires targeted interventions, including regular training and CPD focused on appropriate antimicrobial prescribing and adherence to treatment guidelines.