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Antibiotic Use and Resistance Among Prescribers: Current Status of Knowledge, Attitude, and Practice in Egypt

Authors El-Sokkary R, Kishk R, Mohy El-Din S, Nemr N, Mahrous N, Alfishawy M, Morsi S, Abdalla W, Ahmed M, Tash R

Received 31 December 2020

Accepted for publication 3 March 2021

Published 25 March 2021 Volume 2021:14 Pages 1209—1218

DOI https://doi.org/10.2147/IDR.S299453

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Suresh Antony


Rehab El-Sokkary,1 Rania Kishk,2 Sally Mohy El-Din,3 Nader Nemr,4 Nageh Mahrous,4 Mostafa Alfishawy,5 Samar Morsi,1 Wael Abdalla,6 Mohamed Ahmed,7 Rehab Tash1

1Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt; 2Microbiology and Immunology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; 3Ministry of Health and Population, Cairo, Egypt; 4Endemic and Infectious Diseases, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; 5Infectious Diseases Consultants and Academic Researchers of Egypt (IDCARE), Cairo, Egypt; 6General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt; 7Obstetrics & Gynecology, Faculty of Medicine, Benha University, Benha, Egypt

Correspondence: Rehab El-Sokkary 12 Abd Aziz Ali Street, Zagazig, Sharkeia, Egypt
Tel +201005650273
Fax +20 55 230 7830
Email [email protected]

Introduction: The problem of antimicrobial resistance (AMR) is rising worldwide. One of the most significant factors influencing antimicrobial resistance in low- and middle-income countries is the lack of the skills and knowledge of health care providers for proper antimicrobial use.
Aim: To identify knowledge, characterize practices and describe the attitude of Egyptian prescribers towards antibiotic use.
Methods: A self-administered validated questionnaire was distributed among Egyptian prescribers.
Results: Five hundred Egyptian physicians responded to the questionnaire, 113 (22.6%) reported having Antibiotic Stewardship Program (ASP) at their workplace, 99 (19.8%) use international antibiotic guidelines as the main source for prescribing activity, 358 (71.6%) recorded adequate knowledge. Elder prescribers and those who work in private or university hospitals were significantly more knowledgeable (p=0.031 and 0.001, respectively). Forty-seven (9.4%) showed a positive attitude towards proper antibiotic prescription. The type of work institution; primary health clinics and private, or university hospital and the specialty are significantly associated with a positive attitude (p=0.009 and 0.015, respectively). Seventy-eight (15.6%) expressed a proper antibiotic prescription practice. Elder age, more experienced and trained prescribers showed more proper practice. The implementation of ASP and using proper sources of information were significantly associated with proper practice (p=0.012 and 0.008, respectively).
Conclusion: Egyptian prescribers have a good level of knowledge about antibiotics. However, low rates of positive attitude and proper practice towards the problem of AMR and ASP are recorded.

Keywords: antibiotics, resistance, stewardship, prescribers, multidrug resistance, low- and middle-income countries

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