BackgroundAntibiotic resistance (ABR) is a serious threat that requires coordinated global intervention to prevent its spread. There is limited data from the English-speaking Caribbean.MethodsAs part of a national programme to address antibiotic resistance in Jamaica, a survey of the knowledge, attitudes and antibiotic prescribing practices of Jamaican physicians was conducted using a 32-item self-administered questionnaire.ResultsOf the eight hundred physicians targeted, 87% responded. The majority thought the problem of resistance very important globally (82%), less nationally (73%) and even less (53%) in personal practices. Hospital physicians were more likely to consider antibiotic resistance important in their practice compared to those in outpatient practice or both (p < 0.001). Composite knowledge scores were generated and considered good if scored > 80%, average if 60–79% and poor if < 60%. Most had good knowledge of factors preventing resistance (83%) and resistance inducing potential of specific antibiotics (59%), but only average knowledge of factors contributing to resistance (57%). Knowledge of preventative factors was highest in females (p = 0.004), those with postgraduate training (p = 0.001) and those > four years post graduation (p = 0.03). Empiric therapy was often directed by international guidelines and cultures were not routinely done. Limited laboratory and human resources were identified as challenges.ConclusionPhysicians in this study were aware of the problem of ABR, but downplayed its significance nationally and personally. These results will guide a national antibiotic stewardship programme.
The distribution of the major MRSA clones in the French (Guadeloupe and Martinique) and non-French West Indies (Jamaica, Trinidad, and Tobago) is different, and the clones most closely resemble those found in the home countries of the travelers who visit the islands most frequently. The distribution might be affected by tourist migration, which is specific to each island.
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