Antibiotic prescription behaviours in Lao People's Democratic Republic: a knowledge, attitude and practice survey

Abstract

ObjectiveTo assess the antibiotic prescribing practices of doctors working in the Lao People's Democratic Republic and their knowledge of local antibiotic resistance patterns.MethodsDoctors attending morning meetings in 25 public hospitals in four provinces were asked to complete a knowledge, attitude and practice survey. The questionnaire contained 43 multiple choice questions that the doctor answered at the time of the meeting.FindingsThe response rate was 83.4% (386/463). Two hundred and seventy doctors (59.8%) declared that they had insufficient information about antibiotics. Only 14.0% (54/386) recognized the possibility of cephalosporin cross-resistance in methicillin-resistant Staphylococcus aureus. Most participants had no information about local antibiotic resistance for Salmonella Typhi (211/385, 54.8%) and hospital-acquired pneumonia (253/384, 65.9%). Unnecessary antibiotic prescriptions were considered as harmless by 115 participants and 148 considered locally-available generic antibiotics to be of poor quality. Nearly three-quarters (280/386) of participants agreed that it was difficult to select the correct antibiotics. Most participants (373/386) welcomed educational programmes on antibiotic prescribing and 65.0% (249/383) preferred local over international antibiotic guidelines.ConclusionDoctors in the Lao People's Democratic Republic seem to favour antibiotic prescribing interventions. Health authorities should consider a capacity building programme that incorporates antibiotic prescribing and hospital infection control.

The knowledge, attitude and practice of health practitioners towards antibiotic prescribing and resistance in developing countries—A systematic review

“…The systematic search resulted in a total of 384 papers, with 345 papers left after removing duplicates, and 28 relevant papers upon reviewing titles and abstracts. Of these, 15 articles fulfilled our inclusion criteria upon full‐text review (Figure ), according to the United Nations, World Economic Situation and Prospects: four from Africa (two from East Africa: Ethiopia, the Democratic Republic of Congo, one from North Africa: Egypt and one from West Africa: The Gambia); nine from Asia (three from East Asia: Lao People's Democratic Republic, Malaysia, four from South Asia: Bangladesh, India and two from Western Asia: Saudi Arabia); and two from Latin America and the Caribbean (one from the Caribbean: West Indies and one from South America: Peru). All the studies were cross‐sectional, 13 were quantitative studies using questionnaires, and two were qualitative studies.…”

“…Based on correct answers, two of the studies reported level of knowledge based on the proportion of respondents with correct responses to questions that assessed their knowledge, with an overall proportion of 80.9% . Three of the studies reported mean score of knowledge as 5.9 of 10 (SD ± 1.3), 6.0 of 7.0 (SD ± 1.3) and 4.7 of 7 (SD ± 1.29) . Thriemer et al reported a proportion of 60.9% of the respondents had a score of more than 4.0 of 8.0, and Rajiah et al reported 59.5% of the respondents had a “good understanding” of antibiotic use, based on a score of 8.0 or more points of 15.0.…”

“…Five studies reported on the participants’ knowledge on local resistance patterns of pathogens in their health facilities . Overall, an average of 39.6% was aware of the local resistance patterns .…”

“…Fathi et al reported an average of 40.5% of the respondents did not know the level of resistance of selected organisms in their health facilities. Eleven studies provided data on the extent of antibiotic resistance problem . Overall, by the proportion of respondents, antibiotic resistance was reported to be a general problem by 75.2%, a global problem by 84.7%, a national problem by 88.0%, a problem in their health facilities by 71.9% and a problem in their daily practice by 71.7% .…”

“…Overall, 78.2% of the participants reported that they were very confident or confident. However, in the study by Quet et al, it was reported that 72.5% of the respondents reported having difficulties with prescribing the correct antibiotics, and Garcia et al reported that 31% of the respondents agreed that it is difficult for them to select the correct antimicrobial; thus, by average from these two studies, 51.8% had difficulty choosing the right antibiotic.…”