Knowledge, Attitudes and Practices of Patients on Antibiotic Resistance and Use in Public Hospitals of Amhara Regional State, Northwestern Ethiopia: A Cross-Sectional Study

Abstract

Background Although inappropriate antibiotic use could contribute to the spread of antimicrobial resistance, data on the knowledge, attitude and practice of antibiotic use and resistance among patients in north-western Ethiopia are scarce. This study assessed patients’ knowledge, attitudes and practices regarding antibiotic use and resistance in selected public hospitals of Amhara regional state, Ethiopia. Methods A cross-sectional study was conducted in selected public hospitals of Amhara regional state from November to December 2020 to assess the knowledge, attitude, and practice of patients on antibiotic resistance and use. Data were collected from 233 participants using a structured questionnaire and analyzed using SPSS version 23. Results According to the findings, 60.3% of the participants obtained their antibiotics without a prescription from private pharmacies, and the most commonly used antibiotic to treat human diseases was ampicillin (70.7%). Even though 69.8% of the patients heard about antibiotics and antibiotic resistance from several sources, 68.1–87.9% of them were unaware on the factors that contribute to the transmission of resistant bacteria to humans and the impact of antibiotic resistance on human and animal health. Using the mean score of 3.15 ± 0.08 as the cut-off, 37.5% of patients know about antimicrobial resistance and use. With a mean score of 27.6 ± 0.3, 45.3% of patients had positive attitudes toward prudent antibiotic use and resistance. About 44% of participants had a good practice, with a mean practice score of 4.95 ± 0.17. A higher level of education was associated with better knowledge, positive attitudes, and better practices regarding antibiotic use and resistance. Although 57.3% of respondents viewed poor handwashing practices in hospitals as a major factor contributing to increased antibiotic resistance, 59.9% of respondents viewed implementing hygiene, infection prevention, and control practices as a major strategy contributing to reducing antibiotic use and resistance. Conclusion According to the present study, there is a low level of awareness among patients about the proper antibiotics use and resistance. It is essential to raise awareness, develop, and implement interventions to reduce antimicrobial use and antibiotic resistance in the study area.

Knowledge, attitude and practices of residents toward antimicrobial usage and resistance in Gondar, Northwest Ethiopia

“…Similarly, participants with a college or university education, a secondary education, or a vocational education had higher knowledge scores than those with only primary education or no formal education. It corroborates the findings of Bhardwaj et al [ 17 ] in India, Sindato et al [ 18 ] in Tanzania, Geta and Kibret [ 20 ] in Ethiopia and Karuniawati et al [ 24 ] in Indonesia. There was also a statistically significant ( p < 0.05) relationship found between respondents’ knowledge and practice, knowledge and attitude, and practice and attitudes.…”

“…Inappropriate AMU and the associated risk of AMR are a growing public health issue worldwide [ 15 – 17 ]. The misuse and abuse of antimicrobials in agriculture, veterinary medicine, and human medicine have been identified as major contributors to the global spread of AMR [ 18 – 20 ]. The emergence and spread of antimicrobial-resistant pathogens impede the use of antibiotics for both preventative and therapeutic purposes.…”

“…On the other hand, the evidence on antimicrobial use is limited and anecdotal [ 34 ]. Antimicrobial resistance must be addressed through a variety of interventions, including interventions that reduce inappropriate and unnecessary antimicrobial use in humans and animals while also ensuring that effective antimicrobial therapy is available when needed [ 20 , 35 ].…”

Antibiotic Resistance Profiles of Bacteria Isolated from Hotspot Environments in Bahir Dar City, Northwestern Ethiopia

“…According to the reports from studies conducted in Amhara regional state, tetracycline, ampicillin, gentamicin, ciprofloxacin, and cotrimoxazole were the most frequently used groups of antibiotics in animals, 38 and ampicillin, ciprofloxacin, and tetracycline were the most frequently used groups of antibiotics. 39 Most of the isolates isolated from dairy waste and wastewater (66.7%) and beef waste and wastewater (85.7%) were resistant to ampicillin and tetracycline, respectively, and norfloxacin was the most effective antibiotic for isolates from these waste samples. This finding is inconsistent with the results reported in South Africa, which showed that ciprofloxacin and gentamicin were the most effective and erythromycin was the least effective antibiotic in the control of the bacteria in this study.…”

“…According to the reports from studies conducted in Amhara regional state, tetracycline, ampicillin, gentamicin, ciprofloxacin, and cotrimoxazole were the most frequently used groups of antibiotics in animals, 38 and ampicillin, ciprofloxacin, and tetracycline were the most frequently used groups of antibiotics. 39 …”