Analysis of Knowledge and Practice on Antibiotics Prescribing with Physicians in Hospitals Goma, RD Congo
AbstractBackground: Improving good practice in antibiotics use is critical in challenging antimicrobial resistance. This study assessed knowledge and practices regarding antibiotic prescribing in children by physicians in both public and private health care in Goma, East of the Democratic Republic of Congo, a low-income country.Methods: A cross-sectional study using self -administered questionnaires was applied.Results: 147 physicians from twenty-five health care providers in the city of Goma participated in the study. More than three-quarters [85.7% (n=147] were General Practitioners from primary health care settings. More than two-thirds of the participants had over five years’ experience. In approximately three-quarters of cases [72.1%, (n=147)], the participants declared lack of recent training on antibiotic prescribing. In the five clinical situations posed to the participants, antibiotics prescribing practice was felt to be inappropriate or unnecessary in 15 to 80%. Antibiotic prescribing for symptoms of cough and fever, yellowish sputum, odynophagia, cold and flu and fever, positive “Thick smear” test and fever were categorized as unnecessary or inappropriate. An incorrect response concerning the susceptibility of Staphylococcus Methicillin-Resistant (MRSA) was demonstrated in more than three-quarters in General Practitioners [76.4%, (n=123)] compared to less than half in Specialists [41.2%, (n=123)] (p=0.00). With regard to Enterococcus susceptibility, an incorrect response was noted in more than three-quarters in both General Practitioners and Specialists. A number of internal factors or determinants in health care institutions (Publics and Privates sectors) were noted to restrict good practice in antibiotics prescribing. Factors contributing to poor to practice in antibiotics prescribing were the uncertainty in the diagnosis, physicians who had only practiced in private hospitals and clinics and frequent antibiotics stock shortage in public or semi-public hospital. In more than a third of physicians, antibiotics resistance was not perceived as a problem in their daily practice or as a public health problem.Conclusions: Hospitals in Goma demonstrated inappropriate antibiotic prescribing practice. Strategies and policies such as Antimicrobial Stewardship and socio-anthropological approach need to be explored.Keywords: Knowledge, Practice, Antibiotic prescribing, Goma hospitals
Copyright (c) 2020 T. E. Busha, Y. Coppieters, N. P. Mitangala, O. Vandenberg, F. Vermeulen, C. M. Harrison, B. Byl
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