title: Knowledge, attitudes and practice survey about antimicrobial resistance and prescribing among physicians in a hospital setting in Lima, Peru.
abstract: BACKGROUND
  Misuse of antimicrobials (AMs) and antimicrobial resistance (AMR) are global concerns. The present study evaluated knowledge, attitudes and practices about AMR and AM prescribing among medical doctors in two large public hospitals in Lima, Peru, a middle-income country.
  
  
  METHODS
  Cross-sectional study using a self-administered questionnaire
  
  
  RESULTS
  A total of 256 participants completed the questionnaire (response rate 82%). Theoretical knowledge was good (mean score of 6 ± 1.3 on 7 questions) in contrast to poor awareness (< 33%) of local AMR rates of key-pathogens. Participants strongly agreed that AMR is a problem worldwide (70%) and in Peru (65%), but less in their own practice (22%). AM overuse was perceived both for the community (96%) and the hospital settings (90%). Patients' pressure to prescribing AMs was considered as contributing to AM overuse in the community (72%) more than in the hospital setting (50%). Confidence among AM prescribing was higher among attending physicians (82%) compared to residents (30%, p < 0.001%). Sources of information considered as very useful/useful included pocket-based AM prescribing guidelines (69%) and internet sources (62%). Fifty seven percent of participants regarded AMs in their hospitals to be of poor quality. Participants requested more AM prescribing educational programs (96%) and local AM guidelines (92%).
  
  
  CONCLUSIONS
  This survey revealed topics to address during future AM prescribing interventions such as dissemination of information about local AMR rates, promoting confidence in the quality of locally available AMs, redaction and dissemination of local AM guidelines and addressing the general public, and exploring the possibilities of internet-based training.
authors.affiliation: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Perú. coralith.garcia@upch.pe
authors.forename: Coralith
authors.initials: C
authors.lastname: García
authors.forename: Liz P
authors.initials: LP
authors.lastname: Llamocca
authors.forename: Krystel
authors.initials: K
authors.lastname: García
authors.forename: Aimee
authors.initials: A
authors.lastname: Jiménez
authors.forename: Frine
authors.initials: F
authors.lastname: Samalvides
authors.forename: Eduardo
authors.initials: E
authors.lastname: Gotuzzo
authors.forename: Jan
authors.initials: J
authors.lastname: Jacobs
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D004352:Drug Resistance, Microbial; D006779:Hospitals, Public; D006786:Hospitals, Urban; D006801:Humans; D057970:Inappropriate Prescribing; D007239:Infections / Q000188:drug therapy; D007318:Inservice Training; D020407:Internet; D008505:Medical Staff, Hospital; D057240:Patient Preference; D010568:Peru; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011361:Professional Competence; D011795:Surveys and Questionnaires
chemical_list: D000890:Anti-Infective Agents
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