title: A questionnaire-based survey to ascertain the views of clinicians regarding rational use of antibiotics in teaching hospitals of Kolkata.
abstract: OBJECTIVE
  The objective was to assess the views of clinicians in teaching hospitals of Kolkata regarding the use of antibiotics in their own hospitals, focusing on perceived misuse, reasons behind such misuse and feasible remedial measures.
  
  
  METHODS
  A total of 200 clinicians from core clinical disciplines was approached in six teaching hospitals of Kolkata through purposive sampling. A structured, validated questionnaire adopted from published studies and modified to suit the responding population was completed by consenting respondents through face-to-face interaction with a single interviewer. Respondents were free to leave out questions they did not wish to answer.
  
  
  RESULTS
  Among 130 participating clinicians (65% of approached), all felt that antibiotic misuse occurs in various hospital settings; 72 (55.4% of the respondents) felt it was a frequent occurrence and needed major rectification. Cough and cold (78.5%), fever (65.4%), and diarrhea (62.3%) were perceived to be the commonest conditions of antibiotic misuse. About half (50.76%) felt that oral preparations were more misused compared to injectable or topical ones. Among oral antibiotics, co-amoxiclav (66.9%) and cefpodoxime (63.07%) whereas among parenteral ones, ceftriaxone and other third generation cephalosporins (74.6%) followed by piperacillin-tazobactam (61.5%) were selected as the most misused ones. Deficient training in rational use of medicines (70.7%) and absence of institutional antibiotic policy (67.7%) were listed as the two most important predisposing factors. Training of medical students and interns in rational antibiotic use (78.5%), implementation of antibiotic policy (76.9%), improvement in microbiology support (70.7%), and regular surveillance on this issue (64.6%) were cited as the principal remedial measures.
  
  
  CONCLUSIONS
  Clinicians acknowledge that the misuse of antibiotics is an important problem in their hospitals. A system of clinical audit of antibiotic usage, improved microbiology support and implementation of antibiotic policy can help to promote rational use of antimicrobial agents.
authors.affiliation: Department of Pharmacology, R. G. Kar Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Dattatreyo
authors.initials: D
authors.lastname: Chatterjee
authors.affiliation: Department of Clinical and Experimental Pharmacology, School of Tropical Medicine, Kolkata, West Bengal, India.
authors.forename: Sukanta
authors.initials: S
authors.lastname: Sen
authors.affiliation: Department of Pharmacology, R. G. Kar Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Sabnam Ara
authors.initials: SA
authors.lastname: Begum
authors.affiliation: Department of Pharmacology, R. G. Kar Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Anjan
authors.initials: A
authors.lastname: Adhikari
authors.affiliation: Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India.
authors.forename: Avijit
authors.initials: A
authors.lastname: Hazra
authors.affiliation: Department of Pharmacology, R. G. Kar Medical College and Hospital, Kolkata, West Bengal, India.
authors.forename: Anup Kumar
authors.initials: AK
authors.lastname: Das
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D017723:Drug Utilization Review; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006784:Hospitals, Teaching; D006801:Humans; D007194:India; D000069342:Medical Overuse; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents
keywords: Clinicians; rational antibiotic usage; teaching hospitals; views
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