Antibiotic prescribing practices: A national survey of Cambodian physicians.
Antibiotic resistance is a threat to global health security. We assessed knowledge, attitudes, and practices in regard to antibiotic prescribing and resistance in Cambodian physicians from public hospitals.



A cross-sectional knowledge, attitudes, and practices survey was distributed to physicians from 19 public hospitals.



The response rate was 78% (689 out of 881). The majority (88%; 607 out of 686) of physicians understood that antibiotic resistance was a local challenge. More than half (54%; 366 out of 682) believed that antibiotic prescribing was inappropriate in their hospital and 93% (638 out of 684) had difficulties in selecting appropriate antibiotics to treat common infections. The majority (86%; 574 out of 667) and one-third of physicians (36%; 236 out of 665) would prescribe antibiotics for uncomplicated common cold and diarrhea in children < 5 years of age, respectively. Half (58%; 385 out of 668) had experience treating methicillin-resistant Staphylococcus aureus infection, but the majority (73%; 188 out of 258) could not identify antibiotics to treat this infection. Only 17% (115 out of 667) had experience treating endemic melioidosis. All physicians agreed that knowledge about local antibiotic resistance, treatment guidelines, and educational programs were necessary.



Cambodian physicians are aware of antibiotic resistance challenges but they do not possess the required knowledge of local antibiotic resistance patterns that would assist their prescribing practices. Cambodian physicians need support to improve antibiotic prescribing.
School of Public Health and Community Medicine, UNSW Medicine, UNSW Australia, Sydney, New South Wales, Australia.
Chhorvoin
C
Om
Department of Clinical Sciences Antwerp, Institute of Tropical Medicine, Antwerp, Belgium.
Erika
E
Vlieghe
Diagnostic Microbiology Development Program, Phnom Penh, Cambodia.
James C
JC
McLaughlin
Diagnostic Microbiology Development Program, Phnom Penh, Cambodia.
Frances
F
Daily
School of Public Health and Community Medicine, UNSW Medicine, UNSW Australia, Sydney, New South Wales, Australia. Electronic address: m.mclaws@unsw.edu.au.
Mary-Louise
ML
McLaws
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D044466:Asian People; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D004352:Drug Resistance, Microbial; D006779:Hospitals, Public; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D010820:Physicians; D010818:Practice Patterns, Physicians'; D055656:Prescriptions; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents
Attitude; Infectious disease; Knowledge; Public hospital; Resistance