一项针对加勒比国家医生对抗生素耐药性的知识、态度和处方实践的全国性调查。
A national survey of the knowledge, attitudes and prescribing practices of doctors regarding antibiotic resistance in a Caribbean country.
机构信息
1Department of Microbiology, The University of the West Indies (UWI), Kingston, Jamaica.
2Department of Surgery, Radiology, Anaesthesia and Intensive Care, UWI, Kingston, Jamaica.
出版信息
Antimicrob Resist Infect Control. 2018 Feb 15;7:23. doi: 10.1186/s13756-018-0315-3. eCollection 2018.
BACKGROUND
Antibiotic resistance (ABR) is a serious threat that requires coordinated global intervention to prevent its spread. There is limited data from the English-speaking Caribbean.
METHODS
As part of a national programme to address antibiotic resistance in Jamaica, a survey of the knowledge, attitudes and antibiotic prescribing practices of Jamaican physicians was conducted using a 32-item self-administered questionnaire.
RESULTS
Of the eight hundred physicians targeted, 87% responded. The majority thought the problem of resistance very important globally (82%), less nationally (73%) and even less (53%) in personal practices. Hospital physicians were more likely to consider antibiotic resistance important in their practice compared to those in outpatient practice or both ( < 0.001). Composite knowledge scores were generated and considered good if scored > 80%, average if 60-79% and poor if < 60%. Most had good knowledge of factors preventing resistance (83%) and resistance inducing potential of specific antibiotics (59%), but only average knowledge of factors contributing to resistance (57%). Knowledge of preventative factors was highest in females ( = 0.004), those with postgraduate training ( = 0.001) and those > four years post graduation ( = 0.03). Empiric therapy was often directed by international guidelines and cultures were not routinely done. Limited laboratory and human resources were identified as challenges.
CONCLUSION
Physicians in this study were aware of the problem of ABR, but downplayed its significance nationally and personally. These results will guide a national antibiotic stewardship programme.
背景
抗生素耐药性（ABR）是一个严重的威胁，需要全球协调干预来防止其传播。英语加勒比地区的数据有限。
方法
作为牙买加应对抗生素耐药性国家计划的一部分，使用 32 项自我管理问卷对牙买加医生的知识、态度和抗生素处方实践进行了调查。
结果
在 800 名目标医生中，有 87%的人做出了回应。大多数人认为全球范围内耐药问题非常重要（82%），全国范围内的耐药问题稍少（73%），个人实践中甚至更少（53%）。与门诊实践或两者兼有的医生相比，医院医生更有可能认为抗生素耐药性在其实践中很重要（ < 0.001）。生成了综合知识评分，如果得分> 80%则认为良好，如果得分为 60-79%则认为平均，如果< 60%则认为较差。大多数人对预防耐药性的因素（83%）和特定抗生素诱导耐药性的因素（59%）有很好的了解，但对导致耐药性的因素（57%）只有平均了解。预防因素的知识在女性中最高（ = 0.004），在有研究生培训的人中（ = 0.001）和毕业后超过四年的人中（ = 0.03）最高。经验性治疗通常由国际指南指导，常规不进行培养。有限的实验室和人力资源被认为是挑战。
结论
本研究中的医生意识到 ABR 的问题，但在国家和个人层面上都淡化了其重要性。这些结果将指导国家抗生素管理计划。
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