Pattern of Use, Knowledge, Attitude and Practice of Healthcare Workers about Antibioticsin Egyptian Primary Healthcare Facilities

Background: Studies have shown that a relatively large proportion of antibiotic use is inappropriate or unnecessary.

Aims: This study was conducted to assess the pattern of antibiotics use among healthcare workers in primary healthcare facilities as well as to assess their knowledge, attitude and practice towards antibiotics use with exploring its associated factors.

Methods: A cross sectional study with an analytic component was conducted on 218healthcare workers in Mahallat Damanah family health center, Dakahlia governorate, Egypt using a modified self-administered semi-structured questionnaire.

Results: The study showed that the most frequent prescribed antibiotic was amoxicillin. The most frequent source of antibiotics used was pharmacy with prescription (43.1%) followed by pharmacy without prescription (38.5%). The main reasons for antibiotic use without prescription were previous knowledge (37.6%) followed by mild condition (20.2%) and previous experience (17.4%)while the main reasons for not completing the antibiotic course were improvement (38.1%) followed by fear of side effects (25.2%). The total mean score for knowledge, attitude and practice were 11.07±2.58,24.83±3.80 and 5.73±2.22 respectively. It was found that 88.5% of healthcare workers had good knowledge, 47.7% expressed favorable attitude and56.9% showed good practice. Medical staff (OR=5.5) and working experience >5 years (OR=2.6) were predictors of good knowledge. Furthermore, working experience >5 years (OR=4.5) and working hours <42 h (OR=2.9) were predictors of good practice while the only predictor of good attitude was the working experience >5 years (OR=2.1).

Conclusions: The study mainly found that the most common reasons for antibiotic use without prescription were: previous knowledge, mild condition, previous experience, counseling without prescription, costly counseling, easy to buy and others with similar condition. While the reasons for not completing course of antibiotic were improvement, fear of side effects, the antibiotics were forgotten and the antibiotics were kept for future. Also, although the study showed an adequate level of knowledge which resulted in an appropriate practice, the attitude was unfavorable.

Keywords: pattern of use; antibiotics; knowledge, attitude and practice; healthcare workers; primary healthcare facilities.