Assessment of physicians’ perception about antibiotic use and resistance and factors influencing antibiotic prescribing: a situational analysis from Pakistan

Background
Antimicrobial resistance is an emerging problem worldwide, having a negative influence on patient outcomes. As compared to high and upper middle-income countries, the condition is miserable in low- and middle-income countries, including Pakistan.

Objectives
This study aims to assess the perception of physicians concerning antibiotic use and resistance, the factors influencing the prescription of antibiotics and interventions to improve the prescribing behavior in Pakistan.

Material and methods
A cross-sectional survey was performed among physicians practicing in different hospitals of Lahore, Pakistan. A 60-item survey instrument was developed in consultation with a group of experts after a literature review of previous comparable studies. The questionnaire was distributed to physicians practicing in different healthcare settings of Lahore, Pakistan.

Results
A total population of 200 physicians filled in the questionnaire, with a response rate of 72.7%. The majority of physicians were younger (n = 124, 62%), with an age group of 23–29 years. Most of the physicians reported that antibiotics are overused nationally (n = 190, 95%). However, they did not always agree that antibiotics are overused in their own institutions. A majority of physicians believed that strong knowledge of antibiotics is important in their career (n = 184, 92%). Of the total, 176 (88%) physicians believed that inappropriate use of antibiotics is professionally unethical.

Conclusions
Our findings showed that physicians are well aware of the importance of antibiotic resistance and reported that rational use of antibiotics will aid in resolving this issue. Therefore, the introduction of educational sessions regarding antibiotic use and its resistance and innovative approaches to attract healthcare practitioners’ attention towards antibiotic stewardship programs are urgently needed.