Understanding and Practice of AWaRe Among Healthcare Professionals in a Tertiary Care Hospital in Nepal; Implications...

Antimicrobial resistance (AMR) is a pressing global issue caused and aggravated by the injudicious use of antimicrobials. The WHO has developed an Access, Watch, and Reserve (AWaRe) system to categorize antimicrobials to promote responsible use and combat resistance. The aim of the study was to assess healthcare professionals' knowledge and application of AWaRe principles in a tertiary care hospital, focusing on their relevance to AMR.

A comparative cross-sectional survey was performed among a total of 166 registered healthcare professionals in a tertiary care hospital using a pre-validated questionnaire. The socio-demographic characteristics of participants were presented as frequencies and proportions. Group differences were tested by the chi-square test (χ ²). Odds ratios with 95% confidence intervals were computed for the binary logistic regression analyses.

The medical professionals showed a higher level of good understanding (59.81%) and practice (60.75%). The medical professionals (OR = 0.137, 95% CI: = 0.137-0.539, p < 0.001), individuals with MD/MS degrees (OR = 0.297, 95% CI: = 0.149-0.592, p < 0.001), male gender (OR = 0.298, 95% CI: = 0.157-0.565, p < 0.001), and those with less experience (OR = 0.528, 95% CI: = 0.285-0.979, p < 0.05) had a better grasp of the AWaRe system. Similarly, individuals with more experience were more likely to engage in good practices (OR = 1.903, 95% CI: = 1.013-3.573, p = 0.044). On the other hand, gender, age, faculty, qualification, and specialization did not show any significant association with practice regarding the AWaRe system.

The study highlighted significant differences in understanding and practices related to AMR among the three professional groups. Medical professionals demonstrated the highest levels of understanding and adherence, followed by pharmacy and nursing professionals. Targeted educational programs could address existing knowledge gaps and strengthen antimicrobial stewardship efforts in resource-limited settings like Nepal.