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Knowledge and Support for Antimicrobial Stewardship Does Not Necessarily Translate into Good Practice: Survey in a
Nadejda Morărescu1,2, Pawel Stefanoff2
1National Agency for Public Health (NAPH), MD-2028 Chișinău, Moldova.
Background/Objectives:
Antimicrobial resistance (AMR) is an increasing problem globally, largely driven by the overuse and misuse of antibiotics. In Moldova, physicians are frequently not following recommendations regarding the use of antimicrobials. Despite the adoption of a national strategy to combat AMR, information on healthcare professionals' knowledge, attitudes, and practices (KAP) related to antimicrobial stewardship (AMS) remains limited. This study aimed to assess KAP related to AMS among staff at a tertiary hospital.
Methods:
We surveyed employees of the Republican Clinical Hospital between 20 May and 30 June 2024. We interviewed doctors, nurses, pharmacists, clinical pharmacologists, and epidemiologists using a structured, self-administered questionnaire. The instrument assessed their KAP regarding antimicrobial stewardship. We analyzed the data collected using descriptive statistics and tests of association.
Results:
Among 138 participants, 65% were female and 54% were nurses. A high proportion demonstrated good knowledge (87%) and a positive attitude (78%) towards AMS. However, only 31% reported good stewardship-related practices. Significant associations were observed between knowledge and attitude (p < 0.001), and between knowledge and practice (p = 0.013). No significant association was found between attitude and practice (p = 0.160).
Conclusions:
These findings reveal a disconnect between knowledge, attitudes, and practical implementation of AMS principles. While healthcare professionals were knowledgeable and well-intentioned, practice remains inconsistent. This suggests that effective AMS interventions must combine individual training with structural support at the institutional level. Tailored strategies should address both general awareness and hospital-specific factors contributing to AMR.
Insights
Healthcare professionals in Moldova show high knowledge and positive attitudes towards antimicrobial stewardship (AMS). However, actual practices lag, indicating a need for interventions addressing both individual training and institutional support to combat antimicrobial resistance (AMR).
Area of Science:
- Healthcare Management
- Infectious Diseases
- Public Health
Background:
- Antimicrobial resistance (AMR) is a growing global health threat.
- Antibiotic overuse and misuse are primary drivers of AMR.
- Physicians in Moldova often deviate from recommended antimicrobial use, despite a national strategy.
Purpose of the Study:
- To assess the knowledge, attitudes, and practices (KAP) of healthcare professionals regarding antimicrobial stewardship (AMS).
- To identify gaps in AMS implementation within a tertiary hospital setting in Moldova.
Main Methods:
- A structured, self-administered questionnaire was used to survey 138 healthcare employees (doctors, nurses, pharmacists, etc.) at the Republican Clinical Hospital.
- Data collection occurred between May 20 and June 30, 2024.
- Descriptive statistics and tests of association were employed for data analysis.
Main Results:
- A high percentage of participants demonstrated good knowledge (87%) and positive attitudes (78%) towards AMS.
- Only 31% reported good stewardship-related practices.
- Significant associations were found between knowledge and attitude (p < 0.001), and knowledge and practice (p = 0.013).
Conclusions:
- A notable gap exists between healthcare professionals' knowledge/attitudes and their actual AMS practices.
- Effective antimicrobial stewardship interventions require a dual approach: individual training and institutional support.
- Tailored strategies are necessary to improve AMS and combat AMR, considering both awareness and hospital-specific factors.
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