Physicians' Approaches to Combating Antimicrobial Resistance: Evaluation of Knowledge, Attitudes, and Practices

Antimicrobial resistance (AMR) is a major global health challenge, largely driven by inappropriate antibiotic use. Physicians play a central role in antibiotic stewardship, and understanding their knowledge, attitudes, and practices is essential for effective resistance control. This study aimed to evaluate physicians' knowledge, attitudes, and practices toward AMR in a state hospital in Western Türkiye.

This cross-sectional study was conducted between June and October 2023 among all physicians working at a state hospital in Aydın, Türkiye. Data were collected using a structured, pre-tested questionnaire adapted from validated tools used in previous studies. The questionnaire included 29 items assessing knowledge (11 items), attitudes (8 items), and practices (10 items). Participants scoring at or above the 50th percentile were considered to have "adequate" knowledge, attitudes, or practices. Associations were examined using the independent-samples t-test, Mann-Whitney U test, and chi-square test, with p<0.05 considered statistically significant.

Of 141 eligible physicians, 99 participated, corresponding to a response rate of 70.2%. The mean age was 40.3 ± 8.5 years, and 74.7% were specialists. Adequate knowledge, attitudes, and practices were found in 48.5%, 51.5%, and 57.7% of respondents, respectively. Training on rational antibiotic use during residency and within the past year was significantly associated with higher knowledge scores (p=0.021, p=0.024). Adequate practices were more frequent among older physicians and those with longer professional experience (p=0.036, p=0.024). While 90.9% perceived AMR as a national problem, only 57.3% considered it an issue in their hospital. Awareness of local resistance data remained low, with correct responses ranging from 9.2% to 28.3%.

Physicians demonstrated moderate knowledge and positive attitudes toward AMR but showed gaps in awareness of local resistance patterns and prescribing practices. Continuous training, better access to local data, and hospital-based stewardship programs are crucial to promoting rational antibiotic use and effectively combating AMR.

Graphic Abstract.