Attitudes and practices for antibiotic prescription and antimicrobial resistance among general physicians -Findings from a multi-country survey

This study aimed to assess the attitudes, and practices (AP) of general physicians (GPs) regarding antibiotic prescribing and antimicrobial resistance (AMR). A cross-sectional, descriptive AP study was conducted by surveying GPs treating community acquired respiratory tract infections (RTIs) across nine countries, including India, Pakistan, Algeria, Thailand, Vietnam, Egypt, Morocco, the United Arab Emirates, and Saudi Arabia. A 29-item, web-based questionnaire was used to collect data between October-2023 and December-2023. Overall, 9249/14207 invited GPs responded, and 1008 responses were included in the analysis after quality control (3341 terminated due to eligibility, 4764 dropped out without completion, 136 excluded for quality concern). Of the included respondents, 78.8% were male and 98% were aged ≥35 years. 41% of GPs agreed, 33% disagreed, and 27% were neutral to questions regarding whether or not antibiotics are helpful in treating infectious respiratory diseases. In total, 62% of GPs agreed that AMR is a concern in their country and 63% agreed that prescribing antibiotics in primary care results in AMR. Pregnant women and patients with comorbidities were populations for whom selecting an appropriate antibiotic was most challenging; 38% of GPs found prescribing antibiotics to children was difficult. Difficulty in correlating susceptibility data (53%), limited availability of information on antibiotics (52%), and lack of availability of appropriate antibiotics (51%) were important challenges for appropriate antibiotic selection. Overall, 94% of GPs agreed that there is a need for frequent training on antibiotic therapy, with 33% and 49% recommending quarterly and biannual trainings, respectively. This study identified current practices, and possible gaps in appropriate antibiotic prescribing for RTIs. As an outcome, specific training needs could be identified to assist GPs with appropriate antibiotic prescribing in an outpatient setting.