RESUMO
Background: Antimicrobial resistance was listed among the most dangerous threats to global health security. Antimicrobial use is influenced by the interplay of the knowledge, expectations, and interactions of prescribers and patients, economic incentives, characteristics of the health system(s) and the regulatory environment. Knowledge, attitudes, and practice of antibiotic prescription among primary health-care doctors are important to understand the antimicrobial resistance; hence, this study aimed to examine these aspects in Bahrain. Objective: The objective of the study was to assess the knowledge, attitudes, and practices of the Primary Health Care Physician (PHP) in Bahrain toward antibiotics use. Materials and Methods: Cross-sectional study have been conducted among PHP working in primary health care centers (PHC) in Bahrain. A structured, anonymous, self-administered questionnaire was used to conduct the study. The following items were collected for each participant: Demographic (age, sex, nationality.etc), work factors (qualification, years of experience, morning or shift.etc) and knowledge, attitude, and practice toward antibiotics use. Each questionnaire was coded and assigned a special identity number for data entry and processing. Data were entered into a data base program (Statistical Package for the Social Sciences). Frequency tables were produced for each item. Cross tabulation with chi square test was done for certain variables with demographic and work related items. Results: A sample of 155 primary care physicians was taken; 138 (89%) were Bahrainis and 17 (11%) were non-Bahrainis, from which 39 (25.2%) were males and 116 (74.8%) were females. They were asked to judge their level of knowledge about antibiotics use in general and 94 of them (61.8%) classified their level as being “good” and 37.5% as excellent. More than half of the doctors (55.2%) admitted that they have not received any kind of formal training about antibiotic use. Almost all the doctors (95.5%) agreed that prescribing antibiotics in an inappropriate way puts the patients at risk. Majority of the doctors (89%) ranked patients’ clinical condition as being the most influencer on their judgment to prescribe antibiotics, followed by obtaining a positive microbiological result in symptomatic patients (85.1%). More than three-quarter of doctors (80.5%) agreed that providing local antimicrobial guidelines will help in decreasing the problem of antibiotics overuse and resistance. More than 85% agree that using antibiotics appropriately will be the ultimate key to decrease antimicrobial resistance. Conclusion: In general, there is a good attitude toward the importance of antibiotics use among PHC doctors, but the knowledge is not as good with only 61.8% of PHC doctors considered their knowledge as good toward antibiotics use and around half (55.2%) stated that they did not receive any formal training in this field. Antibiotics use and antimicrobial resistance should be strengthened in the curriculum of undergraduate and postgraduate training programs.