Antibiotic prescribing practices: A national survey of Cambodian physicians

- Physicians were aware that antibiotic resistance was a local challenge.
- Knowledge about local antibiotic resistance was poor resulting in habitually inappropriate prescribing.
- The majority prescribed antibiotics for uncomplicated viral infections.
- Physicians did not utilize appropriately microbiology services.
- Physicians needed support to improve their prescribing.

BackgroundAntibiotic resistance is a threat to global health security. We assessed knowledge, attitudes, and practices in regard to antibiotic prescribing and resistance in Cambodian physicians from public hospitals.MethodsA cross-sectional knowledge, attitudes, and practices survey was distributed to physicians from 19 public hospitals.ResultsThe response rate was 78% (689 out of 881). The majority (88%; 607 out of 686) of physicians understood that antibiotic resistance was a local challenge. More than half (54%; 366 out of 682) believed that antibiotic prescribing was inappropriate in their hospital and 93% (638 out of 684) had difficulties in selecting appropriate antibiotics to treat common infections. The majority (86%; 574 out of 667) and one-third of physicians (36%; 236 out of 665) would prescribe antibiotics for uncomplicated common cold and diarrhea in children < 5 years of age, respectively. Half (58%; 385 out of 668) had experience treating methicillin-resistant Staphylococcus aureus infection, but the majority (73%; 188 out of 258) could not identify antibiotics to treat this infection. Only 17% (115 out of 667) had experience treating endemic melioidosis. All physicians agreed that knowledge about local antibiotic resistance, treatment guidelines, and educational programs were necessary.ConclusionsCambodian physicians are aware of antibiotic resistance challenges but they do not possess the required knowledge of local antibiotic resistance patterns that would assist their prescribing practices. Cambodian physicians need support to improve antibiotic prescribing.