Assessment of Knowledge, Attitude, and Practice (KAP) Regarding Antimicrobial Stewardship Among Resident Doctors in a Tertiary Care Teaching Hospital

Authors

  • Abid Manzoor Tutor, Department of Physiology, Balvir Singh Tomar Institute of Medical Sciences and Research, Jaipur. Author
  • Mohd Fadil Salmani Tutor, Army College of Medical Sciences, Delhi, India. Author
  • Dr. Kumaraswamy Dabburu Professor, Department of Pharmacology, Bridgetown International University School of Medicine, Bridgetown International University, Barbados Author

DOI:

https://doi.org/10.66328/ijprmh.2026.020104

Keywords:

Antimichrobial, Resident Doctors, KAP, Study, Resistance

Abstract

Background:
Antimicrobial resistance (AMR) represents a major global health challenge, driven largely by inappropriate antimicrobial use. Antimicrobial stewardship programs (ASPs) aim to optimize antibiotic prescribing; however, their effectiveness depends significantly on the knowledge, attitude, and practices (KAP) of frontline prescribers, particularly resident doctors.

Methods:
A cross-sectional, questionnaire-based study was conducted at a tertiary care teaching institution in North India over six months. A structured, validated Google Forms proforma was used to assess KAP related to antimicrobial stewardship among resident doctors. A total of 1500 residents participated. Data were analyzed using descriptive and inferential statistics, with p < 0.05 considered statistically significant.

Results:
Among participants, 48% demonstrated good knowledge, while 78% exhibited a positive attitude toward antimicrobial stewardship. Awareness of AMR was high (92%), but familiarity with WHO AWaRe classification was limited (44%). Appropriate prescribing practices were observed in only 44% of residents. Senior residents had significantly better knowledge compared to junior residents (p < 0.001). A notable gap between knowledge and practice was identified.

Conclusion:
Despite adequate awareness and favorable attitudes, substantial deficiencies in stewardship-related knowledge and prescribing practices persist among resident doctors. Structured training programs and strengthened institutional stewardship measures are essential to improve rational antimicrobial use and bridge the knowledge–practice gap.

Author Biography

  • Dr. Kumaraswamy Dabburu, Professor, Department of Pharmacology, Bridgetown International University School of Medicine, Bridgetown International University, Barbados

    NIL

References

1. O’Neill J. Tackling drug-resistant infections globally: final report and recommendations. London: Review on Antimicrobial Resistance; 2016.

2. Laxminarayan R, Duse A, Wattal C, Zaidi AKM, Wertheim HFL, Sumpradit N, et al. Antibiotic resistance—the need for global solutions. Lancet. 2013;382(9893):1057–1098.

3. Barlam TF, Cosgrove SE, Abbo LM, MacDougall C, Schuetz AN, Septimus EJ, et al. Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis. 2016;62(10):e51–e77.

4. World Health Organization. AWaRe classification of antibiotics for evaluation and monitoring of use. Geneva: WHO; 2019.

5. Pulcini C, Williams F, Molinari N, Davey P, Nathwani D. Junior doctors’ knowledge and perceptions of antibiotic resistance and prescribing: a survey in France and Scotland. Clin Microbiol Infect. 2011;17(1):80–87.

6. Dyar OJ, Nathwani D, Monnet DL, Gyssens IC, Stålsby Lundborg C, Pulcini C. Do medical students feel prepared to prescribe antibiotics responsibly? Results from a cross-sectional survey in 29 European countries. J Antimicrob Chemother. 2018;73(8):2236–2242.

7. Abbo LM, Cosgrove SE, Pottinger PS, Pereyra M, Sinkowitz-Cochran R, Srinivasan A, et al. Medical students’ perceptions and knowledge about antimicrobial stewardship: how are we educating our future prescribers? Clin Infect Dis. 2013;57(5):631–638.

8. Hsia Y, Sharland M, Jackson C, Wong ICK, Magrini N, Bielicki JA. Consumption of oral antibiotic formulations for young children according to the WHO Access, Watch, Reserve (AWaRe) classification. Lancet Infect Dis. 2019;19(1):67–75.

9. Castro-Sánchez E, Drumright LN, Gharbi M, Farrell S, Holmes AH. Mapping antimicrobial stewardship in undergraduate medical, dental, pharmacy, nursing and veterinary education in the United Kingdom. PLoS One. 2016;11(2):e0150056.

10. Charani E, Castro-Sánchez E, Sevdalis N, Kyratsis Y, Drumright L, Shah N, et al. Understanding the determinants of antimicrobial prescribing within hospitals: the role of “prescribing etiquette”. Clin Infect Dis. 2013;57(2):188–196.

11. Gharbi M, Moore LS, Castro-Sánchez E, Spanoudaki E, Grady C, Holmes AH, et al. A needs assessment study for optimising prescribing practice in secondary care junior doctors: the antibiotic prescribing education among doctors (APED). BMC Infect Dis. 2016;16:456.

12. Dyar OJ, Hills H, Seitz LT, Perry A, Ashiru-Oredope D. Assessing the knowledge, attitudes and behaviors of human and animal health students towards antibiotic use and resistance: a pilot cross-sectional study in the UK. Antibiotics (Basel). 2018;7(1):10.

13. Abbo LM, Cosgrove SE, Pottinger PS, Pereyra M, Sinkowitz-Cochran R, Srinivasan A, et al. Medical students’ perceptions and knowledge about antimicrobial stewardship: how are we educating our future prescribers? Clin Infect Dis. 2013;57(5):631–638.

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Published

2026-03-31

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Section

Original Research Articles

How to Cite

Assessment of Knowledge, Attitude, and Practice (KAP) Regarding Antimicrobial Stewardship Among Resident Doctors in a Tertiary Care Teaching Hospital. (2026). International Journal of Public Research in Medicine and Health, 2(1). https://doi.org/10.66328/ijprmh.2026.020104