Assessing the knowledge, attitudes and perceptions of junior doctors on antimicrobial use and antimicrobial resistance in Greece

Abstract Objectives Understanding antimicrobial prescribing attitudes and perceptions, especially in the early stage of training, is an important driver for appropriate interventions. We examined junior doctors’ knowledge, attitudes and perceptions regarding antimicrobial use and antimicrobial resistance in Greece. Methods Self-administered internet-based questionnaire survey to trainees and residents of all primary care centers and hospitals in Crete, Greece. Results From a total of 313 invited junior doctors, 214 (68.4%) fully completed the questionnaire. Mean correct knowledge score (4 items) was 60%. The highest confidence rates with prescribing were recorded in diagnosing accurately an infection that needs antimicrobial treatment, selecting appropriate administration route, and selecting appropriate dosage. The lowest confidence rates were recorded in modifying antimicrobial treatment based on clinical and/or microbiological evidence, prescribing antimicrobial combinations, and not prescribing an antimicrobial in a febrile patient without severity criteria and uncertain diagnosis of infection. Use of guidelines and expert consultation were perceived as the most important factors influencing antimicrobial prescribing practices. Most participants were aware of the antimicrobial resistance problem in Greece, considering excessive prescribing of antimicrobials and broad-spectrum antimicrobials as the most important causes. Availability of local and national guidelines and antimicrobial resistance data, senior consultation, and infectious diseases specialist consultation, were the preferred interventions to improve antibiotic prescribing. Conclusions The findings of this study will contribute to the design of appropriate interventions, based on local evidence, for the establishment of antimicrobial stewardship programs in a country characterized by excessive use of antimicrobials and high resistance rates.