Knowledge, Attitudes and Practice Survey about Antimicrobial Resistance and Prescribing Among Physicians in Governmental Hospitals in North of Palestine

Antimicrobials resistance and irrational use of antimicrobials (AMs) are a worldwide problem. The objective of this study is to assess knowledge, attitudes and practices about an-timicrobial resistance (AMR) and AM prescribing among physicians in the northern districts of the occupied Palestinian territories. A cross-sectional study using a self-administered ques-tionnaire was conducted at governmental hospitals in the northern districts of the occupied Palestinian territories to assess knowledge, attitudes and practice of physicians about antibi-otic prescribing and AMR. This study was conducted in the period starting October 2016 until April of 2017.The average knowledge score was 5 out of 7(SD + 0.17). The vast majority (95.8%) strongly agreed that AMR is a worldwide problem. Although (84.9%) agreed that AMR is a problem in their daily practice, about (69.2%) of them did not know the rate of AMR in their hospitals. Confidence about AMs prescribing was higher among residents than attending physicians (47%, 40%, respectively). With respect to the sources of information, the majority of participants (78.9%) found that the internet is a very useful source of infor-mation while more than half (52.4%) sometimes ask their colleagues. The pressure which the patients put on the physicians to prescribe AMs (54.2% in the community versus 25.9% in the hospital setting) and the availability of AMs in hospitals (26%) contributed to AM over-use. The majority of participants (99.4%) were interested in more AMs prescribing educa-tional programs and local AM guidelines (81.3%).This study highlighted the areas of weak-nesses that need to be addressed for future AM prescribing interventions such as increasing awareness about local AMR rates, preparation and dissemination of local AM guidelines based on local AMR data, as well as raising the general public’s awareness about AMs and AMR and exploring the possibilities of internet-based training.