Received Date: March 03, 2021; Accepted Date: March 19, 2021; Published Date: March 29, 2021
Citation: Nirmal H, Rida I, Sohail M, Johnny G (2021) Knowledge, Attitude and Practices of Antibiotic Resistance among Nurses at Services Hospital Lahore. J Intensive & Crit Care Vol.7 No. 3:39
Antibiotic acts by attacking the pathogenic bacteria on different levels in the human body. These medicines prevent bacterial infection. Overuse or misuse of antibiotics increases the risk of the spread of resistant strains of bacteria. Antibiotic resistance occurs when bacteria change in some way that eliminates the effects of drugs chemicals which are providing to cure or prevent infections.
Aim: This study will help nurses to increase the knowledge, attitude, and practice regarding antibiotics.
Background: Examining the knowledge, attitude, and practice of the nurses regarding antibiotic resistance and usage can help us in commendable proper educational involvements for nurses.
Methods: This study is done on 105 tests of nurses out of 600 nurses by Colvin's strategy and is conducted by exploiting a cross-sectional method that incorporates a distinctive Likert scale rating
Results: Senior staff nurse and generic nurses have a good knowledge regarding antibiotic resistance as compared to diploma nurses.
Conclusions: Demoralization is considered to be further investigated for better understanding.
Keywords: Antibiotic resistance; knowledge; Attitude; Practice.
Antibiotic acts by attacking the pathogenic bacteria on different levels in the human body. These medicines prevent bacterial infection. Overuse or misuse of antibiotics increases the risk of the spread of resistant strains of bacteria.
Antibiotic resistance occurs when bacteria change in some way that eliminates the effects of drugs chemicals which are providing to cure or prevent infections.
Antibiotics are the most extensively used medication in clinical practices, this differentiated usage of antibiotic resistance is increasing at leaps and bounds and it presents a major challenge to health care facilities.
Antimicrobial has become a global public health concern. The WHO estimated that this public health concern leads to an increase in mortality rate.
A potential post-antibiotic era threatens current and future medical advances the current worldwide increase in resistant bacteria and, at the same time, the downward trend in the development of new antibiotics has serious consequences.
In Pakistan, there is avoidable use of antibiotics and due to the overuse of these drugs bacteria are developing resistance against the drugs.
Scientific studies from different hospitals situated in different places of Pakistan have reported that bacteria from different infections now becoming gradually resistant to traditional bacteria.
There is a need to develop strategies to overcome the misuse of antibiotics and reduce the resistance of antibiotics.
Misuse of antibiotics is associated to wrong prescribing behavior amongst physicians. Patient’s wrong habits and their insufficient knowledge also stand for another leading cause for antimicrobial resistance.
It is significant to empowered the community, apply strict policies on the usage of antibiotics, and bring a change in the behavior of the client and it will promote the proper use of antibiotics.
It is identified that student starts antibiotics by their self with subsequent reasons such as cold, flu, sore throat, cough, abdominal pain and skin infections. The conclusion to start antibiotics was predisposed by being fulfilled from earlier antibiotics use, test fees, drug store, and surrounding advice .
The knowledge regarding how to take and how to store antibiotics insufficient among health care professionals. Results show that neither doctor nor pharmacist advises against consumption of antibiotics 
Antibiotics are used to fight bacterial infections and these are not effective against viral infection. Frequent use of antibiotics will lead to resistance and decrease future effectiveness .
There is a high need for proper rule of antibiotics control policies restricting the availability of drugs to the public. Educational programmers should make health care practitioners aware including pharmacists/chemists and consumers alike. Safe practices need to be repeated .
Antibiotic resistance is a major health problem and it requires great attention. Individuals related to medicine should have great knowledge about antibiotics. Sufficient knowledge should be given to the doctors of the future and the better healthcare system .
Health care professionals do not practice what they know. It is significant to create more attentiveness around this issue throughout their students.
Results showed that the students had a fair good knowledge regarding the part of antibiotics their consumptions and the linked adverse reactions .
Low compensation and middle wages countries are essential in worldwide response to antimicrobial defiance. Civilians were conscious of antibiotics. But the usage of specialized concepts of antibiotics was diminished by sectional interpretation like ant-inflammatory medicine .
Nurses are the main source of information in healthcare profession. Nurses have good knowledge about antibiotics defiance but some misconceptions were also present .
Antibiotic resistance is a major health problem and it requires great attention. Individuals related to medicine should have great knowledge about antibiotics. Sufficient knowledge should be given to the doctors of the future and the better healthcare system . Healthcare-associated infections and antimicrobial resistance are substantial threats to community health and wellbeing. As resistant organisms continue to transpire and grow, and antimicrobial drugs become less effective, infection prevention and control remain a vigorous characteristic of preserving public health, predominantly amongst susceptible and vulnerable population groups such as older people and young children. Since the aggregate convolution of healthcare managements and involvements, patients are becoming progressively vulnerable to healthcare-associated infections and resistant organisms .
Adult persons in the community use antibiotics to a great extent. A cross sectional study was showed. Adults had lack of knowledge related to antibiotic resistance. More information should be provided to them 
Resistance to antibiotics has converted a foremost wellbeing risk universal, and one of the furthermost vital funding features is the prevalent overdoing of antimicrobials. However, miserable knowledge and awareness among caregivers of children also results in inappropriate demand for antibiotic preparations for their children.
However, insufficient time and funding are superficial to be major come across in the application of such stewardship programs in many centers in the USA .
Descriptive cross-sectional study design was use for this research.
Study was directed at services hospital Lahore.
Population was the diploma nurses, BSN Nurses and Post RN Staff nurses of services hospital.
Respondents’ selection was done by convenient sampling method for this study. It is the easiest and the most convenient method, way of recruiting the sources of the primary data for research. There were four sections in questionnaire.
Section 1: Demographic Data It included 4 items (Age, Gender, Qualification, Experience and Marital status)
Section 2: Knowledge regarding antibiotic resistance It included 10 items
Section 3: Attitude regarding antibiotic resistance It included 5 items
Section 4: Practice regarding antibiotic resistance It included include 5 items
The questionnaire was used as a research tool for researching study participants. There were four sections in the questionnaire.
Data gathering procedure
A formal letter of permission was used for conducting this research. Consent was taken from all the participants and a free hand was given to the participants to took part in the study or refused to participate, participants were have also be the right to mentioned name or not.
Enough information of research was provided to participants with help of full consent and this was achieved via a consent form attached to the questionnaire.
Methods used to analyze data
Data analysis was done by SPSS version 21. Statistical computer software for data analysis. This was descriptive study and all the descriptive statistics were obtained through the SPSS software. Chi Square test will be implemented for data analysis.
Data from study participants was collect from 16 April10 May 2020
Consents was taken from all the participants and free hand was given to the participants to took part in the study or refused to participate, participants were have also be the right to mentioned name or not.
Enough information of research was provided to participants with help of full consent and this was achieved via a consent form attached to the questionnaire.
Confidentiality was considered by informing participants. The rights of participants were protected by Nuremberg Code of Ethics.
Age of respondents:
Table 1: This table representing the age criteria of respondents that 54% nurse were (25-30) 38 % were in (30-35) and 8% were in the age group of (35-40).
Sex of respondents:
Table 2: This table representing the Sex of respondents that 94.3% were female nurses and 5.7% were male nurses.
Education of nurses:
|Post RN BSN||61||58.1|
Experience of nurses in the field:
|Less than 5 years||65||61.9|
|5 years less than 10 years||33||31.4|
|More than 10 years||7||6.7|
Table 3: This table showing the education of nurses that there are 40% are diploma nurses, 58.1% are post RN nurses and 1.9% are BSN Generic.
Table 4: This table represents the experience of nurses that there are 61.9% are experienced less than 5 years, 31.4% are experienced 5 years to less than 10 years and 6.6% are experienced more than 10 years.
Have you heard of antibiotics before:
Table 5: This table represents the marital status that there are 39% are single and 61% are married respondents.
Do you think antibiotics are the same as antipyretics:
Table 6: This table describes that 95% of nurses known about antibiotics and 4.7% are unknown about antibiotics.
Do you think antibiotics are the same as anti- Inflammatory:
Table 7: This describes that 98% of nurses known and 1.9% are not known that antibiotics and antipyretics are not the same.
Should patients follow physician’s directions while taking antibiotics:
Table 8: This table describes that 82.9% of nurses known that anti-inflammatory and antibiotics are different and 17.1% of nurses known these are the same.
Is it okay to stop taking an antibiotics regimen if symptoms are improving:
Table 9: This table describes that 88% of nurses follow the physician’s direction while taking antibiotics and 11.4% of nurses do not follow directions.
Should flu-like symptoms always be treated with antibiotics:
Table 10: It describes that 95.2% of nurses are agreed to not stop taking antibiotics when symptoms relieved and 4.7% agree to stop.
Should pneumonia always be treated with antibiotics:
Table 11: This table describes that there are 82.8% nurses not willing to take antibiotic for flu like symptoms and there are 17.1% nurses who are willing to take antibiotics for flue like symptoms.
Should you take antibiotics according to the instructions on the package:
Table 12: This table describe that 78.1% nurses known that pneumonia treatable with antibiotics and 21.9% nurses known that it should not be treated with antibiotics.
Do some antibiotics cause adverse effects:
Table 13: This table describe that 83.8% nurses do’not take antibiotics according to instructions on package and 16.1% nurses taking antibiotics according to instruction that is available on package.
Do you think that it’s harmful to follow physician directions while taking:
Table 14: This table shown that 80% nurses known that antibiotics cause adverse effects and 20% nurses do not know that antibiotics has adverse effects.
Would you follow the physician’s direction about antibiotic use:
Table 15: This table represents that 35.2% respondents think that it is harmful to follow physician direction while taking antibiotics and 64.7% think that there iss no harm to follow doctor instructions while taking antibiotics.
Would you visit for follow up after taking antibiotics:
Table 16: This table shows that there are 86.6% nurses follow doctor direction and 0.95% nurses is cumulative result of those nurses who did not answer and who are not agree to follow physician directions.
If you had flu like symptoms would you like prescription containing antibiotics:
Table 17: This table shows that there are 92.3% nurses who visit after taking antibiotics and 7.6% who do not visit after taking antibiotics.
If you had pneumonia would you prefer a prescription containing antibiotics:
Table 18: This table describes that there are 93.3% nurses who would not like prescription containing antibiotics for flu like symptoms and 6.6% are those who will accept that prescription.
If your doctor prescribes antibiotics but not explain the reason would you be satisfied:
Table 19: This table shows that 92.3% nurses prefer prescription containing antibiotics and 7.6% nurses would not prefer prescription without antibiotics.
Do you keep antibiotic in refrigerator:
Table 20: This table describes that 80% nurses would not be satisfied if the doctor not explain the reason about antibiotic and 20% people would be satisfied without explanation.
If you are pregnant should you take antibiotics:
Table 21: This table describes that 85% nurses do not keep antibiotics in refrigerator and 14% keep antibiotics in refrigerator.
If your family member is sick, do you give your family members your antibiotic:
Table 22: This table describes the answer that is related to female nurses because majority of respondent were female. According to the results there are 91% nurses who know that they should not take antibiotics in pregnancy and 8.57% female who are not known.
While taking antibiotic do you follow the physician instruction:
Table 23: This table describes that 91% nurses understand that if family member is sick they will not give antibiotic and 8.5% nurses use their antibiotics for family members.
Stop without consultation:
Table 24: This table describes that 79.05% nurses will follow the physician instruction and 20.9% nurses will not follow the physician instruction while taking antibiotics.
Decrease without consultation:
Table 25: This table describes that 90.4% nurses do not stop antibiotics without consultation and 9.5% nurses will stop antibiotics without consultation.
Take the medicine irregularly:
Table 26: This table describes that 90% will not decrease antibiotics without consultation and 8.5% will decrease the dosage.
If ill with flu-like symptoms and the doctor does not prescribe antibiotics, what would you do? visit another doctor for antibiotics:
Table 27: This table shows that 96.1% nurses take medicine regularly and 3.8% nurses think that they can take medicine irregularly.
Buy antibiotics elsewhere:
Table 28: This table describes that 89% of nurses will not follow another doctor for antibiotics and 10.4% will follow another doctor.
Not be concerned:
Table 29: This table represents that nurses 87% nurses will not buy antibiotics elsewhere if physicians not prescribed and 12% of nurses will buy antibiotics from elsewhere.
Request that the doctor prescribe antibiotics:
Table 30: This table describes that 80.9% of nurses will not request the doctor to prescribe antibiotics and 19.05% will request the doctor to prescribe antibiotics.
This study provides useful information regarding the knowledge, practice and attitudes among nurses towards antibiotics resistance and usage. Results showed the bulk of the nurses questioned had good knowledge about the role of antibiotics, their consumption, and therefore the related adverse reactions. Most of the sample answered correctly to any or all the things administered. Indeed, around most junior nurses sample was not aware of the use of antimicrobial drugs, antipyretic and anti-inflammatory. These results established by current studies on this subject. A survey performed in Services Hospital Lahore how most the nurses interviewed were aware that inappropriate use of antimicrobials could harm patients and cause antibiotic resistance. Regardless of the fair good level of data, high rates of incorrect behaviors were observed. Hence, it looks as if despite having a sufficient hypothetical background; School of nursing students does not practice what they learn. Indeed, 9% of the sample declared to prevent taking antibiotics when symptoms improve and to use leftover antibiotics without consulting a doctor. A mainstream always consulted a doctor before starting on an antibiotic and most of always completed the total course of the prescribed treatment. Previous studies have shown high rates of self-medication amongst nurses concerning antibiotics.
There were several limitations to this study. Firstly, the sample size was small, cross-sectional study sample should be large to get the accurate findings of results from participants of the study. Second, the self-report questions for young nurses was another limitation in this study, it mostly affects the study with biasness. The too much small sample size of this study cannot be generalized to the whole population.
It demonstrates that almost all of the scholars were tuned in to the antimicrobial resistance, its consequences, and its usage.
The sole concern was their unpremeditated attitude about antibiotic use. The extent of data about antibiotics were quite high amongst experienced and well-educated nurses but some attitudes and practices are still incorrect mostly in junior nurses. Further educational interventions are necessary to boost their understanding and perceptions of antibiotic resistance, also as their attitude towards antibiotic use. Since the nurses are going to be a behavioral model for citizens and patients and, it's important to make more awareness on this subject during the courses. It might be advisable to introduce a selected course and training on antibiotics within the core curriculum of the varsity of Nursing.