Addressing antimicrobial resistance in Nigerian hospitals: exploring physicians prescribing behavior, knowledge, and perception of antimicrobial resistance and stewardship programs

Expert Rev Anti Infect Ther. 2021 Apr;19(4):537-546. doi: 10.1080/14787210.2021.1829474. Epub 2020 Nov 2.


Introduction: We assessed the knowledge of, attitude toward antimicrobial resistance (AMR) and practice of antimicrobial stewardship (AMS) among physicians in Nigeria to provide future guidance to the Nigerian National Action Plan for AMR.

Methods: A descriptive cross-sectional questionnaire-based study explored the physicians' self-reported practice of antibiotic prescribing, knowledge, attitude, and practice of AMR and components of ASPs.

Results: The majority (217; 67.2%) of respondents prescribed antibiotics daily in their clinical practice AMR was recognized as a global and local problem by 308 (95.4%) and 262 (81.1%) respondents, respectively. Only 91 (28.2%) of respondents have ever heard of antibiotic stewardship. The median AMR knowledge score was 40 (19-45)out of 45while that for ASP was 46.0(32-57) out of 60. There was significant statistical difference between the ASP median scores among the medical specialties category (P value <0.0001) More respondents had good knowledge of AMR than ASPs (82.7% versus 36.5%; p < 0.0001).

Conclusion: Respondents in this study were more knowledgeable about AMR than AMS and its core components.

Keywords: Antibiotic stewardship; Nigeria; antibiotic prescription; inappropriate use of antimicrobials; rational use of antimicrobials; tertiary healthcare facilities.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage*
  • Antimicrobial Stewardship
  • Attitude of Health Personnel
  • Cross-Sectional Studies
  • Drug Resistance, Bacterial
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Hospitals
  • Humans
  • Male
  • Middle Aged
  • Nigeria
  • Physicians / statistics & numerical data*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Surveys and Questionnaires
  • Young Adult


  • Anti-Bacterial Agents