Clinicians’ attitudes towards participation in AntiMicrobial Stewardship (AMS) programs in Thailand

Introduction: A multidisciplinary approach is considered best practice in AMS. Effective hospital-wide AMS programs need multidisciplinary engagement that includes all professionals involved in antimicrobial use. Differences and similarities between professions will affect implementation of AMS programs. Clinicians’ attitudes have not been investigated in Thailand. The aim of this study was to describe clinicians’ perceptions and attitudes towards participation in AMS programs in a Thai acute care setting. Methods: A paper-based survey was distributed to doctors, nurses and pharmacists in a 1,000- bed university hospital in Bangkok Thailand. A total of 1,087 clinicians took part in this study: 392 doctors, 613 nurses and 82 pharmacists. Results: The majority of participants agreed that improving antimicrobial prescribing would decrease AMR and should be a priority of formal hospital policy. However, doctors were less likely to agree with policy that limited antimicrobial prescribing than nurses and pharmacists (P<0.001). Doctors were less likely to be interested in participating in AMS education and training than other health professionals (P<0.001). Pharmacists indicated higher agreement with the statement recommending a team consisting of an infectious diseases specialist physician and pharmacist providing individualized antimicrobial prescribing advice (P<0.01). Pharmacists were more likely to agree that feedback would assist with antimicrobial selection than other professional groups (P<0.001). Conclusion: AMS programs are considered a significant element for improving antimicrobial use by clinicians in hospitals. There are differences in perceptions about elements of AMS between professional groups that need to be understood in order to facilitate evidence-based antimicrobial use and support AMS programs.