Open Access Research article

Knowledge, attitudes and practice survey about antimicrobial resistance and prescribing among physicians in a hospital setting in Lima, Peru

Coralith García12*, Liz P Llamocca1, Krystel García1, Aimee Jiménez1, Frine Samalvides12, Eduardo Gotuzzo12 and Jan Jacobs34

Author Affiliations

1 Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Perú

2 Hospital Nacional Cayetano Heredia, Lima, Perú

3 Institute of Tropical Medicine Antwerp, Antwerp, Belgium

4 Department of Medical Microbiology, Faculty of Health, Life Sciences and Medicine, Maastricht University, The Netherlands

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BMC Clinical Pharmacology 2011, 11:18  doi:10.1186/1472-6904-11-18

Published: 15 November 2011



Misuse of antimicrobials (AMs) and antimicrobial resistance (AMR) are global concerns. The present study evaluated knowledge, attitudes and practices about AMR and AM prescribing among medical doctors in two large public hospitals in Lima, Peru, a middle-income country.


Cross-sectional study using a self-administered questionnaire


A total of 256 participants completed the questionnaire (response rate 82%). Theoretical knowledge was good (mean score of 6 ± 1.3 on 7 questions) in contrast to poor awareness (< 33%) of local AMR rates of key-pathogens. Participants strongly agreed that AMR is a problem worldwide (70%) and in Peru (65%), but less in their own practice (22%). AM overuse was perceived both for the community (96%) and the hospital settings (90%). Patients' pressure to prescribing AMs was considered as contributing to AM overuse in the community (72%) more than in the hospital setting (50%). Confidence among AM prescribing was higher among attending physicians (82%) compared to residents (30%, p < 0.001%). Sources of information considered as very useful/useful included pocket-based AM prescribing guidelines (69%) and internet sources (62%). Fifty seven percent of participants regarded AMs in their hospitals to be of poor quality. Participants requested more AM prescribing educational programs (96%) and local AM guidelines (92%).


This survey revealed topics to address during future AM prescribing interventions such as dissemination of information about local AMR rates, promoting confidence in the quality of locally available AMs, redaction and dissemination of local AM guidelines and addressing the general public, and exploring the possibilities of internet-based training.

Antimicrobial resistance - Antimicrobial use - Knowledge; attitude and practice survey