PHYSICIANS’ BEHAVIOR RELATED TO ANTIBIOTIC PRESCRIBING AND ANTIMICROBIAL RESISTANCE

Aim. The aim of the study was to assess the attitudes of physicians in Lithuanian hospitals towards the issue of rational antimicrobial drug use and antimicrobial resistance.Material and methods. A quantitative descriptive study was conducted in 2024, involving 414 physicians from 36 general hospitals. A modified questionnaire developed by the European Centre for Disease Prevention and Control, "Healthcare Workers' Knowledge and Attitudes about Antibiotics and Antimicrobial Resistance," was used for the survey. Differences between study groups were assessed using the chi-square (χ²) test, and Fisher's exact test was employed when expected frequencies were < 5. The Spearman correlation coefficient was calculated to determine correlations between ordinal variables.Results. The study revealed that the majority of physicians perceive antimicrobial resistance (AMR) as a relevant issue both globally (99.3%) and in Lithuania (98.8%). Every second respondent agreed that the promotion of antimicrobial drug use and public awareness of AMR in Lithuania are properly implemented. A smaller proportion of physicians (29.0%) recognized their role as a key factor in AMR management. Physicians believe that AMR is most effectively managed at all levels, including the public, environmental, and veterinary sectors. However, they also highlighted individual management – the responsibility of both the physician and each member of society. In evaluating the resources regularly used for infection management, most physicians rely on clinical practice guidelines, institution-approved treatment algorithms, or previous clinical experience. The majority (85.3%) of respondents trust infection management recommendations, and two-thirds stated that they have easy access to them. In the past 12 months, two-thirds of physicians received information on how to avoid unnecessary antimicrobial drug prescriptions. Every second respondent changed their perspective on irrational antimicrobial prescribing based on this information, but only one-third changed their behavior. The most common reasons for not changing behavior were adherence to rational antimicrobial prescribing principles, information being irrelevant, or a lack of opportunities to apply it in practice. Seminars, conferences, and guidelines were identified as the most effective tools for changing attitudes toward irrational antimicrobial prescribing. Physicians cited conferences, seminars, training sessions, national infection control guidelines, and journal articles as the most important sources of information on rational antimicrobial drug use and AMR awareness. They considered lectures, clinical case discussions, and active learning as the most useful learning methods.Conclusions. Physicians have a correct understanding of the significance of AMR, but not all recognize their role in addressing the issue. They regularly receive information about antimicrobial prescribing and AMR, which influences their attitudes toward irrational prescribing, though it does not always lead to behavioral changes.