Knowledge, attitude, perception and practice towards antimicrobial use in upper respiratory tract infections in Qatar: a systematic review

Background: The emergence and spread of resistance related to the inappropriate use of antimicrobials is a global public health problem. A substantial proportion of all antimicrobials are prescribed in the community, and Upper Respiratory Tract Infection (URTI) is one of the commonest conditions in health care settings for which antimicrobial prescriptions are widely used. We assessed knowledge, attitude, perception and practice towards antibiotic use for URTIs in patients visiting healthcare settings in Qatar. Aim: To explore the knowledge, attitude, perception and practice towards antimicrobial use in upper respiratory tract infections in patients visiting healthcare settings in Qatar. Methodology: Systematic review was performed using a predetermined protocol and in accordance with standardized reporting guidelines. MEDLINE, PubMed, EMBASE, Global Health and PsycINFO were searched for relevant published studies using relevant MESH terms and key words. Results: Three articles were included, one in a primary care setting, one in a secondary care setting and one in the private sector. Overprescribing was noted in all settings. Our findings demonstrate low expectations to receive antibiotics, among the Qatari population, in primary care (28.1%). In fact, the majority of patients would be satisfied with reassurance rather than receiving antimicrobials. Many patients were satisfied with explanation from physicians and counselling. Private sector registered high prevalence of antimicrobial misuse for respiratory tract infections (RTIs) in which 85% deemed inappropriate. This finding was also noted at a medical intensive care unit (MICU) which showed high antimicrobial use (76%) and RTIs accounted for 57% of prescriptions. Conclusions: Studies are needed to determine factors and population based rates of antimicrobial use in all health care settings. There is also a need for interventional programs for both physicians and public on appropriate use of antimicrobials to combat global antimicrobial resistanc