Knowledge, Attitude, and Practice of Healthcare Workers Regarding Antibiotic Use and Antimicrobial Resistance at Dongola Specialized Hospital, Sudan, 2025
Wafa Mohammed Hussein Abuelgasim
Medical Laboratory Sciences, Nile University, Sudan.
Muslih Haroun Elhussien Gamea *
Department of Medical laboratory Sciences, Diagnostic Immunology, Al Neelain University, Sudan.
Ahmed Mohamed Farah Shadoul
General Sudan Medical Specialization Baord, Sudan.
Abdalwahhab Ahmed Awadalseed Ahmed
University of Dongola, Sudan.
Omeir Mokhtar Salih Hamed
University of Dongola, Sudan.
Ahmed Mohammed Zain
Department of Microbiology (Virology), Dongola University, College of Medicine, Northern State, Sudan.
*Author to whom correspondence should be addressed.
Abstract
Background: An antibiotic is a chemical compound, derived from a living organism or produced synthetically, that has therapeutic activity at very low doses by inhibiting bacterial growth (bacteriostatic effect) or destroying bacteria (bactericidal effect). Bacterial resistance to antibiotics is a major global health threat that leads to treatment failure, increased treatment costs, prolonged hospital stays and increased mortality. It has been estimated that antimicrobial resistance could cause approximately 10 million deaths annually by 2050 if effective efforts are not implemented. Resistance is a complex phenomenon resulting from the natural evolution of microbes; however, it is intensified by human activity and selective pressure due to antibiotic overuse in humans, animals and agriculture. Inappropriate antibiotic use is a main driver of resistance, including overuse, self-medication, failure to complete antibiotic courses and poor adherence to guidelines, often influenced by socioeconomic factors, limited access to diagnostic tools and quality antibacterials, and poor health literacy.
Objectives: To assess the knowledge, Attitudes and practices of healthcare workers regarding antibiotic use and resistance in Dongola locality, Northern State, Sudan, in order to identify gaps and contribute to problem-solving.
Methods: An institution-based, descriptive cross-sectional study was conducted to assess the knowledge, Attitudes and practices (KAP) of healthcare workers regarding antibiotic use and antibiotic resistance at Dongola Specialized Hospital from August 2025 to April 2026. Data were collected using a structured, close-ended questionnaire comprising four sections: sociodemographic characteristics, knowledge, Attitudes and practices. A total of 252 HCWs, including doctors, Pharmacists and nurses, participated in the study; the calculated minimum sample size was 228. Data were collected using Google Forms and analyzed using SPSS.
Among the 252 HCWs investigated, 57.0% had a good level of knowledge, 36.0% had a moderate knowledge and 7.0% had a poor level. Positive attitudes were reported in 56.0%, while 33.0% showed a moderate level of attitude and 11.0% had poor attitudes. Good practices were observed in 23.0%, while 53.0% showed a moderate level of practices and 24.0% had poor practices.
Conclusion: The study revealed that high knowledge does not necessarily indicate optimal practice. Knowledge is necessary but insufficient because medical practice is not an automatic application of information; rather, it is a multifactorial behaviour.This confirms that future interventions should go beyond providing information and should address the reasons for prescribing despite existing knowledge.
Keywords: Antibiotic use, antimicrobial resistance, knowledge, attitudes, practices, healthcare workers, antimicrobial stewardship, prescribing behaviour, Dongola Specialized Hospital, Sudan