Download We thank and appreciate you for sparing your valuable time. We

We thank and appreciate you for sparing your valuable time. We anticipate this appraisal will
facilitate us to become skilled to do an improved work by way of antimicrobials utilization in our
hospital. Please answer all questions in the best possible manner. Please remember that information
collected will be strictly confidential and anonymity will be maintained.
Demographic and professional characteristics of Clinicians of western region, Saudi Arabia
ggffff Gender gggggg
M
F
Age
< 30
31-40
41-50
Level of education
Resident
General
Physician
Specialist
Consultant
Department
Medicine
Surgery
Subspeciality
ENT
Pediatrics
Obs & Gyneac
Questions regarding your usual antimicrobial prescribing practices:
How often do you prescribe
antimicrobial in your practice

Once
a day
3-5
times a
week
1-2
times a
week
< Once a
week
Which of the following factors affects your choice of the antimicrobial regimen?
Factors
Parent / Patient’s demand
Reading scientific materials (e.g., books, articles, internet)
Attending courses and lectures
Cost of the antibiotic
Effectiveness and previous experience with the drug
Recommended by other colleagues
The knowledge gained during undergraduate or postgraduate training
Clinician’s ‘Peace of mind’
1
Yes
No
Tick which of the antimicrobials more commonly use in your clinical practice?
For empirical treatment
Penicillin
Cephalosporins
Oral
Amoxicillin+
clavulanate
Amoxicillin
Cephalexin
Quinolones
Ciprofloxacin
Macrolides
Other
Azithromycin
Co-trimoxazole
Metronidadozle
Tetracycline
Clindamycin
no
Parental
Amoxicillin+
clavulanate
Ampicillin
Cefuroxime
Ceftriaxone
Metronidadozle
Clindamycin
no
Dosage, duration and frequency of most of the antimicrobials prescribed by the Clinicians
Antibiotic
Dosage and
frequency
Number of days
3
Amoxycillin
Amoxacillin+clavulanate
Clindamycin
Metronidazole
Azithromycin
2
250mg x 3
500 mg x 3
500mg x 4
625 mg x 3
1gm x 3
1gm x 2
150 x 3
300 x 3
500 x 3
250 x 3
500 x 3
500 x 4
250mg x 2
500 mg x 1
500mg x 3
5
7
> 10
Frequency of Antimicrobial prescribing & Duration based on (Tick)
Institutional Antibiotic guidelines
Knowledge gained during training
Expert opinion
Saudi National drug Formulary
Effectiveness of different antimicrobial continuing education sources*
Education sources
Institutional antimicrobial guidelines
The knowledge gained during training
Attending physicians other than ID faculty
Other staff physicians
Medical Journals
Internet websites
Pocket Book of Infectious Disease Therapy
I Phone or Smartphone
Saudi Drug Formulary
ID = Infectious disease
3
Useful
Not useful
Unfamiliar/Do not use
Knowledge and awareness about the current scope of antimicrobial agents
Strongly
agree
Specific antibiotic with specific is needed
for specific infection.
Acquaintance about doses, frequency and
duration of using of antibiotic is essential.
Awareness about drug interaction with
antibiotic and specific adverse drug
reaction is crucial.
Acquaintance of antibiotic prophylactic
specific regimen is important.
If the patient have allergy to antibiotic,
knowledge of alternative antibiotic is
vital.
Precise and clear prescription writing is
essential.
Knowledge of types of antibiotic that
have broad spectrum activity is
imperative.
Familiarity of Commercial name of
antibiotic with its scientific name is
preferable.
Differentiation between child and adult
dose is essential.
4
Agree
Uncertain
Disagree
Strongly
disagree
Knowledge about antimicrobial use:
AMR**: Antimicrobial Resistance; AM*: Antimicrobial
Strongly Agree
agree
Do you believe antimicrobials are used too
much in clinical practice?
Patients consulting another clinician to
prescribe antimicrobials if their clinician
disagreed to do so.
Do you think that patients should be
informed about judicious antimicrobials
use?
AMR** is a problem worldwide
AMR** is a problem in Saudi Arabia.
AMR** is a problem in your daily practice
I would like the development of AM*
educational programs.
My choice of AM* is more influenced by
its availability rather than by the cause of
disease.
A local AM* guideline would be more
useful than an international one.
Knowledge on AMR** should be
considered when AMs are prescribed to a
patient.
Antibiotics may kill “friendly”/“good”
microbes.
Antibiotic might develop allergy leading to
death.
Antibiotics could be harmful for children’s
teeth.
Antimicrobial resistance is due to:
1- Using antimicrobials when they are
not necessary.
2- Not completing the full course of
antimicrobials
3- Using the same antimicrobials with a
different brand.
4- Using antimicrobials without
physician prescription (self medication).
5
Uncertain
Disagree
Strongly
disagree
Factors influencing antimicrobial misuse/overuse
Factors
Strongly
agree
Agree
Uncertain
Disagree
Strongly
disagree
1- Patient’ pressure
2- Lack of Health Education
3- Aantimicrobials cost
4 - Self medication
The following questions are related to the use of antimicrobials and the rates of
antimicrobial resistance (Please tick  on correct answer)
1.
A 40 year-old woman went to the Emergency room complaining of 4 days of diarrhoea (3 unformed
stools per day). No history of fever. One month before she had a urinary tract infection and took
ciprofloxacin. . Which antibiotic will you recommend?
 Ciprofloxacin
 Trimethoprim-sulfamethoxazole
 No need of antimicrobial use.
Oral Rehydration Salt Solution
2.
A 32 year-old male went to the clinic complaining of fever (39 oC), nasal discharge and throat
pain for 3 days. Which antibiotic will you recommend?
 Amoxicillin
 Clarithromycin
 Trimethoprim-sulfamethoxazole
 No need of antibiotic use
3.
During your stay in the ward, you have seen two patients with impaired kidney function. Patient A is a
68 year-old male with cellulitis in the lower limb. He received Clindamycin. Patient B is a 64 year-old
woman with diabetes who received empirically treatment for sepsis with ceftriaxone and gentamicin.
In which case you will need to adjust the antibiotic dose?.
 patient A
 patient B
 patient A and B
 Neither patient A nor patient B
6.
Clostridium difficile infection following use of which antimicrobials
7.
 Cefalotin
 Ceftriaxone
 Cefuroxime
 None of these antibiotics
Select a suitable microbial for β-lactamase positive E.coli bacteremia
 Clindamycin
8.
 Ceftriaxone
Select an optimal regimen regimen foe a complicated case of urinary tract infection
 Ciprofloxacin 500 mg bid, 10 d
 Piperacillin/tazobactam 2 g/0.5 g q8h, 5d – 14d
6
 Vancomicin
 Gatifloxacin 400 mg od, 7 d – 10 d
 Cefoperazone 1 g bid, 5 d
Thank you for completing this survey. Please feel free to give us any comments or
suggestions on antimicrobial use.
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