State of Kuwait Ministry of Health Directorate of Infection Control Hospital Gender: Position: Experience, yrs: 1. M 2. F 1.

Trainee Outside Kuwait:

Antibiotic Questionnaire

Kuwait National Campaign for the Proper Use of Antibiotics

Department: Age, years: 2. Assist. Registrar 3. Registrar Inside Kuwait: 4. S. registrar

Unit: Nationality: 5. Specialist Inside department: 6. S. Specialist 7. Consultant

Choose ONLY ONE answer

1. To combat antibiotic resistance, doctors should Prescribe antibiotics in any case of fever Prescribe antibiotic for longer duration with lesser doses Not prescribe antibiotics for common cold and flu Prescribe broad spectrum antibiotics whenever possible 2. The effect of prescription of unnecessary antibiotics If no benefit, no harm If there is a harm, it would be minimal Often useful and protective It will induce bacterial resistance 3. The aim of the antibiotic policy is Prescribe the proper antibiotic/ avoid over-prescription Reduce the emergence of antimicrobial resistance Cut unnecessary expenses All of the above 4. Two resistant bacteria frequently encountered in Kuwait Vancomycin resistant enterococci and group B streptococci MRSA and vancomycin resistant enterococci MRSA and ESBL-producing Gram negatives Extremely drug resistant TB and brucella spp. 5. ESBL-producing gram negative organisms Sensitive to 3rd generation cephalosporins Sensitive to all beta lactam antibiotics Carbapenems are the drugs of choice Piperacillin is the drug of choice 6. Multi-resistant Acinetobacter spp. Very rarely encountered in Kuwait hospitals There is no available antibiotics to be used There are still many antibiotics that can be used There are few antibiotics that can be used 7. Isolation precautions for multidrug resistant organisms are Not necessary Preferred Optional Mandatory

What do you think about the following statements

Statement
1. There is an antibiotic resistance problem in Kuwait 2. Antibiotic resistance is a problem in my daily practice 3. Doctors prescribe antibiotics more than necessary 4. Misuse of antibiotics by the public is a cause of antibiotic resistance 5. Absence of laws regulating antibiotic use is a cause of antibiotic resistance 6. Non-compliance with infection control guidelines is a cause of antibiotic resistance 7. Use of antibiotics in animals and food products is a cause of antibiotic resistance 8.Lack of knowledge about proper use is a cause of antibiotic over-prescription 9. Patient satisfaction is a main cause of antibiotic over-prescription 10. Promotion by pharmaceutical companies is a cause of antibiotic over-prescription Agree Not sure Disagree

Choose your preference in the following situation(s)

I prescribe an antibiotic Broad Narrow spectrum spectrum antibiotic antibiotic I prescribe no antibiotics

1. Concerns about a legal action (litigation concerns) 2. Nasal purulent discharge / Running nose 3. Diagnostic uncertainty 4. Treatment uncertainty 5. Upon patient's request or just for patient satisfaction purpose 6. The patient has fever (recent onset, short period) 7. If there is no time to perform the required investigations 8. Antibiotic resistance concern 9. Fear of complications 10. As a routine to protect asymptomatic immunocompromised patients

What are your source of information about antibiotic use

Source 1. Text books 2. Colleagues or seniors 3. Local guidelines for antibiotic use (antibiotic policy) 4. International guidelines for antibiotic use 5. Brochures of pharmaceutical companies Always Sometimes Never

Antibiotic use
1. Do you have restrictions for antibiotic prescription in your hospital? 2. Is there an antibiotic policy in your department? 3. Do you follow the antibiotic policy of your department? 4. Do you adjust your prescription according culture results Yes No

What are the obstacles which prevent adherence to the antibiotic policy?
1. Unawareness of having an antibiotic policy in the department 2. There are no copies of the antibiotic policy of the department/ poor policy distribution 3. Neglect of reading the antibiotic policy of the department 4. Being not convinced by the antibiotic policy of the department 5. Forgetfulness 6. The antibiotic policy does not cover all conditions treatable with antibiotics which I face 7. There is no role model from the seniors 8. Absence of feedback from senior staff 9. Antibiotic policy of the department is not updated 10. Patients usually ask for a specific antibiotic 11. Shortage of supply of certain antibiotics throughout the year 12. Insufficient knowledge regarding infections and microbiology 12. Other reasons, specify Yes No

If you are a surgeon and surgical antibiotic prophylaxis is indicated, when and for how long would you prescribe the antibiotic?
1. Within 1 hour prior to surgery once or repeated within 24 hours 2. Start three days before and continue till 3 days after the operation 3. On induction and for 7 days after the operation 4. Other, specify Yes No