Antimicrobial Stewardship Knowledge Gaps among Healthcare Professionals at a Ghanaian Tertiary Hospital: A Cross-Sectional Study

The inappropriate use of antimicrobials enhances antimicrobial resistance (AMR). Antimicrobial stewardship (AMS) is a coordinated effort of prescribers, pharmacists, and nurses. Still, local data regarding AMS-related knowledge, attitudes, and practices (KAP) are scarce in many low and middle-income countries. We evaluated KAP regarding AMS among the healthcare providers at Komfo Anokye Teaching Hospital (KATH), Ghana, and found the related factors. A cross-sectional survey in the form of a descriptive survey was conducted among medical doctors, pharmacists, and nurses at KATH. Knowledge, attitude, and practice were evaluated using a structured questionnaire. The scores were converted into percentages and classified as good (>=60%) or poor (<60%). Chi-square tests were used to test associations, and logistic regression to predict good KAP (p<0.05). A total of 349 healthcare professionals participated, which comprised: 91 medical doctors (26.1%), 101 pharmacists (28.9%), and 157 nurses (45.0%). The majority of the respondents had formal AMS/AMR training (69.6%), and 37.0% had updated training the previous year. Only 18.6% demonstrated good AMS-related knowledge, although attitudes were largely positive (95.7% good) and reported practices were mostly appropriate (77.4% good). In multivariable models, greater years of practice (5-9 years: adjusted odds ratio [AOR] 2.32; >=15 years: AOR 2.77) and formal training (AOR 2.94) were associated with good knowledge. Formal training was also associated with good attitudes (AOR 5.19). Compared with medical doctors, nurses had lower odds of good practice (AOR 0.29), while pharmacists had higher odds (AOR 1.41). Participants with 10-14 years of experience had higher odds of good practice (AOR 3.18). This study revealed that marked knowledge deficits exist, despite favourable attitudes and generally good self-reported AMS practices. Role-tailored, competency-based AMS training with regular updates and reinforcement through practical stewardship tools is needed to translate positive attitudes into evidence-based prescribing and administration behaviours.