Table 2 Knowledge questions regarding antimicrobial use and resistance and results
No. question and possible answers (correct answer in bold) | Overall (N = 182) | MD (N = 100) | Internist (N = 50) | Other specialists (N = 32) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Correct N (%) | Incorrect N (%) | I don’t know [N (%)] | Correct N (%) | Incorrect N (%) | I don’t know [N (%)] | Correct N (%) | Incorrect N (%) | I don’t know [N (%)] | Correct N (%) | Incorrect N (%) | I don’t know [N (%)] | |
1. Which one of the following antibiotics is part of the antimicrobial stewardship program in Iran? (a) Voriconazole (b) Ganciclovir (c) Piperacillin/tazobactam (d) I don't know | 18 (9.9) | 35 (19.2) | 129 (70.9) | 1 (1%) | 10 (10) | 89 (89) | 12 (24) | 16 (32) | 22 (44) | 5 (15.6) | 9 (28.1) | 18 (56.2) |
2. Which one of the following is not true in case of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL)? (a) The antibiotic of choice for severe infections with these organisms is a carbapenem (b) In mild infections, combined beta-lactam/beta-lactamase inhibitors may be used (c) In cases of cystitis, third-generation cephalosporins can be used (d) I don’t know | 42 (23) | 96 (52.7) | 44 (24.2) | 16 (16) | 50 (50) | 34 (34) | 17 (34) | 26 (52) | 7 (14) | 9 (28.1) | 20 (62.5) | 3 (9.4) |
3. Which one of the following is true when prescribing antibiotics for surgical prophylaxis? (a) Antibiotics should usually be given 2 h before surgery (b) Vancomycin and ciprofloxacin should be given 1 to 2 h before surgery (c) Ceftazidime is preferable to cefazolin in most surgeries (d) I don’t know | 18 (9.9) | 141 (77.5) | 23 (12.6) | 7 (7) | 80 (80) | 13 (13) | 3 (6) | 40 (80) | 7 (14%) | 8 (25) | 21 (65.6) | 3 (9.4) |
4. Which one of the following antibiotic most effectively crosses the blood–brain barrier? (a) Vancomycin (b) Ceftriaxone (c) Clindamycin (d) I don’t know | 90 (49.5) | 72 (39.5) | 20 (11) | 45 (45) | 43 (43) | 12 (12) | 30 (60) | 17 (34%) | 3 (6) | 15 (46.9) | 12 (37.5) | 5 (15.6) |
5. Aminoglycosides such as gentamicin are very active if they are administered as follows: (a) Parenteral once daily (b) Orally three times daily (c) Parenteral three times daily (d) I don’t know | 64 (35.2) | 83 (45.6) | 35 (19.2) | 36 (36) | 37 (37) | 27 (27) | 18 (36) | 28 (56) | 4 (8) | 10 (31.3) | 18 (56.2) | 4 (12.5) |
6. To start treatment of a patient with sever sepsis, vancomycin and meropenem are prescribed to cover which organisms, respectively? (a) MRSA-ESBL (b) MRSA-VRE (c) VRE-CRO (d) I don't know | 108 (59.3) | 39 (21.4) | 35 (19.2) | 56 (56) | 21 (21) | 23 (23) | 39 (78) | 7 (14) | 4 (8) | 13 (40.6) | 11 (34.4) | 8 (25) |
7. Proteus mirabilis is intrinsic resistant to which of the following antibiotic? (a) Colistin (b) Ampicillin/sulbactam (c) Amikacin (d) I don't know | 40 (22) | 55 (30.2) | 87 (47.8) | 12 (12) | 27 (27) | 61 (61) | 20 (40) | 17 (34) | 13 (26) | 8 (25) | 11 (34.4) | 13 (40.6) |
8. Which one of the following is true in case of A. baumannii which is resistant to all of antibiotics with the exception of colistin? (a) Extensively drug-resistant (b) Pandrug resistant (c) Not-multidrug resistance (d) I don’t know | 79 (43.4) | 16 (8.8) | 87 (47.8) | 39 (39) | 4 (4) | 57 (57) | 32 (64) | 5 (10) | 13 (26) | 8 (25) | 7 (21.9) | 17 (53.1) |
9. Which one of the following antibiotics has the best activity against anaerobes? (a) Ciprofloxacin (b) Cotrimoxazole (c) Metronidazole (d) I don’t know | 151 (83) | 23 (12.6) | 8 (4.4) | 81 (81) | 15 (15) | 4 (4) | 43 (86) | 5 (10) | 2 (4) | 27 (84.4) | 3 (9.4) | 2 (6.2) |
10. Which one of the following is not an important risk factor for initiating experimental treatment with vancomycin in community-acquired pneumonia? (a) Known colonization or prior infection with MRSA (b) Gram-positive cocci in clusters on good-quality sputum Gram stain (c) Gram-negative bacilli seen on good-quality sputum Gram stain (d) I don't know | 79 (43.4) | 56 (30.8) | 47 (25.8) | 30 (30) | 35 (35) | 35 (35) | 34 (68) | 11 (22) | 5 (10) | 15 (46.9) | 10 (31.2) | 7 (21.9) |