Background Antimicrobial resistance (AMR) is a global problem compromising the effective treatment of infectious diseases. The World Health Organization (WHO) is encouraging and promoting awareness creation among health workers as one of its strategies to reduce the rate of emergence and transmission of AMR. Available data on the prescribing behavior of healthcare workers (HCWs) in Nigeria remains incomplete. This study was designed to provide an up-to-date estimate of the knowledge, attitude and antibiotic prescribing behavior of HCWs in Nigeria. Methods This is a cross-sectional study. Self-administered questionnaires were distributed to healthcare workers selected from six states, one each from the 6 geopolitical zones in Nigeria. A multi-stage sampling technique was used to reflect the three tiers of healthcare: primary, secondary and tertiary levels. Quantitative data was summarized using descriptive statistics. All data analysis was done using the Statistical package for social sciences version 26.0. Results Of the 420 questionnaires distributed, 358 (85.2%) responded. The mean year of practice of the respondents was 9.32 ± 7.8 years. About a half (50.3%) agreed that their prescribing behavior could promote antimicrobial resistance. 49.2% had a good knowledge of AMR and physicians had significantly better knowledge than other HCWs (X2 = 69.59, P < 0.001). Several participants prescribed antibiotics for common viral infections such as sore throats (75.7%), measles (37.7%), common cold and flu (21.2%). Over 60.3% admitted prescribing antibiotics just to be on the safe side. In general, 70.9% of the respondents frequently or moderately use practice guidelines while 25.7% often apply the delayed antibiotic prescription (DAP) strategy to reduce antimicrobial prescription. Conclusion This study reveals an overall moderate level of knowledge of AMR and attitude towards minimizing the emergence of antimicrobial resistance though this did not translate significantly to practice. Further efforts must be made in order to improve rational prescription of antimicrobials among HCWs in Nigeria.

This study was carried out in 2 chest referral clinics in Lagos, Nigeria, between February 2000 and May 2001 to assess the effects of knowledge, attitude, and practice of 168 newly diagnosed tuberculosis (TB) patients on their care-seeking behaviour. At the onset of symptoms patients sought treatment from one or more of the local private orthodox and traditional health providers, and patent medicine dealers before presenting at a chest clinic. There was a correlation between the level of knowledge and awareness of TB with time of presentation at the chest clinic. Of the 32 patients who presented and were diagnosed at the chest clinics within 4 weeks of onset of symptoms, 50% had knowledge of the aetiological agent of the disease and 60% had some idea of the mode of transmission. Of the 105 patients who presented and were diagnosed 12 weeks after the onset of symptoms, 97% had no knowledge of the aetiological agent and 95% had no idea of the mode of transmission. Overall there was a low level of knowledge and awareness of the disease as well as an apparently high level of improper health care-seeking behaviour amongst the patients studied which probably contributed significantly to the delay in early and accurate diagnosis of most of the cases. These findings indicate an urgent need to educate communities and care providers on the cause and mode of transmission of TB, and the need to attend designated health facilities for early diagnosis and proper treatment.

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