Awareness, attitudes, and self-reported clinical management of antimicrobial-associated neurocognitive adverse effects among healthcare providers in Saudi Arabia.

BACKGROUND

Antimicrobials are among the most frequently prescribed medications worldwide, yet their neurocognitive adverse effects remain underrecognized. The adverse effects range from mild symptoms to serious effects and unrecognized adverse effects may influence prescribing behaviors and inappropriate continuation or discontinuation of antimicrobial therapy. Evidence on healthcare providers' awareness, attitudes, and self-reported clinical management regarding neurocognitive risks is limited, especially in Saudi Arabia. This study aimed to evaluate healthcare providers' awareness, attitudes, and self-reported clinical management of antimicrobial-associated neurocognitive adverse effects in Saudi Arabia.

METHODS

A cross-sectional survey was conducted among healthcare providers in primary, secondary, and tertiary healthcare settings. A structured, self-administered questionnaire assessed awareness, attitudes, and self-reported clinical management related to neurocognitive adverse effects. Descriptive statistics and inferential analyses (Chi-square/Fisher's exact tests) were performed.

RESULTS

Among 370 participants, 41.1% reported encountering neurological or cognitive symptoms during antimicrobial therapy, most commonly confusion and agitation. Fluoroquinolones were most frequently implicated (61.9%). High awareness was observed in 31.1%, while 27.0% demonstrated low awareness. Positive attitudes toward considering neurocognitive risks were reported by 74.6%. Most providers (94.1%) reported appropriate clinical management of suspected neurocognitive adverse effects, but only 46.2% reported consistent documentation. Physicians demonstrated significantly higher awareness, more positive attitudes, and more appropriate management than other professions (p < 0.05).

CONCLUSION

Important gaps in awareness and documentation of neurocognitive adverse effects persist among healthcare providers. Strengthening multidisciplinary education, integrating neurocognitive safety into antimicrobial stewardship programs, and improving reporting systems are essential to enhance patient safety.