Health workers' knowledge, perceptions, and practices relating to antimicrobial use and resistance in cross river state, Nigeria: a cross sectional study.

INTRODUCTION: Antimicrobial resistance (AMR) is a serious global health issue with health workers (HWs) being central to addressing this issue. This study aimed to assess the knowledge, perceptions, and practices of HWs regarding antimicrobial use/AMR in Cross River State, Nigeria. METHODOLOGY: This cross-sectional survey involved 431 HWs in randomly selected healthcare facilities (13 primary and 23 secondary facilities) in Cross River State. Data were collected using a structured questionnaire. Descriptive and inferential analysis were performed using SPSS version 23. RESULTS: Of 431 HWs approached, 427 (99.1%) responded. Nurses comprised the largest group (37%), followed by medical doctors (26.5%). Overall, 60% of the respondents demonstrated good knowledge 30% demonstrated moderate knowledge, and 10% demonstrated poor knowledge of AMR and antimicrobial use. Perceptions were positive, with 81% categorized as good. Practices were good in 65% (of consenting HWs although 54.3% (n = 232) admitted to prescribing antibiotics not in accordance with guidelines. Identified gaps included prescribing due to patient pressure (47%) and stock availability (66%). Professional role (χ² = 41.72, df = 18, p = 0.001) and years of experience (χ² = 26.78, df = 10, p = 0.013) were significantly associated with good knowledge. Also, professional role (χ² = 28.41, df = 9, p = 0.001) and years of experience χ² = 14.67, df = 5, p = 0.012) were significantly associated with good practices. No statistically significant associations were found with perceptions. CONCLUSION: HWs in Cross River State exhibited predominantly good knowledge and perceptions of AMR, but practices, though good, revealed areas for improvement, particularly in guideline adherence and resistance to external pressures.