Health workers' knowledge, perceptions, and practices relating to antimicrobial use and resistance in Cross River State, Nigeria

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 study 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 (27%), followed by medical doctors (18%). Overall, 60% (M = 18.2, SD 3.4) demonstrated good knowledge (defined as ≥ 80% or ≥ 19/24 points), 30% (M = 14.5, SD 2.1) moderate (50–79% or 12–18 points), and 10% (M = 9.8, SD 1.7) poor knowledge (< 50% or < 12 points) of AMR and antimicrobial use. Perceptions were positive, with 81% (M = 128.6, SD 15.2) categorized as good (defined as > 105/175 points). Practices were good in 65% (M = 25.3, SD 4.1) of respondents (defined as ≥ 70% or ≥ 23/33 points), though gaps included prescribing due to patient pressure (47%) and stock availability (66%). Significant associations were found between professional role and years of experience with knowledge (p = 0.003 and p = 0.013) and practices (p = 0.008 and p = 0.012), but not perceptions. Conclusion HWs in Cross River 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.