Knowledge, attitudes and practices related to the use of oral cephalosporins in community-acquired pneumonia in India

Abstract

Background: Community-acquired pneumonia (CAP) is a leading cause of mortality and morbidity and requires extensive antibiotic treatment.

Aims and Objectives: This study aimed to understand the knowledge, attitudes, and practices (KAP) of consulting physicians in treating CAP.

Materials and Methods: A cross-sectional, descriptive KAP study surveyed 250 consulting physicians treating CAP from metro, tier-1, and tier-2 cities in India. A web-based questionnaire with 7 main questions was used to collect data between August and September 2024.

Results: Of the 250 physicians enrolled in the study, Streptococcus pneumoniae was identified by 74% of physicians as the most common cause of CAP, followed by Haemophilus influenzae (49.2%), across all zones. Most physicians (89.6%) scored 50–79% on CAP knowledge questions, indicating moderate knowledge. Most physicians (94%) highlighted the need to regularly update knowledge for CAP. Clinical experience was relied upon by 54.6%, 32% disagreed, and 13.4% remained neutral. Majority (89.2%) viewed antibiotic resistance as a major concern, and 87.6% agreed treatment should target S. pneumoniae. 61.6% were concerned about increased side effects from cephalosporin–clavulanic acid combinations. Patient compliance was a key factor for 91.6%, with 79.2% preferring simpler dosing regimens. In the survey, 82% followed moderately accurate practices (50–79%) for managing CAP, including diagnostics, risk assessment, and antibiotic selection. However, 17.2% demonstrated poor accuracy, scoring below 50%.

Conclusion: This study identified current practices and possible gaps in appropriate antibiotic prescribing for CAP. Targeted education programs on rational antibiotic use can be an effective strategy to strengthen antimicrobial stewardship and combat resistance in India.