Knowledge, attitudes and practices associated with antibiotic use and resistance among postnatal mothers attending treatment at Case Hospital

Abstract

Antimicrobial resistance (AMR) is an escalating global health crisis, with low- and middle-income countries like Uganda bearing the greatest burden. Postnatal mothers play a critical role in the spread of AMR due to their antibiotic use practices. CASE Hospital in Kampala has witnessed increasing incidences of antibiotic-resistant postnatal infections, including puerperal sepsis, urinary tract infections (UTIs) and surgical site infections (SSIs), raising concerns about antibiotic misuse and the need for targeted interventions. This study aimed to assess the knowledge, attitudes and practices (KAP) related to antibiotic use and AMR among postnatal mothers attending treatment at CASE Hospital. A cross-sectional study was conducted among 128 postnatal mothers using structured questionnaires. Data was analysed using descriptive statistics and logistic regression to determine associations between practices and knowledge levels. Most respondents (over 85%) demonstrated correct knowledge of AMR, recognizing that resistance occurs in bacteria. However, 93% admitted they would take antibiotics for non-bacterial illnesses, indicating poor attitudes. Alarmingly, 91.4% practiced self-medication and 86.7% used leftover antibiotics. Multivariate analysis revealed that self-medicating mothers were 15.5 times more likely to lack AMR knowledge (AOR = 15.5; p = 0.004) and those who failed to complete antibiotic doses were 14 times more likely to have poor knowledge (AOR = 14.0; p = 0.002). Despite high awareness of AMR among postnatal mothers at CASE Hospital, poor attitudes and risky antibiotic practices persist, strongly linked to gaps in knowledge. These findings highlight the disconnect between awareness and behaviour, emphasizing the need for interventions beyond information dissemination. To combat AMR, AMR education should be integrated into routine maternal care. There is an urgent need for stronger regulation of antibiotic access and enhanced follow-up on postnatal antibiotic use