Factors influencing the use of microbiology services: A cross-sectional study in Ethiopian public hospitals.

Background: Empiric management of infectious diseases is prevalent in low-resource settings. This has resulted in the emergence and spread of antimicrobial resistance. In Ethiopia, there is scarce evidence on the extent of use and factors influencing the utilization of microbiologic services in routine clinical practice. This study aims to address this gap.

Methods: A cross-sectional study was conducted on 400 clinicians from eight public hospitals in Addis Ababa, Ethiopia. After obtaining informed consent, participants completed a self-administered questionnaire. The collected data was cleaned and analyzed using SPSS 27, with binomial and multinomial regression tests performed to measure statistical association between identified factors and microbiologic service utilization.

Result: Two-hundred-twelve (53.0%) of the 400 clinicians had limited knowledge on the availability and/or types of microbiologic services provided in their facilities. Only fifty-nine (14.8%) consistently sent out culture tests when clinically indicated. The primary reasons for clinicians' reluctance to prescribe culture tests included perceived gaps in availability, turnaround time, completeness of antimicrobial susceptibility test (AST) panels, and lack of concordance with clinical pictures. Besides their overall impact on diagnostic stewardship, these gaps have also left a negative impression on prescribers. Discordance with clinical profile (AOR = 0.28, 95% CI = 0.09, 0.88, P = 0.03), and incomplete AST panels (AOR = 0.82, 95% CI = 0.11, 0.94, P = 0.04) have negatively affected the perception interviewed clinicians had on reliability of services provided.

Conclusion: The findings highlight key areas for targeted intervention in the knowledge, attitudes, and use of microbiology services in public healthcare, largely due to concerns about service quality and timeliness. The determinant factors identified present opportunities to improve laboratory services and better support clinicians in their practice. Despite the critical role of culture and sensitivity tests in combating antimicrobial resistance (AMR), their use remains limited. This underscores the urgent need for coordinated action to strengthen microbiology services as a key strategy in the fight against AMR.