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Filimonovic J, Ristić ZS, Gazibara T, Saponjic V, Dotlic J, Jovanovic V, Arsovic A, Vukajlovic I, Joksimovic B, Sokolovic D, Drakul D, Dimitrijevic D, Plavsa D, Milic M. Trends and patterns of antibiotics use in Serbia from 2006 to 2021: Pre-COVID-19 period versus COVID-19 pandemic. Am J Infect Control 2024; 52:293-304. [PMID: 37726055 DOI: 10.1016/j.ajic.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/09/2023] [Accepted: 09/11/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Global rise in antibiotic utilization has been strongly associated with the resistance of bacteria to antibiotics. The COVID-19 saw an increase in the use of antibiotics in some countries. The aim of this study was to evaluate antibiotic utilization from 2006 to 2021 in the Republic of Serbia. METHODS Data on antibiotic use were retrieved from the national annual reports on the official website of the Medicines and Medical Devices Agency of Serbia during the period 2006 to 2021. To evaluate trends in the use of antibiotics in Serbia, linear, and joint regression analyses were performed. RESULTS The analysis of the antibiotics use over a sixteen-year period included a total of 50 antibiotics. A significant increase during the COVID-19 pandemic was observed for glycylcyclines that is, new-generation tetracyclines (tigecycline), third-generation cephalosporins (ceftazidime, ceftriaxone, and cefixime), respiratory fluoroquinolones (levofloxacin and moxifloxacin), carbapenems (ertapenem), and oxazolidinones (linezolid) utilization. Moreover, an almost negligible use of new β-lactam/β-lactamase inhibitors during the prepandemic period increased significantly during the COVID-19 pandemic period. CONCLUSIONS A significant increasing trend in the use of specific antibiotics classified as the "Watch" and "Reserve" antibiotics during the pandemic period was observed.
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Affiliation(s)
- Jelena Filimonovic
- Department of Epidemiology, Faculty of Medicine, University of Pristina temporarily seated in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | - Zorica Stanojević Ristić
- Department of Pharmacology, Faculty of Medicine, University of Pristina temporarily seated in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | - Tatjana Gazibara
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vladan Saponjic
- Department of Epidemiology, Institute of Public Health of Serbia "Dr Milan Jovanovic Batut", Belgrade, Serbia
| | - Jelena Dotlic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Department of Gynecology, Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia
| | - Verica Jovanovic
- Department of Epidemiology, Institute of Public Health of Serbia "Dr Milan Jovanovic Batut", Belgrade, Serbia
| | - Aleksandra Arsovic
- Military Medical Academy, Medical Faculty, University of Defense, Belgrade, Serbia
| | - Ivana Vukajlovic
- Department of Pharmacoepidemiology, Medicines and Medical Devices Agency of Serbia (ALIMS), Belgrade, Serbia
| | - Bojan Joksimovic
- Department of Pathophysiology, Faculty of Medicine Foca, University of East Sarajevo, Bosnia and Herzegovina
| | - Dragana Sokolovic
- Department of Pathophysiology, Faculty of Medicine Foca, University of East Sarajevo, Bosnia and Herzegovina
| | - Dragana Drakul
- Department of Pathophysiology, Faculty of Medicine Foca, University of East Sarajevo, Bosnia and Herzegovina
| | - Dragana Dimitrijevic
- Department of Epidemiology, Institute of Public Health of Serbia "Dr Milan Jovanovic Batut", Belgrade, Serbia
| | - Dragana Plavsa
- Department of Epidemiology, Institute of Public Health of Serbia "Dr Milan Jovanovic Batut", Belgrade, Serbia
| | - Marija Milic
- Department of Epidemiology, Faculty of Medicine, University of Pristina temporarily seated in Kosovska Mitrovica, Kosovska Mitrovica, Serbia; Department of Epidemiology, Institute of Public Health of Serbia "Dr Milan Jovanovic Batut", Belgrade, Serbia.
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Al-Tarawneh A, Ali T, Al-Taani GM. Public Patterns and Determinants of Antibiotic Self-Medication and Antibiotic Knowledge in Southern Jordan. Antibiotics (Basel) 2024; 13:98. [PMID: 38275327 PMCID: PMC10812463 DOI: 10.3390/antibiotics13010098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
Antibiotic self-medication, which refers to acquisition and using antibiotics to treat infections based on personal experience and/or without a doctor's advice or prescription, is a significant public health issue jeopardizing patient health outcomes. The purpose of the present cross-sectional online survey was to assess the frequency of self-medication among the general public in various geographical locations in southern Jordan, as well as to examine the determinants to self-medication. The survey was distributed through several social media networks over the period November-December 2022, and included demographic information as well as items related to the use and abuse of antibiotics, information sources about antibiotics, the duration of use of antibiotics, and assessment of the public knowledge about appropriate antibiotic use. Inferential analysis, such as the Chi-Square test and logistic regression, were adopted to assess the associations between the different variables with self-medication. A total of 984 respondents were enrolled in the study. Of these, 752 had been using antibiotics during the last year. However, the self-medicating cases were 413 of the 752. The main source of information about the utilization of antibiotics among participants in the survey was pharmacists. The participants commonly (36.0%) tended to use antibiotics until the symptoms disappeared. Nearly half of the respondents reported usually taking antibiotics for treating a runny nose (rhinorrhea). The logistic regression analysis indicated that self-medication with antibiotics was significantly associated with female gender (p-value < 0.001), low educational level (p-value = 0.014), rural living location (p-value 0.003), no health insurance (p-value = 0.001) and occupation (p-value = 0.005). Meanwhile age had no significant relationship to self-medication. Finally, the results revealed poor understanding of key appropriate antibiotic usage, which inevitably influences self-medication practice. It is crucial to come up with several programs and governmental policies to suppress widespread antibiotic self-medication as it will affect the health of future generations of Jordanian citizens.
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Affiliation(s)
- Alaa Al-Tarawneh
- Department of Allied Medical Sciences, Karak University College, Al-Balqa Applied University, Karak 19117, Jordan; (A.A.-T.); (T.A.)
| | - Tasneem Ali
- Department of Allied Medical Sciences, Karak University College, Al-Balqa Applied University, Karak 19117, Jordan; (A.A.-T.); (T.A.)
| | - Ghaith M Al-Taani
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid 21163, Jordan
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Lin R, Duan L, Liu C, Wang D, Zhang X, Wang X, Zhang X, Wang Q, Zheng S, Liu C. The public's antibiotic use behavioural patterns and their determinants for upper respiratory tract infections: a latent class analysis based on consumer behaviour model in China. Front Public Health 2023; 11:1231370. [PMID: 38162628 PMCID: PMC10754980 DOI: 10.3389/fpubh.2023.1231370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Background The irrational use of antibiotics among the public is a major contributor to antimicrobial resistance (AMR), which is a serious global threat. Prior studies have demonstrated that there are different behavioural patterns regarding antibiotic use among the public, and targeted interventions for subgroups with different behavioural patterns may be more effective. Thus, this study aimed to identify the public's behavioural patterns of antibiotic use for upper respiratory tract infections (URTIs) and their influencing factors. Methods A cross-sectional survey was conducted among the general population in Chongqing, China. Consumer decision-making (Consumer Behaviour Model, CBM) was used to assess the public's behaviours regarding antibiotic use, including need recognition, information searching, alternative evaluation, obtaining antibiotics, antibiotic consumption, and postuse evaluation. Furthermore, a latent class analysis was used to identify the underlying behavioural patterns among the public. The identified behavioural patterns of antibiotic use were further linked with individuals' capacity, opportunity, and motivation factors of antibiotic use based on a multinominal logistic regression to explore possible determinants. Results A total of 815 respondents were enrolled in the study. The public's irrational use of antibiotics was prevalent, including antibiotic self-medication (39.63%), nonprescription antibiotic purchasing (59.02%), and early stopping of antibiotic prescriptions (76.56%). Participants had inadequate knowledge of antibiotics (Mean = 2.33, SD = 1.71), reported high availability to antibiotics (Mean = 7.13, SD = 2.41), held strong belief in antibiotic effectiveness (Mean = 10.29, SD = 2.71), and demonstrated a high perceived threat of AMR (Mean = 12.30, SD = 3.20). Four behavioural patterns regarding antibiotic use for URTIs were identified, namely, "antibiotic self-medicators" (n = 165, 20.25%), "formal health care seekers" (n = 216, 26.50%), "various treatment users" (n = 198, 24.20%), and "self-medication without antibiotics" (n = 236, 28.96%). Individuals' self-efficacy of antibiotic use, belief in antibiotic effectiveness, awareness of antibiotic side effects, perceived antibiotic availability, social influence, and demographics (age, education, medical insurance, and having a medical background) were significantly associated with the public's different behavioural patterns of antibiotic use for URTIs. Conclusion This study calls for collaborative efforts among the public, physicians, policy makers, and the implementation of precise and multifaceted interventions to effectively reduce irrational use of antibiotics in the public. Such interventions include identifying subgroups within the public to provide more targeted education about antibiotics and the management of URTIs, reinforcing the regulation of antibiotic dispensing, and improving physicians' rational antibiotic prescriptions.
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Affiliation(s)
- Rujiao Lin
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lixia Duan
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Dan Wang
- School of Management, Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xi Wang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xinyi Zhang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qianning Wang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shuangjiang Zheng
- Department of Medical Affairs, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chenxi Liu
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Purić D, Petrović MB, Živanović M, Lukić P, Zupan Z, Branković M, Ninković M, Lazarević LB, Stanković S, Žeželj I. Development of a novel instrument for assessing intentional non-adherence to official medical recommendations (iNAR-12): a sequential mixed-methods study in Serbia. BMJ Open 2023; 13:e069978. [PMID: 37369402 PMCID: PMC10410978 DOI: 10.1136/bmjopen-2022-069978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVES We aimed to (1) develop a novel instrument, suitable for the general population, capturing intentional non-adherence (iNAR), consisting of non-adherence to prescribed therapy, self-medication and avoidance of seeking medical treatment; (2) differentiate it from other forms of non-adherence, for example, smoking; and (3) relate iNAR to patient-related factors, such as sociodemographics, health status and endorsement of irrational beliefs (conspiratorial thinking and superstitions) and to healthcare-related beliefs and experiences ((mis)trust and negative experiences with the healthcare system, normalisation of patient passivity). DESIGN То generate iNAR items, we employed a focus group with medical doctors, supplemented it with a literature search and invited a public health expert to refine it further. We examined the internal structure and predictors of iNAR in an observational study. SETTING Data were collected online using snowball sampling and social networks. PARTICIPANTS After excluding those who failed one or more out of three attention checks, the final sample size was n=583 adult Serbian citizens, 74.4% female, mean age 39.01 years (SD=12.10). PRIMARY AND SECONDARY OUTCOME MEASURES The primary, planned outcome is the iNAR Questionnaire, while smoking was used for comparison purposes. RESULTS Factor analysis yielded a one-factor solution, and the final 12-item iNAR Questionnaire had satisfactory internal reliability (alpha=0.72). Health condition and healthcare-related variables accounted for 14% of the variance of iNAR behaviours, whereas sociodemographics and irrational beliefs did not additionally contribute. CONCLUSIONS We constructed a brief yet comprehensive measure of iNAR behaviours and related them to health and sociodemographic variables and irrational beliefs. The findings suggest that public health interventions should attempt to improve patients' experiences with the system and build trust with their healthcare practitioners rather than aim at specific demographic groups or at correcting patients' unfounded beliefs. STUDY REGISTRATION The design and confirmatory analyses plan were preregistered (https://osf.io/pnugm).
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Affiliation(s)
- D Purić
- Department of Psychology, University of Belgrade, Belgrade, Serbia
- Laboratory for Research of Individual Differences, University of Belgrade, Belgrade, Serbia
| | - M B Petrović
- Department of Psychology, University of Belgrade, Belgrade, Serbia
- Laboratory for Research of Individual Differences, University of Belgrade, Belgrade, Serbia
| | - M Živanović
- Laboratory for Research of Individual Differences, University of Belgrade, Belgrade, Serbia
- Institute for Psychology, University of Belgrade, Belgrade, Serbia
| | - P Lukić
- Department of Psychology, University of Belgrade, Belgrade, Serbia
- Laboratory for Research of Individual Differences, University of Belgrade, Belgrade, Serbia
| | - Z Zupan
- Laboratory for Research of Individual Differences, University of Belgrade, Belgrade, Serbia
- Institute for Psychology, University of Belgrade, Belgrade, Serbia
| | - M Branković
- Institute for Philosophy and Social Theory, Belgrade, Serbia
- Singidunum University, Belgrade, Serbia
| | - M Ninković
- Department of Psychology, University of Belgrade, Belgrade, Serbia
- Laboratory for Research of Individual Differences, University of Belgrade, Belgrade, Serbia
| | - L B Lazarević
- Laboratory for Research of Individual Differences, University of Belgrade, Belgrade, Serbia
- Institute for Psychology, University of Belgrade, Belgrade, Serbia
| | - S Stanković
- Laboratory for Research of Individual Differences, University of Belgrade, Belgrade, Serbia
- Institute for Psychology, University of Belgrade, Belgrade, Serbia
| | - I Žeželj
- Department of Psychology, University of Belgrade, Belgrade, Serbia
- Laboratory for Research of Individual Differences, University of Belgrade, Belgrade, Serbia
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Tomic T, Henman M, Tadic I, Antic Stankovic J, Santric Milicevic M, Maksimovic N, Odalovic M. Antimicrobial utilization and resistance in Pseudomonas aeruginosa using segmented regression analysis: a comparative study between Serbia and eight European Countries. Int J Clin Pharm 2023:10.1007/s11096-023-01603-y. [PMID: 37284904 PMCID: PMC10246517 DOI: 10.1007/s11096-023-01603-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/10/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND In Europe, Serbia occupies a high position in antibiotic utilization and antimicrobial resistance (AMR). AIM The aim was to analyse utilization trends of meropenem, ceftazidime, aminoglycosides, piperacillin/tazobactam and fluoroquinolones (2006-2020), and the reported AMR in Pseudomonas aeruginosa (2013-2020) in Serbia and to compare with data from eight European countries (2015-2020). METHOD Joinpoint regression was used to analyse antibiotic utilization data (2006-2020) and the reported AMR in Pseudomonas aeruginosa (2013-2020). Data sources were relevant national and international institutions. Antibiotic utilization and AMR in Pseudomonas aeruginosa data in Serbia were compared with eight European countries. RESULTS There was a significantly increased trend for ceftazidime utilization and reported resistance in Pseudomonas aeruginosa, Serbia (p < 0.05) (2018-2020). For ceftazidime, piperacillin/tazobactam, and fluoroquinolones resistances in Pseudomonas aeruginosa an increased trend was observed, Serbia (2013-2020). A decrease in both the utilization of aminoglycosides, Serbia (p < 0.05) (2006-2018) and contemporaneous Pseudomonas aeruginosa resistance (p > 0.05) was detected. Fluoroquinolone utilization (2015-2020) was highest in Serbia compared to Netherlands and Finland, 310 and 305% higher, similar compared to Romania, and 2% less compared to Montenegro. Aminoglycosides (2015-2020) were 2550 and 783% more used in Serbia compared to Finland and Netherlands, and 38% less regarding Montenegro. The highest percentage of Pseudomonas aeruginosa resistance was in Romania and Serbia (2015-2020). CONCLUSION The use of piperacillin/tazobactam, ceftazidime and fluoroquinolones should be carefully monitored in clinical practice due to increased Pseudomonas aeruginosa resistance. The level of utilization and AMR in Pseudomonas aeruginosa is still high in Serbia compared to other European countries.
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Affiliation(s)
- Tanja Tomic
- Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, Belgrade, Serbia.
| | - Martin Henman
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | - Ivana Tadic
- Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, Belgrade, Serbia
| | | | | | | | - Marina Odalovic
- Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, Belgrade, Serbia
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Despotović A, Milić N, Cirković A, Milošević B, Jovanović S, Mioljević V, Obradović V, Kovačević G, Stevanović G. Incremental costs of hospital-acquired infections in COVID-19 patients in an adult intensive care unit of a tertiary hospital from a low-resource setting. Antimicrob Resist Infect Control 2023; 12:39. [PMID: 37085906 PMCID: PMC10120483 DOI: 10.1186/s13756-023-01240-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 04/07/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Hospital-acquired infections (HAIs) are a global public health problem and put patients at risk of complications, including death. HAIs increase treatment costs, but their financial impact on Serbia's healthcare system is unknown. Our goal was to assess incremental costs of HAIs in a tertiary care adult intensive care unit (ICU) that managed COVID-19 patients. METHODS A retrospective study from March 6th to December 31st, 2020 included patients with microbiologically confirmed COVID-19 (positive rapid antigen test or real-time polymerase chain reaction) treated in the ICU of the Teaching Hospital for Infectious and Tropical Diseases, University Clinical Centre of Serbia. Demographic and HAI-specific data acquired in our ICU were collected, including total and stratified medical costs (services, materials, laboratory testing, medicines, occupancy costs). Median total and stratified costs were compared in relation to HAI acquisition. Linear regression modelling was used to assess incremental costs of HAIs, adjusted for age, biological sex, prior hospitalisation, Charlson Comorbidity Index (CCI), and Glasgow Coma Scale (GCS) on admission. Outcome variables were length of stay (LOS) in days and mortality. RESULTS During the study period, 299 patients were treated for COVID-19, of which 214 were included. HAIs were diagnosed in 56 (26.2%) patients. Acinetobacter spp. was the main pathogen in respiratory (38, 45.8%) and bloodstream infections (35, 42.2%), the two main HAI types. Median total costs were significantly greater in patients with HAIs (€1650.4 vs. €4203.2, p < 0.001). Longer LOS (10.0 vs. 18.5 days, p < 0.001) and higher ICU mortality (51.3% vs. 89.3%, p < 0.001) were seen if HAIs were acquired. Patients with ≥ 2 HAIs had the highest median total costs compared to those without HAIs or with a single HAI (€1650.4 vs. €3343.4 vs. €7336.9, p < 0.001). Incremental costs in patients with 1 and ≥ 2 HAIs were €1837.8 (95% CI 1257.8-2417.7, p < 0.001) and €5142.5 (95% CI 4262.3-6022.7, p < 0.001), respectively. CONCLUSIONS This is the first economic evaluation of HAIs in Serbia, showing significant additional costs to our healthcare system. HAIs prolong LOS and influence ICU mortality rates. Larger economic assessments are needed to enhance infection control practices.
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Affiliation(s)
- Aleksa Despotović
- Department of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Nataša Milić
- Department of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Anđa Cirković
- Department of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Branko Milošević
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Teaching Hospital for Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Snežana Jovanović
- Department of Microbiology, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Vesna Mioljević
- Department of Hospital Epidemiology and Nutrition Hygiene, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Vesna Obradović
- Teaching Hospital for Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Gordana Kovačević
- Teaching Hospital for Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Goran Stevanović
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Teaching Hospital for Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, Serbia
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Ćirković I, Marković-Denić L, Bajčetić M, Dragovac G, Đorđević Z, Mioljević V, Urošević D, Nikolić V, Despotović A, Krtinić G, Rakić V, Janićijević I, Šuljagić V. Microbiology of Healthcare-Associated Infections: Results of a Fourth National Point Prevalence Survey in Serbia. Antibiotics (Basel) 2022; 11:antibiotics11091161. [PMID: 36139941 PMCID: PMC9495255 DOI: 10.3390/antibiotics11091161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/18/2022] [Accepted: 08/24/2022] [Indexed: 12/03/2022] Open
Abstract
Millions of patients acquire healthcare-associated infections (HAIs) every year, putting them at risk for serious complications and prolonged hospitalization. Point prevalence surveys (PPS), guided by the European Centre for Disease Prevention and Control framework, are one of the primary methods by which countries in the European Union conduct surveillance of HAIs. Serbia, though not in the EU, implemented this approach in its national PPS. The microbiological and antimicrobial resistance (AMR) analyses comprised patients in 61 out of 65 hospitals included in the fourth PPS conducted in November 2017. A total of 515/12,380 (4.2%) of the adult patients included in the PPS had at least one HAI, with intensive care units carrying the highest prevalence of 15.9%. Urinary tract and surgical site infections were the most frequently identified types of HAIs (23.9% and 23.0%, respectively). Enterobacterales comprised almost half (47.0%) of all causative agents, most notably Klebsiella spp. (16.7%). AMR was very high for most pathogens—80.5% of nonfermentative Gram-negative bacilli were resistant to carbapenems whereas 62.9% of Enterobacterales were resistant to third generation cephalosporins. The calculated AMR index of 61% is one of the highest in Europe. Further efforts are needed to reduce the burden of HAIs in Serbia that carry very high resistance rates to antibiotics currently used in clinical practice.
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Affiliation(s)
- Ivana Ćirković
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Institute of Microbiology and Immunology, 11000 Belgrade, Serbia
- Correspondence: ; Tel.: +381-11-3643374
| | - Ljiljana Marković-Denić
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Institute of Epidemiology, 11000 Belgrade, Serbia
| | - Milica Bajčetić
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Institute of Pharmacology, Clinical Pharmacology and Toxicology, 11000 Belgrade, Serbia
| | - Gorana Dragovac
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Zorana Đorđević
- Department of Hospital Infection Control, University Clinical Centre of Kragujevac, 34000 Kragujevac, Serbia
| | - Vesna Mioljević
- Department of Hospital Epidemiology and Hygiene, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | | | - Vladimir Nikolić
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Institute of Epidemiology, 11000 Belgrade, Serbia
| | | | | | - Violeta Rakić
- Institute of Public Health of Serbia, 11000 Belgrade, Serbia
| | | | - Vesna Šuljagić
- Faculty of Medicine of Military Medical Academy, University of Defence, 11000 Belgrade, Serbia
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8
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Yin X, Gong Y, Sun N, Li D, Wu J, Wang J, Qiu L, Li H. Prevalence of inappropriate use behaviors of antibiotics and related factors among chinese antibiotic users: an online cross-sectional survey. BMC Infect Dis 2022; 22:689. [PMID: 35964018 PMCID: PMC9375431 DOI: 10.1186/s12879-022-07671-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 08/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background Inappropriate use of antibiotics could have a profound negative impact on individual and community. This study aimed to assess the prevalence of inappropriate use behaviors of antibiotics in Chinese antibiotic users and explored their related factors. Methods A cross-sectional survey was conducted from July 1, 2018 to September 30, 2018. A structured questionnaire was widely distributed on the online survey platform (Questionnaire Star, https://www.wjx.cn) and was used to collect data from respondents in China on demographic and sociological characteristics, antibiotic use and related knowledge. Main outcomes included self-medication with antibiotics (SMA), self-storage with antibiotics (SSA), and non-adherence to antibiotic treatment (NAAT). Logistic regression was used to identify the related factors of above inappropriate use behaviors of antibiotics. Results Of the 15,526 participants, 37.1% reported SMA in the past 6 months, 67.9% reported SSA in the past 6 months, and 48.3%, 15.2%, 25.5% and 78.0% of respondents said that they had missed antibiotics, increased antibiotic dosage, decreased antibiotic dosage, and discontinued antibiotics once symptoms disappear, respectively. Overall, 53.3% reported NAAT during this period. After adjusting for other variables, multivariate logistic regression analyses showed that those aged 30–44 years old, with higher levels of education, poorer status of self-perceived health, or lower levels of antibiotic knowledge were more likely to have these inappropriate use behaviors of SMA, SSA, and NAAT (P < 0.05). Conclusions The prevalence of SMA, SSA, and NAAT is high in China. Developing a nationwide action plan for the rational use of antibiotics among publics, including national media publicity, online and offline health education, and medication guidance from general practitioners, is urgently needed. Self-medication with antibiotics, self-storage with antibiotics, and non-adherence to antibiotic treatment are important performances of inappropriate use behaviors of antibiotics. The results of this study showed that the prevalence of inappropriate use behaviors of antibiotics among Chinese antibiotic users were between 37.1% and 67.9%. A nationwide action plan for rational use of antibiotics is urgently needed in China.
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Affiliation(s)
- Xiaoxv Yin
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Yanhong Gong
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Na Sun
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Dandan Li
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Jianxiong Wu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Jing Wang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Lei Qiu
- International School of Public Health and One Health, Hainan Medical University, Haikou, 570100, People's Republic of China.
| | - Hui Li
- School of Health Services Management, Anhui Medical University, Hefei, 230032, People's Republic of China.
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Mahmoudi H. Assessment of knowledge, attitudes, and practice regarding antibiotic self-treatment use among COVID-19 patients. GMS HYGIENE AND INFECTION CONTROL 2022; 17:Doc12. [PMID: 35909654 PMCID: PMC9284720 DOI: 10.3205/dgkh000415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: Self-medication with antibiotics is a common practice across different age groups and different cultures that can cause problems such as drug resistance, side effects, and rising costs for the healthcare system community. During the coronavirus pandemic (COVID-19), people with mild symptoms have avoided seeing a doctor, preferring to self-medicate. The impact of self-medication in COVID-19 patients is an important public health issue. The aim of this study was to evaluate the knowledge of, attitudes toward, and performance of self-medication with antibiotics in COVID-19 patients. Methods: This cross-sectional study was conducted among patients with COVID-19. Participants were selected by random sampling. A survey of knowledge, attitude and practice of taking antibiotics in patients with COVID-19 was conducted. Data were analyzed using SPSS version 22 software. Results: The prevalence of self-medication with antibiotics in patients with COVID-19 was 56.1%. Most COVID-19 patients have the overall knowledge, attitude and practice score of self-medication with antibiotics. There was a significant difference between the knowledge and attitudes of educated and uneducated patients (p<0.01). Of the demographic variables, there was no significant difference between sexes in terms of attitude and practice of antibiotic self-medication in COVID-19 patients (p>0.05). Conclusion: Considering the high prevalence of antibiotic self-medication in COVID-19 patients, it is recommended to provide the necessary education and practical means of reducing the amount of antibiotic self-medication.
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Affiliation(s)
- Hassan Mahmoudi
- Department of Microbiology, Hamadan University of Medical Sciences, Hamadan, Iran,Assistant Professor of Medical Bacteriology, Nahavand School of Allied Medical Sciences, Hamadan, Iran,*To whom correspondence should be addressed: Hassan Mahmoudi, Department of Microbiology, Hamadan University of Medical Sciences, Hamadan 65961-46354 , Iran, Phone: +989189539458, E-mail:
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Antibiotic (Mis)Use in COVID-19 Patients before and after Admission to a Tertiary Hospital in Serbia. Antibiotics (Basel) 2022; 11:antibiotics11070847. [PMID: 35884101 PMCID: PMC9311622 DOI: 10.3390/antibiotics11070847] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 02/06/2023] Open
Abstract
Antimicrobial resistance (AMR) is a global concern, and antibiotic use has risen throughout the COVID-19 pandemic. Up to 75% of COVID-19 patients are treated with antibiotics despite little evidence for their use. A retrospective study from 6 March 2020 (the start of the pandemic in Serbia) to 31 December 2021 was conducted at the Clinic for Infectious and Tropical Diseases, University Clinical Centre of Serbia. In total, 523 patients with a microbiological diagnosis of COVID-19 were included. Patient data were analysed, including antibiotic use before and after admission. Pre-admission use of antibiotics for COVID-19 treatment was documented in more than half of patients (58.1%), of which a third (34.1%) used more than one antibiotic. Macrolides, cephalosporins, and fluoroquinolones were mainly used, most frequently among patients aged between 31−45 years (75.2%). Prior antibiotic use was associated with a longer duration of illness at admission (8.8 vs. 5.7, p < 0.001), oxygen therapy upon admission (27.6% vs. 16.0%, p = 0.002), and a lower vaccination rate (60.7% vs. 50.7%, p = 0.04). When hospitalised, 72.1% of patients received antibiotics, primarily cephalosporins (71.9%). Significant efforts are needed to reduce antibiotic use in the community and improve prescribing rates by healthcare professionals.
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Self-Medication Perceptions and Practice of Medical and Pharmacy Students in Serbia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031193. [PMID: 35162213 PMCID: PMC8834465 DOI: 10.3390/ijerph19031193] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 12/03/2022]
Abstract
Background. Attitudes towards conventional and complementary medicine among future healthcare professionals can impact their future pharmacotherapy practice. This study aimed to determine the prevalence and predisposing factors related to self-medication among medical and pharmacy students. Methods. This cross-sectional questionnaire-based study was performed at the Faculty of Medicine, University of Novi Sad, Serbia, on first- and final-year students of medicine and pharmacy. The multivariate Poisson regression model with robust variance was used to identify the main predictors of self-medication. Results. The overall self-medication prevalence in the past year was 81.3%. Independent risk factors for self-medication identified in the regression analysis were the final study year, housing condition, i.e., living in a leased apartment or in a student dormitory in comparison to living with parents, and cigarette consumption. The conventional drugs were the most frequently used, mostly for the symptoms of cold and pain. Final-year students had more confidence in conventional medicines than in herbal drugs and were more aware of the risks of their concomitant use. Conclusion. Self-medication is highly prevalent among students of medical sciences, especially among final-year students. Increased medical knowledge led to the higher awareness of the drug interaction risks.
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Ben Mabrouk A, Larbi Ammari F, Werdani A, Jemmali N, Chelli J, Mrabet HE, Rassas A, Sfar MH, El Mhamdi S, Mahjoub B. Parental self-medication with antibiotics in a Tunisian pediatric center. Therapie 2021; 77:477-485. [PMID: 34776255 DOI: 10.1016/j.therap.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/31/2021] [Accepted: 10/12/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Self-medication of antibiotics among children is a very common problem in Tunisia. Its prevalence isn't well established. The aims of this study are to evaluate parents' knowledge concerning antibiotic use, and identify the factors associated with this problem. PATIENTS AND METHODS We conducted a cross-sectional study over a one year period (between August 2019 and July 2020). Data collection was performed using a questionnaire guided interview. We included parents of children consulting or hospitalized in the pediatric department of the university hospital Taher Sfar in Mahdia. RESULTS A total of 354 parents were included with an average age of 36.4±9.2 years. The average knowledge score was 2±1.3 points. In fact, 61.6% of the parents had poor knowledge about antibiotics. The frequency of non-prescription antibiotics use among children was 20.6%. Amoxicillin was the most used antibiotic (72.6%). Sore throat, important fever and flu-like symptoms were the main symptoms justifying non-prescription antibiotic use among our pediatric population in 60.3%, 34.2% and 23.3% of cases respectively. The main reason of self-medication was the fact that the same antibiotic was once prescribed to treat the same symptoms (58.9%). The used antibiotic came from an old prescription for the same child in 57.5% of the cases and was recommended by the pharmacist in 39.7% of the cases. After multivariate analysis, the factors associated with parental self-medication with antibiotics were: the advanced parent's age, the ability to name an antibiotic and knowledge's score>2. CONCLUSION Our study confirmed that parental knowledge about antibiotic use is low. In fact, the government should from one hand, organize antibiotic delivery and prohibit off the counter sells and in the other hand promote the education of the public through different procedures to stop this major health problem.
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Affiliation(s)
- Asma Ben Mabrouk
- University Hospital Taher Sfar de Mahdia, Endocrinology and Internal medicine Department, 5100 Mahdia, Tunisia.
| | - Fatma Larbi Ammari
- University Hospital Taher Sfar de Mahdia, Endocrinology and Internal medicine Department, 5100 Mahdia, Tunisia; Monastir University, Faculty of Medicine, 5019 Monastir, Tunisia
| | - Amina Werdani
- Monastir University, Faculty of Medicine, 5019 Monastir, Tunisia; University Hospital Taher Sfar de Mahdia, Pediatric Department, 5100 Mahdia, Tunisia
| | - Nesrine Jemmali
- Monastir University, Faculty of Medicine, 5019 Monastir, Tunisia; University Hospital Taher Sfar de Mahdia, Pediatric Department, 5100 Mahdia, Tunisia
| | - Jihene Chelli
- University Hospital Taher Sfar de Mahdia, Endocrinology and Internal medicine Department, 5100 Mahdia, Tunisia; Monastir University, Faculty of Medicine, 5019 Monastir, Tunisia
| | - Houcem Elomma Mrabet
- University Hospital Taher Sfar de Mahdia, Endocrinology and Internal medicine Department, 5100 Mahdia, Tunisia
| | - Ahmed Rassas
- Monastir University, Faculty of Medicine, 5019 Monastir, Tunisia; University Hospital Taher Sfar de Mahdia, Pediatric Department, 5100 Mahdia, Tunisia
| | - Mohamed Habib Sfar
- University Hospital Taher Sfar de Mahdia, Endocrinology and Internal medicine Department, 5100 Mahdia, Tunisia; Monastir University, Faculty of Medicine, 5019 Monastir, Tunisia
| | - Sana El Mhamdi
- Monastir University, Faculty of Medicine, 5019 Monastir, Tunisia; University Hospital Taher Sfar de Mahdia, Community and Preventive Medicine Department, 5100 Mahdia, Tunisia
| | - Bahri Mahjoub
- Monastir University, Faculty of Medicine, 5019 Monastir, Tunisia; University Hospital Taher Sfar de Mahdia, Pediatric Department, 5100 Mahdia, Tunisia
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Dillard LK, Wu CZ, Saunders JE, McMahon CM. A scoping review of global aminoglycoside antibiotic overuse: A potential opportunity for primary ototoxicity prevention. Res Social Adm Pharm 2021; 18:3220-3229. [PMID: 34711521 DOI: 10.1016/j.sapharm.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/05/2021] [Accepted: 10/19/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Aminoglycosides are widely used, broad-spectrum antibiotics with significant potential for ototoxicity. Global efforts to prevent ototoxicity must account for aminoglycoside overuse and non-prescription use. OBJECTIVES The goals of this study were to a) estimate the prevalence of aminoglycoside overuse by synthesizing evidence on self-medication, over the counter (OTC) availability, and household antibiotic storage for later use, and to report the specific aminoglycosides used and the predictors of overuse, and b) leverage this information to comment on potential risk of ototoxicity. METHODS Two systematic search strings were conducted to extract peer-reviewed articles published from 2005 to 2020. The first focused on overuse of aminoglycoside antibiotics. The second focused on potentially ototoxic effects of aminoglycosides related to drug overuse. RESULTS A total of 26 articles were included (first search string: n = 21; second search string: n = 5). The prevalence of aminoglycoside self-medication was high and household storage and OTC availability of aminoglycosides was common. Gentamicin was the most commonly overused aminoglycoside. No studies provided information on antibiotic dosing or resultant toxicities, including ototoxicity. CONCLUSIONS The limited available evidence indicates that antibiotic overuse (self-medication, home storage, and non-prescription availability) is relatively common, especially in low resource settings, and that aminoglycoside antibiotics comprise a variable, but concerning, proportion of non-prescribed antibiotics. Additional evidence is needed to evaluate the relationship between these dispensing patterns and ototoxicity.
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Affiliation(s)
- Lauren K Dillard
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA.
| | - Cecilia Z Wu
- Mass General Brigham Home Care, Department of Staff Education, Waltham, MA, USA
| | - James E Saunders
- Section of Otolaryngology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Catherine M McMahon
- Department of Linguistics, Macquarie University, Sydney, New South Wales, Australia
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Brajkovic D, Zjalić S, Kiralj A. Prognostic factors for descending necrotizing mediastinitis development in deep space neck infections-a retrospective study. Eur Arch Otorhinolaryngol 2021; 279:2641-2649. [PMID: 34542654 DOI: 10.1007/s00405-021-07081-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/10/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Descending necrotizing mediastinitis (DNM) is the most serious complication of deep neck infections (DNI). The objective of this retrospective study was to evaluate prognostic factors for DNM development in deep space neck infections. METHODS The study enrolled patients admitted to the Emergency Center of Vojvodina with the diagnosis of multispace DNI with or without DNM either as the primary diagnosis or with discharged diagnosis after surgical treatment during 7-year period. The data were obtained from patient medical records. RESULTS After final analysis total of 141 charts were randomized for statystical analysis, 124 charts in DNI and 17 in DNI + DNM groups. The most common cause of infection in both groups was odontogenic. On multivariate regression analysis of collected data infection of retropharyngeal, pretracheal and carotid space, C-reactive protein and procalcitonine values were statistically significant predictors for DNM development. CONCLUSIONS Treatment and diagnosis of DNM requires multidisciplinary approach, with prompt clinical and radiological examinations, empirical broad spectrum antibiotic therapy and radical surgical debridement. Multispace neck infection and especially infection of retropharyngeal, carotid and pretracheal spaces are the most sensitive predictors for DNM development in deep space neck infections. CLINICAL RELEVANCE If the infection from deep neck spaces reach retropharyngeal, carotid or pretracheal space, the DNM is probable to occur. TRIAL REGISTRATION ClinicalTrials.gov ID NCT04865003. Date of registration 27.4.2021.
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Affiliation(s)
- Denis Brajkovic
- Clinical Center of Vojvodina, Clinic for Maxillofacial and Oral Surgery, Hajduk Veljkova 1-9, 21000, Novi Sad, Serbia.
- Faculty of Medicine, Department for Dentistry and Maxillofacial Surgery, University of Novi Sad, Novi Sad, Serbia.
| | - Severina Zjalić
- Clinical Center of Vojvodina, Clinic for Anesthesiology, Intensive Care and Pain Management, Novi Sad, Serbia
| | - Aleksandar Kiralj
- Clinical Center of Vojvodina, Clinic for Maxillofacial and Oral Surgery, Hajduk Veljkova 1-9, 21000, Novi Sad, Serbia
- Faculty of Medicine, Department for Dentistry and Maxillofacial Surgery, University of Novi Sad, Novi Sad, Serbia
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Yin X, Mu K, Yang H, Wang J, Chen Z, Jiang N, Yang F, Zhang G, Wu J. Prevalence of self-medication with antibiotics and its related factors among Chinese residents: a cross-sectional study. Antimicrob Resist Infect Control 2021; 10:89. [PMID: 34090536 PMCID: PMC8180170 DOI: 10.1186/s13756-021-00954-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 05/17/2021] [Indexed: 01/20/2023] Open
Abstract
Background Self-medication is one of the most common forms of inappropriate use of antibiotics. This study aimed to assess the prevalence of self-medication with antibiotics (SMA) in China and evaluate the related factors. Methods A cross-sectional survey was conducted in Wuhan, Hubei, China from July 1, 2019 to July 31, 2019. Participants were recruited in public places to answer a structured questionnaire. The information of participants’ social demographic characteristics, antibiotic knowledge and health beliefs were collected. Binary Logistics regression analysis was used to examine the associated factors of SMA. Results Of the 3206 participants, 10.32% reported SMA in the past 6 months. Participants who with middle or high perceived barriers to seek health care services showed a higher likelihood of SMA (P < 0.05). Participants who with middle or high perceived threats of self-medication, and who with middle or high self-efficacy to overcome obstacles showed a lower likelihood of SMA (P < 0.05). Conclusions Compared with developed countries, the prevalence of SMA in China is still higher. Measures to conduct public health education and improve the accessibility of health services are crucial to decrease the overall self-medication rate in China. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-021-00954-3.
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Affiliation(s)
- Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Ketao Mu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jie Fang Avenue 1095, Wuhan, 430030, People's Republic of China
| | - Heping Yang
- Wuchang University of Technology, Wuhan, Hubei, People's Republic of China
| | - Jing Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Zhenyuan Chen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Fengjie Yang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China
| | - Guopeng Zhang
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
| | - Jianxiong Wu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People's Republic of China.
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Naumov M, Reznichenko L, Masalykina Y, Styazhkin I. Antibiotic resistance is a common problem in medicine and veterinary. BIO WEB OF CONFERENCES 2021. [DOI: 10.1051/bioconf/20213700049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This scientific article deals with the problem of antibiotic resistance. It is very difficult to give a complete picture of the resistance of microorganisms to antibiotics, because this topic is very diverse and is being actively investigated. Accordingly, information about more and more cases of antibiotic resistance appears very quickly. Less than a century has passed since the beginning of large-scale use of antibiotics. In this short historical period of time, the threat of antibiotic resistance has reached a global level, and it would be wrong to deny that it is humanity that has created such an enemy through its own efforts. Antibiotic resistance is a property of a microorganism that is associated with a decrease in the quality of the effect of an antibiotic on a given culture. The driving force behind this phenomenon is evolution. With the help of random mutations, an individual appears that is not susceptible to the effects of a previously used drug. The emergence of superbugs-cultures that do not respond to the use of currently existing antibiotics will lead to a decrease in the quality of life of people. Diseases that no longer caused concern in modern society will once again become deadly.
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Serbian students' knowledge, attitudes and behaviour towards antibiotic use: is there room for improvement? Int J Public Health 2020; 65:1257-1267. [PMID: 32737562 DOI: 10.1007/s00038-020-01448-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES This study has been aimed at evaluating knowledge, attitudes and behaviour of university students regarding the usage of antibiotics focusing on differences between medical and nonmedical students. METHODS This cross-sectional questionnaire-based study was performed on 800 students of the University of Novi Sad, Serbia. RESULTS The identified predictors of adequate antibiotic knowledge were enrolled in medical program, higher grade average and appropriate use of antibiotics during last infection. Multivariate regression identified following predictors of self-medication: being medical student (B = 0.715; p < 0.001), more frequent (B = 0.628; p < 0.001) and irregular (B = 0.584; p = 0.001) antibiotic use, a family member engaged in medical profession (B = 0.789; p < 0.001), living in dormitory (B = 0.679; p = 0.007) or rented apartment (B = 0.621; p = 0.002), using antibiotics until symptoms resolved (B = 1.616; p < 0.001) or until the bottle was finished (B = 0.628; p < 0.001) during the last infection. CONCLUSIONS Although a high number of students showed adequate knowledge about antibiotics, numerous misconceptions were recorded, including self-medication. Further educational interventions are necessary to improve their understanding, perceptions as well as their behaviour towards antibiotic use.
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Self-Medication with Antibiotics among Nursing Students in Serbia: Pilot Study. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2019. [DOI: 10.2478/sjecr-2019-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Healthcare professionals should serve as promoters of rational antibiotic use in attempt to decrease antibiotics misuse within the process of self-medication. Current pilot study was undertaken with the aim to identify potential predictors of self-medication with antibiotics (SMA) and to describe SMA practice among nursing students in Serbia. Data have been collected during the period March-May, 2016 in Medical school of bachelor degree, in Belgrade. Self-reported questionnaire served as a data source. Descriptive statistic was used to analyse study sample characteristics. Chi-square test was used to test differences between groups. Study sample have included 138 participants. Almost half of them, 43.8%, practice SMA. Life style (smoking, alcohol consumption, sleeping habits and physical activity) and socio-demographic characteristics (excepted school grade) were not shown as SMA determinants. Time & money savings were stated as the most frequent reason for SMA, while common cold, sore throat and cough were the most common conditions cured through SMA. Pharmacists’ recommendations and previous positive experience were specified as the most important in the process of antibiotics selection, indicated by 50.0% and 37.5% participants, respectively. Amoxicillin was the most frequently used antibiotic in SMA, used by 50% of participants who practice SMA. High proportion of SMA and observed practice among nursing students in Serbia call for efforts with regards to relevant education about rational antibiotic use, actual clinical guidelines and potential consequences of misuse.
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Voidăzan S, Moldovan G, Voidăzan L, Zazgyva A, Moldovan H. Knowledge, Attitudes And Practices Regarding The Use Of Antibiotics. Study On The General Population Of Mureş County, Romania. Infect Drug Resist 2019; 12:3385-3396. [PMID: 31802918 PMCID: PMC6827501 DOI: 10.2147/idr.s214574] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 09/03/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Currently, antibiotic resistance is a complex issue that affects the whole of society. This resistance is influenced by the irrational and excessive use of antibiotics by the general population. This study aimed to gather information about the knowledge, attitudes and behaviours regarding the issues related to antibiotic consumption in the general population of Mureș County in the Central Region of Romania. METHODS This was a cross-sectional study using a questionnaire as its research instrument, which consisted of 33 questions analysing the respondents' attitude and their knowledge about the use of antibiotics and antibiotic resistance. RESULTS A total of 996 respondents were eligible for the study. Of the total respondents, 62.65% (624 respondents) considered that antibiotics are used to treat a bacterial infection and 61.45% (612 respondents) used an antibiotic at least once in the previous year, with a distribution of 68.7% and 56.8% of the respondents from rural and urban areas, respectively. Antibiotics were taken by 10.34% of the respondents, following recommendations from family/friends, and 22.9% used antibiotics left over from their last prescription. Of those who consumed antibiotics (868 respondents), 65.9% consulted their physician every time before taking the medication. Furthermore, 82.3% of the total of 996 respondents considered that the use of non-prescription antibiotics has a negative effect, and 85.14% had heard about the antibiotic resistance of bacteria. CONCLUSION The majority of respondents had adequate knowledge of antibiotics and their use and were aware of the fact that non-prescription antibiotics can have repercussions both on them as individuals and on the population as a whole.
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Affiliation(s)
- Septimiu Voidăzan
- Department of Epidemiology, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, Tîrgu Mureş, Romania
| | - Geanina Moldovan
- Department of Community Nutrition, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, Tîrgu Mureş, Romania
| | | | - Ancuța Zazgyva
- Department of Cell and Molecular Biology, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, Tîrgu Mureş, Romania
| | - Horațiu Moldovan
- Department of Occupational Medicine, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, Tîrgu Mureş, Romania
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AlQahtani HA, Ghiasi FS, Zahiri AN, Rahmani NI, Abdullah N, Al Kawas S. Self-medication for oral health problems among adults attending the University Dental Hospital, Sharjah. J Taibah Univ Med Sci 2019; 14:370-375. [PMID: 31488970 PMCID: PMC6717111 DOI: 10.1016/j.jtumed.2019.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/16/2019] [Accepted: 06/21/2019] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this study was to investigate the self-medication practices for oral health problems among adults attending the University Dental Hospital Sharjah (UDHS). The reasons for visits and types, durations, and sources of self-medication were recorded. Methods This cross-sectional study was conducted among adult patients attending UDHS. A total of 566 participants were recruited using pre-determined inclusion and exclusion criteria. Data collection was performed using a self-administered closed-ended questionnaire, and information was analysed using SPSS software version 22. Results Four hundred of 566 (70.7%) respondents indicated that they practice self-medication. Among those who practiced self-medication for oral health problems, the mean age was 26 ± 9.4 years (52% men and 48% women), and the majority (46%) had obtained higher education, although their profession was not related to the medical field (69.97%). The most common factor that triggered self-medication practices was toothache (56.5%), while the main reasons for self-medication were both lack of time to visit a dental clinic (37.6%) and the perception that dental ailments were not serious health issues (36.8%). Analgesics were the main medicines used for self-medication. Conclusion Self-medication for oral health problems is a common practice in UAE. Lack of time to visit dental clinics and the perceived low importance of oral health problems were the main reasons for self-medication. Analgesics for toothache were the most frequent medications purchased from the local pharmacy.
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Horvat O, Mijatović V, Milijasević B, Tomas A, Kusturica MP, Tomić Z, Sabo A. Are There Striking Differences in Outpatient Use of Antibiotics Between South Backa District, Serbia, and Some Scandinavian Countries? Front Public Health 2018; 6:91. [PMID: 29651413 PMCID: PMC5884880 DOI: 10.3389/fpubh.2018.00091] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 03/08/2018] [Indexed: 11/23/2022] Open
Abstract
There is little published information about antibiotic utilization in outpatients in Serbia. The objective of this study was to determine the amount and structure of outpatient antibiotic use in South Backa District (SBD) in Serbia, to assess prescibing quality of antibiotics and to compare with results from Scandinavian countries. Data on the antibiotic use were collected from all private and state-owned pharmacies from January through March 2008 in SBD. Results were expressed as the number of defined daily doses/1,000 inhabitants/day. The drug utilization 90% method was also used. Penicillins were the most frequently used antibiotic subgroup in SBD (35.20%), followed by cephalosporins (19.16%) and macrolides (13.18%). Thirteen drugs accounted for 90% of total antibiotics consumption (DU90% segment). The average cost/DDD within the DU90% segment was 0.95 euros, whereas the average cost/DDD beyond the DU90% segment was 1.89 euros, indicating that less expensive antibiotics were more frequently used. High use of ampicillin, third-generation cefalosporins, co-trimoxazole, and gentamicin, will aggravate the alarming problem of resistance in Serbia. Differences in the amount and structure of antibiotic consumption between SBD and Scandinavian countries indicate the need of updated national guidelines for rational antimicrobial drug use in Serbia.
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Affiliation(s)
- Olga Horvat
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Vesna Mijatović
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Boris Milijasević
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Ana Tomas
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Milica Paut Kusturica
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Zdenko Tomić
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Ana Sabo
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
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Natasa M, Radovanovic S, Vasiljevic D, Kocic S, Jakovljevic M. Sociodemographic Characteristics Of The Over-The-Counter Drug Users In Serbia. ACTA ACUST UNITED AC 2018. [DOI: 10.2174/1876824501806010001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:The analysis of socio-demographic factors on the use of over-the-counter drugs for self-medication and over the counter drugs such as vitamins and minerals for boosting the immune system.Objective:The objective is to look into socio-demographic factors of the interviewees who use Over-the-Counter drugs.Methods:Data obtained through the results of the National health survey of the Republic of Serbia 2013. Dependent variable was transformed such a way that vitamins and herbal medicaments for strengthening the body were merged into one group preparations for boosting the immune system and drugs for self-treatment into the group preparations for self-medication.Results:The interviewees more often use OTC for boosting the immune system rather that OTC for self-medication. Women and highly educated people use OTC preparations more often. Unemployed people coming from rural areas use OTC preparations less often. People who have primary education buy OTC products for boosting the immune system significantly more often in comparison to highly educated people (OR = 3.95), but they use OTC drugs for self-medication less frequently (OR = 0.25). The poorest interviewees buy OTC drugs for self-medication twice times less often than the rich, respectively, but they buy OTC vitamins and other immunoregulators 1.4 times more often than the rich, respectively.Conclusion:Highly educated, rich and people coming from developed regions very often buy OTC drugs for self-medication, while poor, less educated people coming from undeveloped regions more often buy OTC preparations for boosting the immune system.
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