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Vicar EK, Walana W, Fordjour RA, Benneh C, Bentil RE, Wuffelle GM, Osabutey EK, Nachinab G, Obeng‐Bempong M. The use of antibiotics during pregnancy: A cross-sectional study of knowledge, attitude, and practices among antenatal care attendees in Northern Ghana. Health Sci Rep 2024; 7:e2111. [PMID: 38779221 PMCID: PMC11109041 DOI: 10.1002/hsr2.2111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 04/02/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
Background and aims The promotion of rational use of antibiotics among pregnant women is eminent not only for the risk of teratogenicity in the developing fetus but also the risk of drug resistance with its concomitant high cost of health care. Studies on antibiotic self-medication among pregnant women in Northern Ghana are rare. Improving the knowledge and awareness among the vulnerable groups about the appropriate use of antibiotics can help in limiting the antibiotic resistance menace. We, therefore, conducted this study to assess the knowledge, attitude, and practice (KAP) toward antibiotic use among pregnant women attending an antenatal clinic at a primary health care in Tolon, Northern Region, Ghana. Method We conducted a cross-sectional study using an interviewer-administered questionnaire to assess the KAP of 702 pregnant women on antibiotic use. This study was conducted in the Tolon Health Center (THC) from March 2021 and ended in October 2021. Results In this study, 55.6% of pregnant women had good knowledge and 45.3% of them had engaged in self-medication with antibiotics while pregnant. There were statistically significant associations between participants' background and obstetric characteristics and knowledge of antibiotic use and antibiotic resistance, except for age, marital status, and parity. Also, there was a significant association between pregnant women's knowledge and self-medication or over-the-counter purchase of antibiotics. Conclusion We concluded that higher education level, monthly income, good practice, and good knowledge were significantly associated with a reduced likelihood of self-medication with antibiotics. A well-structured education that could be easily accepted and understood by pregnant women on the risks of antibiotic self-medication should be included in the routine education at the antenatal clinics.
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Affiliation(s)
- Ezekiel K. Vicar
- Department of Clinical MicrobiologyUniversity for Development StudiesTamaleGhana
| | - Williams Walana
- Department of Clinical MicrobiologyUniversity for Development StudiesTamaleGhana
| | - Rosemond A. Fordjour
- Department of Midwifery and Women's Health, School of Nursing and MidwiferyUniversity for Development StudiesTamaleGhana
| | - Christiana Benneh
- Department of Midwifery and Women's Health, School of Nursing and MidwiferyUniversity for Development StudiesTamaleGhana
| | - Rosemond E. Bentil
- Department of Midwifery and Women's Health, School of Nursing and MidwiferyUniversity for Development StudiesTamaleGhana
| | - Gifty M. Wuffelle
- Department of Midwifery and Women's Health, School of Nursing and MidwiferyUniversity for Development StudiesTamaleGhana
| | | | - Gilbert Nachinab
- Department of General Nursing, School of Nursing and MidwiferyUniversity for Development StudiesTamaleGhana
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Edri R, Cohen MJ, Dror D, Korem M. Incidence of Invasive Infections Among Hemato-Oncology Patients with Significant Burden of Candida in Stool. Mycopathologia 2023; 188:371-381. [PMID: 37294507 DOI: 10.1007/s11046-023-00758-6] [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: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 06/10/2023]
Abstract
Candidemia is a serious infection associated with increased mortality. It is unclear whether a high concentration of Candida in stool in patients with hematologic malignancies is associated with a higher risk for developing candidemia. In this observational historical study in patients hospitalized in hemato-oncology departments, we describe the association between gastrointestinal Candida colonization and the risk for candidemia and other severe outcomes. Data from 166 patients with heavy burden of Candida in stool were collected and compared to a control group of 309 patients with minimal or no Candida in stool, from 2005 to 2020. Severe immunosuppression and recent use of antibiotics were more common in heavily colonized patients. Outcomes of heavily colonized patients were worse as compared to the control group with statistical significance in 1-year mortality (53% vs. 37.5%, p = 0.001) and borderline statistical significance in candidemia rate (12.6% vs. 7.1%, p = 0.07). Risk factors for 1-year mortality were significant colonization of Candida in stool, older age and recent use of antibiotics. In conclusion, significant stool burden of Candida among hospitalized hemato-oncology patients may pose a risk for 1-year mortality and increased candidemia rate.
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Affiliation(s)
- Ron Edri
- Department of Medicine, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Matan J Cohen
- Clalit Health Services, Jerusalem District, affiliated with the Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Danna Dror
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Hadassah-Hebrew University Medical Center, Hebrew University of Jerusalem, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Maya Korem
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Hadassah-Hebrew University Medical Center, Hebrew University of Jerusalem, P.O. Box 12000, 91120, Jerusalem, Israel.
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Vicar EK, Walana W, Mbabila A, Darko GK, Opare‐Asamoah K, Majeed SF, Obeng‐Bempong M. Drivers of household antibiotic use in urban informal settlements in Northern Ghana: Implications for antimicrobial resistance control. Health Sci Rep 2023; 6:e1388. [PMID: 37396564 PMCID: PMC10308355 DOI: 10.1002/hsr2.1388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 05/09/2023] [Accepted: 06/11/2023] [Indexed: 07/04/2023] Open
Abstract
Background Urban informal settlements have been described as the epicenters of frequent antibiotic misuse, which has local and global consequences on the goals of antimicrobial stewardship. The aim of this study was to assess the relationship between knowledge, attitude, and practices of antibiotic use among households in urban informal settlements in the Tamale metropolis of Ghana. Method This study was a prospective cross-sectional survey of the two major informal settlements in the Tamale metropolis, namely Dungu-Asawaba and Moshie Zongo. In all, 660 households were randomly selected for this study. Households with an adult and at least a child under 5 years old were randomly chosen. An adult with knowledge of household healthcare practices was selected to respond to a structured questionnaire. Results In all, 291 (44.1%) of the 660 households reported taking at least one type of antibiotic within the last month before the study and 30.9% (204/660) had used antibiotics without a prescription. Information on which antibiotics to use was obtained mostly from friends/family members 50 (24.5%) and were commonly purchased from a medical store or a pharmacy 84 (41.2%), saved up from a previously used antibiotic 46 (22.5%), a friend/family members 38 (18.6%), and drug hawkers 30 (14.7%). Amoxicillin 95 (26.0%) was the most frequently used antibiotic and the commonest indication for antibiotics use was diarrhea 136 (37.9%). Female respondents (odds ratio [OR] = 3.07; 95% confidence interval [CI] = 2.199-4.301; p < 0.0001), larger households (OR = 2.02; 95% CI = 1.337-3.117; p = 0.0011) and those with higher monthly household income (OR = 3.39; 95% CI = 1.945-5.816; p < 0.0001) were more likely to have good knowledge of appropriate antibiotic use and antibiotic resistance. Furthermore, bad attitudes influenced participants' use of antibiotics without prescription (OR = 2.41; 95% CI = 0.432-4.05; p = 0.0009). Conclusion This study exposes the drivers of inappropriate use of antibiotics at the household level, particularly in urban informal settlements. Policy interventions aimed at controlling the indiscriminate use of antibiotics in such settlements could improve the responsible use of antibiotics. Keywords: antibiotic resistance, informal settlements, Tamale, Ghana.
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Affiliation(s)
- Ezekiel K. Vicar
- Department of Clinical MicrobiologyUniversity for Development StudiesTamaleGhana
| | - Williams Walana
- Department of Clinical MicrobiologyUniversity for Development StudiesTamaleGhana
| | | | | | - Kwame Opare‐Asamoah
- Department of Biological SciencesUniversity for Development StudiesTamaleGhana
| | - Saeed F. Majeed
- Department of Biological SciencesUniversity for Development StudiesTamaleGhana
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Kabir H, Hasan MK, Akter N, Tassdik DH, Islam DMF, Jannat DH, Tutul AH, Akter O, Ara R, Islam MD, Mahmud S, Akter M, Mitra DK. Antibiotics administration without prescription in Bangladesh. IJID REGIONS 2023; 7:11-17. [PMID: 36941825 PMCID: PMC10023939 DOI: 10.1016/j.ijregi.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 02/12/2023]
Abstract
Background Antibiotic resistance is a global challenge. Therefore, adhering to proper antibiotic administration protocols is essential to mitigating the problem. This study investigated the prevalence, and factors associated with, antibiotics administration without prescription by registered doctors in Bangladesh. Method This cross-sectional survey was carried out among 1102 adults. The outcome variable was antibiotics administration without prescription. The exploratory variables included the those relating to sociodemographics, attitudes, and knowledge (antibiotic-treatable diseases, types of disease specification, and antimicrobial drugs specifications). Descriptive and inferential statistics were performed, with a p-value of 0.05 considered significant with a 95% confidence interval. Results The prevalence of antibiotics administration without prescription was found to be 37.02%. Age was significantly associated with the administration of antibiotics without prescription. Those who had taken antibiotics in the previous 2 months reported a significantly higher prevalence of antibiotics administration without prescription. The participants' attitudes toward antibiotics and knowledge of antibiotic-treatable diseases, types of disease, and antimicrobial drugs were significantly associated with antibiotics administration without prescription. Conclusion These findings may assist in facilitating relevant initiatives to improve the magnitude of antibiotics utilization without prescription, and mitigate the emergence of antibiotic resistance in Bangladesh.
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Affiliation(s)
- Humayun Kabir
- Department of Public Health, North South University, Dhaka-1229, Bangladesh
| | - Md Kamrul Hasan
- Department of Public Health, North South University, Dhaka-1229, Bangladesh
- Department of Biochemistry and Molecular Biology, Tejgoan College, Dhaka-1215, Bangladesh
| | - Nahida Akter
- Grameen Caledonian College of Nursing, Dhaka-1216, Bangladesh
- Penn State Ross and Carol Nese College of Nursing, Penn State University, University Park, PA, USA
| | | | - Dr Md Fakrul Islam
- Department of Public Health, North South University, Dhaka-1229, Bangladesh
| | - Dr Hasina Jannat
- Department of Public Health, North South University, Dhaka-1229, Bangladesh
| | | | - Ojifa Akter
- School of Medical Sciences, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Rawshan Ara
- Prime College of Nursing, Dhaka-1229, Bangladesh
| | - Muhammad Didarul Islam
- School of Medical Sciences, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
- Department of Gerontology and Geriatric Welfare, University of Dhaka, Dhaka-1000, Bangladesh
| | - Sohel Mahmud
- Department of Biochemistry and Molecular Biology, Tejgoan College, Dhaka-1215, Bangladesh
| | - Masuda Akter
- Faculty of Medicine, University of Dhaka, Dhaka-1000, Bangladesh
- Saic Nursing College, Dhaka-1216, Bangladesh
| | - Dipak Kumar Mitra
- Department of Public Health, North South University, Dhaka-1229, Bangladesh
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Haseeb A, Saleem Z, Maqadmi AF, Allehyani RA, Mahrous AJ, Elrggal ME, Kamran SH, AlGethamy M, Naji AS, AlQarni A, Alhariqi KW, Khan MA, Ibrahim K, Raees F, Azmat A, Cook A, Campbell SM, Lorenzetti G, Meyer JC, Godman B, Moore CE. Ongoing Strategies to Improve Antimicrobial Utilization in Hospitals across the Middle East and North Africa (MENA): Findings and Implications. Antibiotics (Basel) 2023; 12:827. [PMID: 37237730 PMCID: PMC10215537 DOI: 10.3390/antibiotics12050827] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/22/2023] [Accepted: 04/23/2023] [Indexed: 05/28/2023] Open
Abstract
Antimicrobial resistance (AMR) is an increasing global concern, increasing costs, morbidity, and mortality. National action plans (NAPs) to minimize AMR are one of several global and national initiatives to slow down rising AMR rates. NAPs are also helping key stakeholders understand current antimicrobial utilization patterns and resistance rates. The Middle East is no exception, with high AMR rates. Antibiotic point prevalence surveys (PPS) provide a better understanding of existing antimicrobial consumption trends in hospitals and assist with the subsequent implementation of antimicrobial stewardship programs (ASPs). These are important NAP activities. We examined current hospital consumption trends across the Middle East along with documented ASPs. A narrative assessment of 24 PPS studies in the region found that, on average, more than 50% of in-patients received antibiotics, with Jordan having the highest rate of 98.1%. Published studies ranged in size from a single to 18 hospitals. The most prescribed antibiotics were ceftriaxone, metronidazole, and penicillin. In addition, significant postoperative antibiotic prescribing lasting up to five days or longer was common to avoid surgical site infections. These findings have resulted in a variety of suggested short-, medium-, and long-term actions among key stakeholders, including governments and healthcare workers, to improve and sustain future antibiotic prescribing in order to decrease AMR throughout the Middle East.
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Affiliation(s)
- Abdul Haseeb
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.H.); (A.F.M.); (R.A.A.); (A.J.M.); (M.E.E.)
| | - Zikria Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan
| | - Aseel Fayk Maqadmi
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.H.); (A.F.M.); (R.A.A.); (A.J.M.); (M.E.E.)
| | - Roaa Abdulrahman Allehyani
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.H.); (A.F.M.); (R.A.A.); (A.J.M.); (M.E.E.)
- Batterjee Medical College, Jeddah 21442, Saudi Arabia
| | - Ahmad J. Mahrous
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.H.); (A.F.M.); (R.A.A.); (A.J.M.); (M.E.E.)
| | - Mahmoud E. Elrggal
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah 24382, Saudi Arabia; (A.H.); (A.F.M.); (R.A.A.); (A.J.M.); (M.E.E.)
| | - Sairah Hafeez Kamran
- Institute of Pharmacy, Lahore College for Women University, Lahore 54000, Pakistan;
| | - Manal AlGethamy
- Department of Infection Prevention and Control Program, Alnoor Specialist Hospital, Makkah 24241, Saudi Arabia;
| | - Asem Saleh Naji
- Infectious Diseases Department, Alnoor Specialist Hospital, Makkah 24241, Saudi Arabia; (A.S.N.); (A.A.); (K.W.A.)
| | - Abdullmoin AlQarni
- Infectious Diseases Department, Alnoor Specialist Hospital, Makkah 24241, Saudi Arabia; (A.S.N.); (A.A.); (K.W.A.)
| | - Khalid W. Alhariqi
- Infectious Diseases Department, Alnoor Specialist Hospital, Makkah 24241, Saudi Arabia; (A.S.N.); (A.A.); (K.W.A.)
| | | | - Kiran Ibrahim
- Primary and Secondary Healthcare Department, DHQ Hospital Khushab, Khushab 41200, Pakistan;
| | - Fahad Raees
- Department of Medical Microbiology, Faculty of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia;
| | - Aisha Azmat
- Department of Physiology, Faculty of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia;
| | - Aislinn Cook
- Centre for Neonatal and Paediatric Infection, St. George’s University of London, London SW17 0RE, UK; (A.C.); (G.L.); (C.E.M.)
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX1 2JD, UK
| | - Stephen M. Campbell
- Centre for Epidemiology and Public Health, School of Health Sciences, University of Manchester, Manchester M13 9PL, UK;
- School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa;
| | - Giulia Lorenzetti
- Centre for Neonatal and Paediatric Infection, St. George’s University of London, London SW17 0RE, UK; (A.C.); (G.L.); (C.E.M.)
| | - Johanna C. Meyer
- School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa;
- South African Vaccination and Immunisation Centre, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
| | - Brian Godman
- School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa;
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow G4 0RE, UK
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
| | - Catrin E. Moore
- Centre for Neonatal and Paediatric Infection, St. George’s University of London, London SW17 0RE, UK; (A.C.); (G.L.); (C.E.M.)
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Azrad M, Vazana D, On A, Paritski M, Rohana H, Roshrosh H, Agay‐Shay K, Peretz A. Antibiotic resistance patterns of Helicobacter pylori in North Israel - A six-year study. Helicobacter 2022; 27:e12932. [PMID: 36110057 PMCID: PMC9786357 DOI: 10.1111/hel.12932] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND One main challenge in Helicobacter pylori (H. pylori) eradication is its increasing antibiotic resistance. Additionally, resistance rates vary between geographic areas and periods. However, data are limited since susceptibility testing is not routinely performed. Thus, it is valuable to gather data regarding H. pylori's resistance rates in Israel that would aid in better adjustment of treatment. MATERIALS AND METHODS The study included 540 H. pylori isolates, recovered from gastric biopsy samples of patients who had undergone endoscopy, during 2015-2020, at the Padeh Poriya Medical Center. Antibiotic susceptibility testing to amoxicillin, clarithromycin, metronidazole, levofloxacin, rifampicin, and tetracycline was performed using the Etest technique. Data regarding participants' sex, age, and ethnic group were collected. For every antibiotic and for multi-resistance, generalized linear models were used to estimate crude and adjusted estimated differences in mean MIC and odds ratios (ORs) for every year, compared with the reference year 2015. RESULTS The highest resistance rates were for clarithromycin and metronidazole (46.3% and 16.3%, respectively). Patients above 18 had higher resistance rate to rifampicin and multi-resistance (3.3% and 14.8%), compared with patients under 18 (0.5% and 8.4%, respectively). Resistance rates for levofloxacin, rifampicin, and multi-resistance were significantly higher among Arab patients, compared with Jewish patients. During the 6-year surveillance, a significant annual trend in MIC for metronidazole and in ORs for metronidazole, levofloxacin, and multi-resistance were observed (after adjustment). During 2020 compared with 2015, significant increased ORs were observed for levofloxacin and metronidazole [5.72 (1.03-31.84); 4.28 (1.30-14.14), respectively]. CONCLUSIONS In light of the remarkable changes in antibiotic resistance of H. pylori during the study's period and the increasing resistance rates to various antibiotics, it is very important to continuously monitor H. pylori antibiotic susceptibly. In order to increase eradication rates of this bacterium, therapy regimes must be based on an updated antibiotic resistance data.
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Affiliation(s)
- Maya Azrad
- Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Tiberias 1528001, affiliated with Azrieli Faculty of MedicineBar Ilan UniversitySafedIsrael
| | - Dafna Vazana
- Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Tiberias 1528001, affiliated with Azrieli Faculty of MedicineBar Ilan UniversitySafedIsrael,Azrieli Faculty of MedicineBar‐Ilan UniversitySafedIsrael
| | - Avi On
- Azrieli Faculty of MedicineBar‐Ilan UniversitySafedIsrael,The Gastroenterological Institute, Baruch Padeh Medical Center, Poriya, Tiberias 1528001, affiliated with Azrieli Faculty of MedicineBar Ilan UniversitySafedIsrael
| | - Maya Paritski
- Azrieli Faculty of MedicineBar‐Ilan UniversitySafedIsrael,The Pediatric Gastroenterological Unit, Baruch Padeh Medical Center, Poriya, Tiberias 1528001, affiliated with Azrieli Faculty of MedicineBar Ilan UniversitySafedIsrael
| | - Hanan Rohana
- Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Tiberias 1528001, affiliated with Azrieli Faculty of MedicineBar Ilan UniversitySafedIsrael
| | - Halim Roshrosh
- Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Tiberias 1528001, affiliated with Azrieli Faculty of MedicineBar Ilan UniversitySafedIsrael
| | | | - Avi Peretz
- Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Tiberias 1528001, affiliated with Azrieli Faculty of MedicineBar Ilan UniversitySafedIsrael,Azrieli Faculty of MedicineBar‐Ilan UniversitySafedIsrael
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Pogurschi EN, Petcu CD, Mizeranschi AE, Zugravu CA, Cirnatu D, Pet I, Ghimpețeanu OM. Knowledge, Attitudes and Practices Regarding Antibiotic Use and Antibiotic Resistance: A Latent Class Analysis of a Romanian Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127263. [PMID: 35742513 PMCID: PMC9224212 DOI: 10.3390/ijerph19127263] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 02/04/2023]
Abstract
Considering the major limitations of the latest studies conducted in Romania on the knowledge, attitudes and practices (KAPs) of antibiotic use and antibiotic resistance, we conducted this study to assess this major public health threat. A cross-sectional survey based on a validated questionnaire was conducted among the general population of Romania for a period of 5 months, i.e., September 2021-January 2022. The questionnaire was distributed using Google Form and it covered demographic characteristics and KAP assessments consisting of 12 items on knowledge, 10 items on attitudes and 3 items on practices. Latent class analyses (LCAs) were conducted to group respondents based on their responses. The response rate was 77%, of which females responded in a greater number (n = 1251) compared to males (n = 674). For most of the respondents (67.32%, n = 1296), the education level was high school, while 23.58% (n = 454) of respondents were college graduates. One in three Romanians (33.3%) know the WHO predictions related to this topic. Overall, the Romanian population is less disciplined when it comes to completing antibiotic treatments, as 29.19% of the respondents stop the course of antibiotic administration if their symptoms improve. The key findings from the present study may help policy makers in designing targeted interventions to decrease confusion, ambiguity or misconceptions about antibiotic use.
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Affiliation(s)
- Elena Narcisa Pogurschi
- Public Health and Food Safety Laboratory, Department Formative Science in Animal Breeding and Food Industry, Faculty of Animal Productions Engineering and Management, University of Agronomic Sciences and Veterinary Medicine of Bucharest, 011464 Bucharest, Romania;
| | - Carmen Daniela Petcu
- Department Animal Production and Public Health, Faculty of Veterinary Medicine, University of Agronomic Sciences and Veterinary Medicine of Bucharest, 050097 Bucharest, Romania;
| | | | - Corina Aurelia Zugravu
- Department-Fundamental Disciplines, Faculty of Midwifery and Nursing, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania;
| | - Daniela Cirnatu
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, “Vasile Goldis” Western University of Arad, 310025 Arad, Romania;
| | - Ioan Pet
- Department of Biotechnologies, Bioengineering, Faculty of Animal Resources, Banat University of Agricultural Science and Veterinary Medicine “Regele Mihai I al Romaniei”, 300645 Timisoara, Romania;
| | - Oana-Mărgărita Ghimpețeanu
- Department Animal Production and Public Health, Faculty of Veterinary Medicine, University of Agronomic Sciences and Veterinary Medicine of Bucharest, 050097 Bucharest, Romania;
- Correspondence: ; Tel.: +40-724529434
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Geta K, Kibret M. Knowledge, Attitudes and Practices of Patients on Antibiotic Resistance and Use in Public Hospitals of Amhara Regional State, Northwestern Ethiopia: A Cross-Sectional Study. Infect Drug Resist 2022; 15:193-209. [PMID: 35115790 PMCID: PMC8799925 DOI: 10.2147/idr.s348765] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/13/2022] [Indexed: 12/14/2022] Open
Abstract
Background Although inappropriate antibiotic use could contribute to the spread of antimicrobial resistance, data on the knowledge, attitude and practice of antibiotic use and resistance among patients in north-western Ethiopia are scarce. This study assessed patients’ knowledge, attitudes and practices regarding antibiotic use and resistance in selected public hospitals of Amhara regional state, Ethiopia. Methods A cross-sectional study was conducted in selected public hospitals of Amhara regional state from November to December 2020 to assess the knowledge, attitude, and practice of patients on antibiotic resistance and use. Data were collected from 233 participants using a structured questionnaire and analyzed using SPSS version 23. Results According to the findings, 60.3% of the participants obtained their antibiotics without a prescription from private pharmacies, and the most commonly used antibiotic to treat human diseases was ampicillin (70.7%). Even though 69.8% of the patients heard about antibiotics and antibiotic resistance from several sources, 68.1–87.9% of them were unaware on the factors that contribute to the transmission of resistant bacteria to humans and the impact of antibiotic resistance on human and animal health. Using the mean score of 3.15 ± 0.08 as the cut-off, 37.5% of patients know about antimicrobial resistance and use. With a mean score of 27.6 ± 0.3, 45.3% of patients had positive attitudes toward prudent antibiotic use and resistance. About 44% of participants had a good practice, with a mean practice score of 4.95 ± 0.17. A higher level of education was associated with better knowledge, positive attitudes, and better practices regarding antibiotic use and resistance. Although 57.3% of respondents viewed poor handwashing practices in hospitals as a major factor contributing to increased antibiotic resistance, 59.9% of respondents viewed implementing hygiene, infection prevention, and control practices as a major strategy contributing to reducing antibiotic use and resistance. Conclusion According to the present study, there is a low level of awareness among patients about the proper antibiotics use and resistance. It is essential to raise awareness, develop, and implement interventions to reduce antimicrobial use and antibiotic resistance in the study area.
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Affiliation(s)
- Kindu Geta
- Department of Biology, Debre Tabor University, Debre Tabor, Ethiopia
- Department of Biology, Bahir Dar University, Bahir Dar, Ethiopia
- Correspondence: Kindu Geta, Email
| | - Mulugeta Kibret
- Department of Biology, Bahir Dar University, Bahir Dar, Ethiopia
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Wong LP, Alias H, Husin SA, Ali ZB, Sim B, Ponnampalavanar SSLS. Factors influencing inappropriate use of antibiotics: Findings from a nationwide survey of the general public in Malaysia. PLoS One 2021; 16:e0258698. [PMID: 34669733 PMCID: PMC8528291 DOI: 10.1371/journal.pone.0258698] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/02/2021] [Indexed: 01/21/2023] Open
Abstract
Antibiotic resistance is one of the biggest threats to global public health. Misuse of antibiotics has never been investigated on a nationwide scale among the general public in Malaysia. This study aimed to identify sociodemographic and knowledge factors associated with inappropriate use of antibiotics in the Malaysian context to inform the development of interventions to mitigate inappropriate antibiotic use. We conducted computer-assisted telephone interviews (CATI) between June 2019 and December 2019. The telephone numbers were randomly generated from the electronic residential telephone directory of all 13 states and 3 Federal Territories in Malaysia. The survey consisted of questions on demographics, knowledge about antibiotics and antibiotic resistance (53 items), and practices of antibiotic use (16 questions). A total of 864 complete responses were received. Pronounced erroneous beliefs that antibiotics are effective against infections caused by viruses and that antibiotics can speed up recovery from coughs and colds were evident. The proportions that were aware of the terms ‘drug resistance’, ‘antimicrobial resistance’, and ‘superbugs’ were low. The mean and standard deviation (SD) for the antibiotic knowledge score was 23.7 (SD ±9.25; range 0 to 50) out of a possible score of 52. Regarding antibiotic practices, a considerable proportion reported non-adherence to recommended doses. The mean and SD for the antibiotic practices score was 37.9 (SD ± 6.5; range 17 to 47) out of a possible score of 48. Participants who earned an average monthly household income of MYR1001-3000 (OR 1.61, 95% CI 1.04–2.50) were more likely to report higher antibiotic practice scores than those with <MYR1000. Participants with tertiary education attainment reported higher antibiotic practice scores (OR 1.99; 95%CI 1.02–3.91) than those with primary school and below. High antibiotic knowledge scores (OR 3.94; 95% CI 2.71–5.73) were associated with higher antibiotic practice scores. Inappropriate antibiotic use is influenced by demographics and antibiotic knowledge. This study calls for education interventions focused on the lower socio-economic status population to increase awareness and to promote appropriate antibiotic use.
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Affiliation(s)
- Li Ping Wong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail: (LPW); (SSLSP)
| | - Haridah Alias
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Suraya Amir Husin
- Infection Control Unit at Medical Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Zawaniah Brukan Ali
- Infection Control Unit at Medical Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Benedict Sim
- Infectious Diseases Unit, Department of Medicine, Sg. Buloh Hospital, Sungai Buloh, Malaysia
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Altorkmani A, Alzabibi MA, Shibani M, Ismail H, Sawaf B, Daher N, Al-Moujahed A. Assessing the Syrian Population's Knowledge, Attitudes, and Practices Regarding Antibiotic Usage. Avicenna J Med 2021; 11:132-138. [PMID: 34646789 PMCID: PMC8500066 DOI: 10.1055/s-0041-1732815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Antibiotic resistance is a serious public health threat that results mainly secondary to antibiotics misuse. The present study aimed to determine the knowledge, attitude, and practice toward antibiotic use among the Syrian population. Methods This cross-sectional study was conducted at the outpatient clinics of two major hospitals in Damascus, Syria. Applying a random convenience sampling, data were collected in a 1-week period by interviewing participants using a structured questionnaire, which targeted demographics, practice, knowledge, and attitude. Data were used to assess the relationship between the knowledge level and attitudes and demographics. Results Most respondents had a moderate level of knowledge (187, 74.8%) and a moderate attitude score (148, 59.2%). In addition, most respondents (149, 59.6%) stated that they take antibiotics based on pharmacist advice only and do not complete the full antibiotic course (200, 80%). A significant association was found between the knowledge level and financial status ( p -value = 0.003), education level ( p -value = 0.001), and having relatives working in the health care sector ( p -value = 0.021). In addition, a significant association was found between the attitude and having health insurance. Conclusion This study provides baseline evidence about the knowledge, attitudes, and practices regarding antibiotics among the Syrian population, that will help in designing targeted interventions to solve the inappropriate use of antibiotics.
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Affiliation(s)
- Abdallah Altorkmani
- Faculty of Medicine, Department of Internal Medicine, Syrian Private University, Damascus, Syria
| | - Mhd Amin Alzabibi
- Faculty of Medicine, Department of Internal Medicine, Syrian Private University, Damascus, Syria
| | - Mosa Shibani
- Faculty of Medicine, Department of Internal Medicine, Syrian Private University, Damascus, Syria
| | - Hlma Ismail
- Faculty of Medicine, Department of Internal Medicine, Syrian Private University, Damascus, Syria
| | - Bisher Sawaf
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Nizar Daher
- Faculty of Medicine, Department of Internal Medicine, Syrian Private University, Damascus, Syria
| | - Ahmad Al-Moujahed
- Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Stanford, California, United States
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11
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Hain G, Goldbart A, Sagi O, Ben-Shimol S. High Rates of Antibiotic Nonsusceptibility in Gram-negative Urinary Tract Infection in Children With Risk Factors Occurring in the Preceding Month: Considerations for Choosing Empiric Treatment. Pediatr Infect Dis J 2021; 40:639-644. [PMID: 33872277 DOI: 10.1097/inf.0000000000003147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Choosing an empiric treatment for urinary tract infections (UTIs) requires epidemiologic data on antibiotic nonsusceptibility (ANS) rates, and risk factors for UTI and ANS in the individual patient. We assessed ANS in community-acquired UTI, and its association with risk factors exposure (previous antibiotic treatment, UTI and hospital visit) <1 month or 1-11 months before the current UTI episode. METHODS This was a retrospective, cohort study. Children <2 years with hospital visits and a positive urine culture obtained <48 hours from hospital admission whose culture yielded Gram-negative bacteria during the years 2015-2016, were included. RESULTS Of the overall 744 episodes, 80% were Escherichia coli. Overall ANS rates were 66% for ampicillin; 27%-29% for amoxicillin/clavulanic acid, cephalosporins (indicating extended-spectrum beta-lactamase) and trimethoprim-sulfamethoxazole; 14% for nitrofurantoin; 5%-6% for gentamicin, ciprofloxacin and piperacillin/tazobactam; and <1% for meropenem and amikacin. Higher ANS rates were associated with Bedouin (vs. Jewish) ethnicity, exposure to risk factors <1 month, and to a lesser extent during the 1-11 months before the studied UTI episode. In episodes with risk factors <1 month, ANS rates were 81% for ampicillin; 47%-58% for amoxicillin/clavulanic acid, cephalosporins and trimethoprim-sulfamethoxazole; 19% for nitrofurantoin; 12%-23% for gentamicin, ciprofloxacin and piperacillin/tazobactam; and 2% for meropenem and amikacin. CONCLUSIONS Previous antibiotic treatment, hospital admission and UTI, especially <1 month before the current episode, and Bedouin ethnicity, were all associated with high rates of ANS. These findings are important and may assist the treating physician in choosing an adequate empiric treatment for UTI.
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Affiliation(s)
- Gavriel Hain
- From the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Pediatrics Department, Soroka University Medical Center, Beer Sheva, Israel
- Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Aviv Goldbart
- From the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Pediatrics Department, Soroka University Medical Center, Beer Sheva, Israel
| | - Orli Sagi
- From the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Microbiology Laboratory, Soroka University Medical Center, Beer Sheva, Israel
| | - Shalom Ben-Shimol
- From the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer Sheva, Israel
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12
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Bulabula ANH, Dramowski A, Mehtar S. Antibiotic use in pregnancy: knowledge, attitudes and practices among pregnant women in Cape Town, South Africa. J Antimicrob Chemother 2021; 75:473-481. [PMID: 31637418 DOI: 10.1093/jac/dkz427] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 09/09/2019] [Accepted: 09/13/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To establish the knowledge, attitudes and practices (KAP) regarding antibiotic use and self-medication among pregnant women. METHODS We conducted a KAP survey of 301 pregnant women hospitalized at a tertiary hospital obstetric service in Cape Town, South Africa in November and December 2017, using an interviewer-administered 12 item questionnaire. We stratified analysis of attitudes and practices by participants' mean knowledge score (K-score) group (<6 versus ≥6 out of 7 questions). Multivariate models were built to identify independent predictors of antibiotic self-medication and K-score. RESULTS The mean age of pregnant women was 29 (SD 6.1) years, 44/247 (17.8%) were nulliparous, 69/247 (27.9%) were HIV-infected, 228/247 (92.3%) had completed secondary school and 78/247 (31.6%) reported a monthly household income in the lowest category of ≤50-100 US dollars (USD). The mean K-score was 6.1 (SD 1.02) out of 7 questions. Sixteen percent of the cohort reported antibiotic self-medication, with higher rates among pregnant women with K-score <6 [18/48 (37.5%) versus 32/253 (12.6%); P<0.001]. The monthly household income category of >500 USD (the highest category) was the only predictor of antibiotic self-medication behaviour [adjusted OR=6.4 (95% CI 1.2-35.2), P=0.03]. CONCLUSIONS Higher antibiotic knowledge scores are associated with lower rates of antibiotic self-medication, whereas higher household income is correlated with increasing self-medication behaviours. Education of pregnant women regarding the potential dangers of antibiotic self-medication and stricter enforcement of existing South African antibiotic prescribing and dispensing regulations are needed.
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Affiliation(s)
- Andre N H Bulabula
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Infection Control Africa Network-ICAN, Cape Town, South Africa
| | - Angela Dramowski
- Infection Control Africa Network-ICAN, Cape Town, South Africa.,Paediatric Infectious Diseases, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
| | - Shaheen Mehtar
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Infection Control Africa Network-ICAN, Cape Town, South Africa
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13
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Shebehe J, Ottertun E, Carlén K, Gustafson D. Knowledge about infections is associated with antibiotic use: cross-sectional evidence from the health survey Northern Ireland. BMC Public Health 2021; 21:1041. [PMID: 34078338 PMCID: PMC8170648 DOI: 10.1186/s12889-021-11018-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 05/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Antibiotic overuse is the main modifiable driver of antibiotic resistance. Factors associated with overuse have been inconsistently reported and vary across populations. Given the burgeoning occurrence of infectious diseases around the world, there remains a great need to identify barriers and solutions to the control of infections. We examined whether knowledge about infections and antibiotic resistance is associated with antibiotic use in a northern European population sample. METHODS The Health Survey Northern Ireland 2014/15 was completed by a cross-sectional sample of 4135 participants aged > 16 years. Participants were asked whether they had taken an antibiotic in the past 12 months; and six questions were asked concerning knowledge about infections and antibiotic resistance. Correct answers to the six knowledge questions defined a knowledge score (score range 0-6 correct answers). We used multivariable logistic regression to estimate odds of self-reported antibiotic use during the last 12 months in association with knowledge score (lowest score, 0/6, as referent), and response to each knowledge question. Covariates included sex, age group, smoking, alcohol drinking, deprivation index, self-rated health, and satisfaction with life. Results were outputted as Odds Ratios (OR) and 95% Confidence Intervals (CI). RESULTS Antibiotic use in the past 12 months was reported by 39.0% (1614/4135); and 84.2% (3482/4135) scored < 6/6 correct on knowledge statements. Compared to the lowest knowledge score (0/6 correct), the highest knowledge score (6/6 correct) was associated with higher odds of antibiotic use (adjusted OR 2.03, 95% CI [1.46, 2.81], p < 0.001), with a P-value < 0.001 for trend with increasing knowledge score. Female sex, age, high deprivation, and poor general health, were independently associated with higher odds of antibiotic use. Stratified analyses showed sex and age group differences. CONCLUSION Knowledge, and other modifiable and non-modifiable risk factors, were positively associated with antibiotic use in the past 12 months. While the causal direction of these associations could not be determined, given the high prevalence of lesser knowledge, as well as independent contributions of other factors including socioeconomic characteristics, health literacy campaigns to raise awareness of antibiotic resistance should take a multi-pronged approach.
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Affiliation(s)
- J Shebehe
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
| | - E Ottertun
- School of Health Sciences, University of Skövde, Skövde, Sweden
| | - K Carlén
- School of Health Sciences, University of Skövde, Skövde, Sweden
| | - D Gustafson
- School of Health Sciences, University of Skövde, Skövde, Sweden
- Department of Neurology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
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14
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Bianco A, Licata F, Zucco R, Papadopoli R, Pavia M. Knowledge and practices regarding antibiotics use: Findings from a cross-sectional survey among Italian adults. EVOLUTION MEDICINE AND PUBLIC HEALTH 2020; 2020:129-138. [PMID: 32983538 PMCID: PMC7502262 DOI: 10.1093/emph/eoaa028] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/23/2020] [Indexed: 12/20/2022]
Abstract
Background and objectives This study aimed to assess the knowledge on antibiotics and antimicrobial resistance (AMR) and the antibiotic use among the general public in Southern Italy and to analyze whether sociodemographic characteristics could be associated with poor knowledge and improper practices. Methodology From March to November 2019, a face-to-face interview was conducted with adult subjects attending the waiting room of 27 randomly selected general practitioners (GPs) in Southern Italy. The questionnaire covered sociodemographic characteristics, knowledge on antibiotics and AMR and practices regarding the consumption of and self-medication with antibiotics. Results The response rate was 89.7%. In the sample, 29.2% thought that antibiotics are effective for viral infections, and 49.5% correctly recognized the definition of AMR. Predictors of good knowledge about antibiotics and AMR were female gender and a higher education level. Almost half of the respondents had used antibiotics in the previous year and 23.6% took antibiotics to treat a common cold and/or fever. Among participants, 25.5% reported to have bought antibiotics without a prescription, and 30.6% were classified as antibiotic self-medication users. Use of antibiotics in the previous 12 months and having taken an antibiotic after a phone consultation with the GP were positively associated with both antibiotic use for a common cold and/or fever and self-medication with antibiotics. Conclusions and implications The findings of this study highlighted a considerable antibiotic consumption in the adult population of Southern Italy together with misconceptions regarding the correct indication for antibiotic use that could foster indiscriminate antibiotic use. Lay Summary The findings of this study highlighted a considerable antibiotic consumption in the adult Italian population together with misconceptions regarding the correct indication for antibiotic use that could foster indiscriminate antibiotic use. Almost a quarter of the respondents took antibiotics to treat a common cold and/or fever and reported to have bought antibiotics without a prescription.
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Affiliation(s)
- Aida Bianco
- Department of Health Sciences, School of Medicine, University of Catanzaro Magna Græcia, Catanzaro 88100, Italy
| | - Francesca Licata
- Department of Health Sciences, School of Medicine, University of Catanzaro Magna Græcia, Catanzaro 88100, Italy
| | - Rossella Zucco
- Department of Health Sciences, School of Medicine, University of Catanzaro Magna Græcia, Catanzaro 88100, Italy
| | - Rosa Papadopoli
- Department of Health Sciences, School of Medicine, University of Catanzaro Magna Græcia, Catanzaro 88100, Italy
| | - Maria Pavia
- Department of Health Sciences, School of Medicine, University of Catanzaro Magna Græcia, Catanzaro 88100, Italy.,Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples 80138, Italy
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15
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Antwi AN, Stewart A, Crosbie M. Fighting antibiotic resistance: a narrative review of public knowledge, attitudes, and perceptions of antibiotics use. Perspect Public Health 2020; 140:338-350. [PMID: 32515278 DOI: 10.1177/1757913920921209] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
AIMS The aims of this study were to ascertain the comprehensive knowledge, perceptions, and attitudes of people from varying socioeconomic regions towards antibiotic use; identify the misperceptions and malpractices; and inform health policy and practice. METHOD EBSCO host databases, PubMed, and Google Scholar were searched to obtain relevant primary research papers within the years 2010-2018. Search phrases included the following: 'antibiotics use', 'community perceptions', 'public opinion, knowledge, behaviour, practices, perceptions'. Initially, selected papers were screened using the Preview, Question, Read, Summarize (PQRS) model. RESULTS Review of the 20 articles selected was based on six identified themes. It was found that insufficient knowledge and awareness of antibiotics use; self-medication and the use of leftover antibiotics; treating viral diseases with antibiotics or used as painkillers; expecting antibiotic prescription as a culmination of consultation; and the credibility of information obtained are issues that cut across different countries. CONCLUSION Evidence from this review suggests that misconceptions of antibiotic use are similar in different countries. Therefore, the need for the development and implementation of transferable policies as well as educating the public is necessary for the fight against ABR.
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Affiliation(s)
- A N Antwi
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK.,Parasitology Department, Noguchi Memorial Institute for Medical Research, P.O. Box LG 581, Legon, Accra, Ghana
| | - A Stewart
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - Michelle Crosbie
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, UK
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CJEM Debate Series: #ChoosingWisely - The Choosing Wisely campaign will not impact physician behaviour and choices. CAN J EMERG MED 2020. [PMID: 29534784 DOI: 10.1017/cem.2017.402] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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17
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Craddock HA, Panthi S, Rjoub Y, Lipchin C, Sapkota A, Sapkota AR. Antibiotic and herbicide concentrations in household greywater reuse systems and pond water used for food crop irrigation: West Bank, Palestinian Territories. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 699:134205. [PMID: 33736191 DOI: 10.1016/j.scitotenv.2019.134205] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/29/2019] [Accepted: 08/29/2019] [Indexed: 06/12/2023]
Abstract
Greywater is increasingly treated and reused for agricultural irrigation in off-grid communities in the Middle East and other water scarce regions of the world. However, there is a dearth of data regarding levels of antibiotics and herbicides in off-grid greywater treatment systems. To address this knowledge gap, we evaluated levels of these contaminants in two types of greywater treatment systems on four farms in the West Bank, Palestinian Territories. Samples of household greywater (influent, n = 23), treated greywater effluent intended for agricultural irrigation (n = 23) and pumped groundwater held in irrigation water ponds (n = 12) were collected from October 2017 to June 2018. Samples were analyzed using high performance liquid chromatography tandem mass spectrometry (LC-MS/MS) for the following antibiotics and herbicides: alachlor, ampicillin, atrazine, azithromycin, ciprofloxacin, erythromycin, linezolid, oxacillin, oxolinic acid, penicillin G, pipemidic acid, sulfamethoxazole, triclocarban, tetracycline, triflualin, and vancomycin. All tested antibiotics and herbicides were detected in greywater influent samples at concentrations ranging from 1.3 to 1592.9 ng/L and 3.1-22.4 ng/L, respectively. When comparing influent to effluent concentrations, removal was observed for azithromycin, alachlor, linezolid, oxacillin, penicillin G, pipemidic acid, sulfamethoxazole, triclocarban, and vancomycin. Removal was not observed for atrazine, ciprofloxacin, erythromycin, oxolinic acid, tetracycline, and trifluralin. Pond water also contained the majority of tested contaminants, but at generally lower concentrations. To our knowledge, this is the first description of an extensive array of antibiotics and herbicides detected in household greywater from off-grid treatment systems.
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Affiliation(s)
- Hillary A Craddock
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Suraj Panthi
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Younes Rjoub
- Arava Institute for Environmental Studies, Ketura, Israel
| | - Clive Lipchin
- Arava Institute for Environmental Studies, Ketura, Israel
| | - Amir Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
| | - Amy R Sapkota
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
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Nepal A, Hendrie D, Robinson S, Selvey LA. Knowledge, attitudes and practices relating to antibiotic use among community members of the Rupandehi District in Nepal. BMC Public Health 2019; 19:1558. [PMID: 31771595 PMCID: PMC6880381 DOI: 10.1186/s12889-019-7924-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 11/08/2019] [Indexed: 11/23/2022] Open
Abstract
Background The development of antibiotic resistance is one of the biggest threats to global public health. Inappropriate use of antibiotics is recognised as a leading cause of antibiotic resistance. The aim of this study was to explore the knowledge, attitudes and practices (KAP) towards antibiotic use among adults in Nepal. Methods A quantitative survey was conducted with 220 community members of the Rupandehi district of Nepal, with cluster sampling techniques applied to select households. Interviews were carried out face-to-face using a structured questionnaire. Responses were presented using descriptive analysis, with chi-squared tests and regression analysis applied to identify factors associated with KAP about antibiotic use and the Spearman’s rank order correlation coefficient calculated to examine the relationship between responses to the KAP questions. Results The sample comprised more females (54%) than males, the average age of respondents was 38.5 years and almost 60% of respondents lived in rural areas. Respondents had relatively good knowledge about aspects of antibiotic use other than identifying antibiotics. The concept of antibiotic resistance was well known but imperfectly understood. Half of respondents (50.9%) were unsure whether skipping doses would contribute to the development of antibiotic resistance, 88.2% indicated they would go to another doctor if not prescribed an antibiotic when they thought one was needed and nearly half (47.7%) believed antibiotics helped them get better more quickly if they had a fever. Most respondents reported correct practices accessing and using antibiotics, however, 84.6% at least sometimes preferred an antibiotic when they have a cough and sore throat. Logistic regression showed respondents with higher levels of education tended to have better knowledge, more appropriate attitudes and better practices about antibiotic use. Rural respondents were less likely to have better knowledge about antibiotic use, while females were more likely to report better practices. Conclusion The study provides baseline evidence about the knowledge, attitudes and practices regarding antibiotic use among the population of the Rupandehl district. Its findings will be useful in designing effective and targeted interventions to decrease misconceptions about antibiotic use and to increase awareness about the risks of inappropriate use of antibiotics in the community.
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Affiliation(s)
- Anant Nepal
- School of Public Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Perth, Western Australia, 6102, Australia.
| | - Delia Hendrie
- School of Public Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Perth, Western Australia, 6102, Australia
| | - Suzanne Robinson
- School of Public Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Perth, Western Australia, 6102, Australia
| | - Linda A Selvey
- School of Public Health, The University of Queensland, Herston Rd, Herston, Qld, 4006, Australia
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Chanvatik S, Kosiyaporn H, Lekagul A, Kaewkhankhaeng W, Vongmongkol V, Thunyahan A, Tangcharoensathien V. Knowledge and use of antibiotics in Thailand: A 2017 national household survey. PLoS One 2019; 14:e0220990. [PMID: 31398242 PMCID: PMC6688796 DOI: 10.1371/journal.pone.0220990] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 07/26/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The Thailand National Strategic Plan on Antimicrobial Resistance (AMR) 2017-2021, endorsed by the Thai Cabinet in 2016, aims to increase public knowledge about antibiotics and AMR awareness by 20% by 2021. This study assesses the prevalence of antibiotics use, clinical indications and sources; knowledge and access to information related to antibiotics and AMR; and factors related to level of knowledge and access to information among Thai adult population. METHODS An AMR module was developed and embedded into the 2017 Health and Welfare Survey; a cross-sectional, two-stage stratified sampling, nationally representative household survey carried out biannually by National Statistical Office. The survey applied a structured interview questionnaire. The survey was conducted in March 2017 where 27,762 Thai adults were interviewed of the AMR module. Data were analyzed using descriptive and inferential statistics. RESULTS The one-month prevalence of antibiotic use was 7.9% for three common conditions; flu (27.0%), fever (19.2%) and sore throat (16.8%). The majority of antibiotics (70.3%) were provided by public or private healthcare facilities, and 26.7% by pharmacies. Thai adults have low levels of knowledge about antibiotics; only 2.6 gave correct answers to all six statements related to antibiotics, while 13.5% gave wrong answers to all six statements. A few factors associated with knowledge and having received information on antibiotics were assessed. People who have higher education levels, and belong to richer wealth quintiles, and receive antibiotics and AMR information have significantly higher levels of knowledge about antibiotics. In the last 12 months, only 17.8% of respondents had heard information about the proper use of antibiotics and AMR; mostly from doctors (36.1%), health workers (24.8%) and pharmacists (17.7%). CONCLUSIONS There is a large gap of public knowledge about the use of antibiotics. The main communication channel is through healthcare professionals, which indicates they are key persons in communicating information about the proper use of antibiotics to the public.
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Affiliation(s)
- Sunicha Chanvatik
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Hathairat Kosiyaporn
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Angkana Lekagul
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Vuthiphan Vongmongkol
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Apichart Thunyahan
- National Statistical Office, Ministry of Information and Communication Technology, Bangkok, Thailand
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Ramchurren K, Balakrishna Y, Mahomed S. Patients’ knowledge, attitudes and practices regarding antibiotic use at a regional hospital in KwaZulu-Natal, South Africa 2017. S Afr J Infect Dis 2018. [DOI: 10.1080/23120053.2018.1516393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- K Ramchurren
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Y Balakrishna
- Biostatistics Unit, South African Medical Research Council, Durban, South Africa
| | - S Mahomed
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
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Yeganeh M, Paritsky M, On A, Azrad M, Roshrosh H, Moalem R, Peretz A. Characteristics of Antibiotic Resistance of Helicobacter pylori Among Adult Arab and Jewish Populations in Northern Israel. Microb Drug Resist 2018; 25:103-107. [PMID: 30129819 DOI: 10.1089/mdr.2018.0148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
AIMS Following reports from various doctors regarding increased treatment failure in Helicobacter pylori infection among the Arab population, we decided to make a prospective comparison between the resistance rates of H. pylori in the Arab and Jewish populations in northern Israel. RESULTS Among the Arab population, higher resistance rates were found for clarithromycin and levofloxacin (LEV), as well as a higher rate of multidrug resistance. Rifampin and LEV were found to have higher resistance rates in the village, whereas LEV had a higher resistance rate among women. CONCLUSIONS Helicobacter pylori in the Arab population compared with the Jewish population in northern Israel is more resistant to treatment. We assume that these results are caused by overexposure combined with unwise use of antibiotics. A correlation was also found between the type of residence and resistance rates to various antibiotics. Further research is needed to determine the resistance mechanism that may explain these results. Due to the high resistance rate and treatment failure, it is appropriate to consider replacing the standard treatment of H. pylori in these populations.
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Affiliation(s)
- Matan Yeganeh
- 1 The Azrieli Faculty of Medicine, Bar-Ilan University , Safed, Israel
| | - Maya Paritsky
- 1 The Azrieli Faculty of Medicine, Bar-Ilan University , Safed, Israel .,2 Gastrointestinal Unit, Baruch Padeh Medical Center, Poriya Affiliated with the Faculty of Medicine, Bar-Ilan University , Galilee, Israel
| | - Avi On
- 1 The Azrieli Faculty of Medicine, Bar-Ilan University , Safed, Israel .,3 Pediatric Gastrointestinal Unit, Baruch Padeh Medical Center, Poriya Affiliated with the Faculty of Medicine, Bar-Ilan University , Galilee, Israel
| | - Maya Azrad
- 4 Clinical Microbiology Laboratory, Baruch Padeh Medical Center , Poriya, Israel
| | - Halim Roshrosh
- 4 Clinical Microbiology Laboratory, Baruch Padeh Medical Center , Poriya, Israel
| | - Rawia Moalem
- 1 The Azrieli Faculty of Medicine, Bar-Ilan University , Safed, Israel .,5 Gastrointestinal Unit, Holy Family Hospital , Nazareth, Israel
| | - Avi Peretz
- 1 The Azrieli Faculty of Medicine, Bar-Ilan University , Safed, Israel .,4 Clinical Microbiology Laboratory, Baruch Padeh Medical Center , Poriya, Israel
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Al Baz M, Law MR, Saadeh R. Antibiotics use among Palestine refugees attending UNRWA primary health care centers in Jordan - A cross-sectional study. Travel Med Infect Dis 2018; 22:25-29. [PMID: 29458088 DOI: 10.1016/j.tmaid.2018.02.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 02/09/2018] [Accepted: 02/13/2018] [Indexed: 11/28/2022]
Abstract
The irrational use of antibiotics is increasing in Jordanian refugee camps and consequently so too is bacterial resistance. About one-third of health expenditures at UNRWA health centers in Jordan are attributed to antibiotics. OBJECTIVE We studied knowledge, attitude and behaviour of Palestine refugees attending UNRWA health centers in Jordan regarding antibiotic use in order to plan public health interventions accordingly. METHODS A cross-sectional, interviewer-administered survey among 250 adult Palestine refugees at four different health centers was conducted. RESULTS Irrational antibiotic use was widespread: 63% of patients share antibiotics at home, 38% use left-over antibiotics and 60% purchase antibiotics directly from the pharmacy without prescription (OTC) .1 At the same time, knowledge about antibiotics side effects, resistance, and target agent was low. 90% of patients trust their doctor, however long waiting hours prevent them from seeking medical advice, which significantly increased self-medication. CONCLUSIONS Our findings suggest a strong need for public education about antibiotics. In addition, health institutional level improvements such as shorter waiting hours and strict regulations prohibiting dispensing without prescription are necessary to combat growing bacterial resistance.
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Affiliation(s)
- Maysun Al Baz
- Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, Germany.
| | - Michael R Law
- Centre for Health Services and Policy Research, School of Population and Public Health, The University of British Columbia, Vancouver, Canada
| | - Rawan Saadeh
- United Nations Relief and Works Agency for Palestine Refugees in the Near East, UNRWA HQ (A), Amman, Jordan
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