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Elkhadry SW, Tahoon MAH. Health literacy and its association with antibiotic use and knowledge of antibiotic among Egyptian population: cross sectional study. BMC Public Health 2024; 24:2508. [PMID: 39285352 PMCID: PMC11403963 DOI: 10.1186/s12889-024-19668-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 07/31/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND High prevalence of inappropriate antibiotic use in different sectors of the community indicates a possible strong influence of social and cultural context, which may be influenced by social determinants of health and thereby affecting individuals' health-related behavior, including antibiotic use. And such health-related behavior is largely determined by individuals' health literacy. OBJECTIVE The purpose of this research was to examine the relationship between the Egyptian population's health literacy, antibiotic use, and antibiotic knowledge. METHOD In Egypt, researchers used a cross-sectional study design, between the period of January and March 2024 using validated questionnaires and recruited a convenient sample of adults from seven governorates representing different geographic areas, and socioeconomic and educational backgrounds with the help of the validated questionnaires the HLS-EU-Q16, a shortened version of the European Health Literacy Survey Questionnaire (derived from the World Health Organization's Antibiotic Resistance: Multi-Country Public Awareness Survey) and, familiarity with drugs and understanding of antibiotic resistance via online methods and face-to-face interviews. RESULTS The survey included a participation of 500 persons in total. The participants' age distribution indicated that 28.8% (n = 144) were aged 18-24, while 27.4% (n = 137) were within the 25-34 age group. Moreover, a total of 274 participants, accounting for 54.8% of the sample, described themselves as female. Significantly, 60.7% of the patients indicated acquiring antibiotics without a prescription. The evaluation of health literacy (HL) levels among the participants revealed that 36.2% had problematic HL, while 8.4% showed inadequate HL. A strong positive link was found between the scores of antibiotic knowledge and the scores of HL (R = 0.876; P-value = 0.001). CONCLUSION Overall, it is imperative to implement awareness-raising curricula and public health education initiatives without delay. Furthermore, it is highly advised to implement public health awareness initiatives about the appropriate use of antibiotics, alongside national policies aimed at regulating the availability and prescription of antibiotics.
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Affiliation(s)
- Sally Waheed Elkhadry
- Department of Epidemiology and Preventive Medicine, National Liver Institute, Menoufia University, Menoufia, Egypt.
| | - Marwa Ali Haseeb Tahoon
- Department of Epidemiology and Preventive Medicine, National Liver Institute, Menoufia University, Menoufia, Egypt
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Kampamba M, Hamaambo B, Hikaambo CN, Mwanza B, Bambala A, Mutenda M, Mukumbuta JM, Mudenda S. Evaluation of knowledge and practices on antibiotic use: a cross-sectional study on self-reported adherence to short-term antibiotic utilization among patients visiting level-1 hospitals in Lusaka, Zambia. JAC Antimicrob Resist 2024; 6:dlae120. [PMID: 39035016 PMCID: PMC11258577 DOI: 10.1093/jacamr/dlae120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Accepted: 07/05/2024] [Indexed: 07/23/2024] Open
Abstract
Background Antimicrobial resistance (AMR) is a global public health problem affecting healthcare systems. Short-term antibiotic non-adherence is thought to be one of the factors contributing to antibiotic resistance. This study aimed to evaluate knowledge and practices towards short-term antibiotic use on self-reported adherence among patients visiting level-1 hospitals in Lusaka, Zambia. Methods This was a multicentre institutional-based cross-sectional study conducted among 385 adult participants from 11 September to 30 September 2023 using an adopted structured questionnaire. Analysis of the data involved descriptive and inferential statistics, where significance was determined at P < 0.05. Results Of the 335 participants, 56.7% displayed good knowledge and 77.3% low adherence towards antibiotic use. 54.6% thought that antibiotics were effective for viral infections, and 43.9% correctly recognized the definition of AMR. Being in formal employment (crude OR: 2.5, CI: 1.08-5.78, P: 0.032) was significantly associated with a higher likelihood of good knowledge about antibiotics while being divorced (adjusted OR: 2.5, CI: 1.23-6.10, P: 0.013) and having good knowledge (adjusted OR: 2.9, CI: 1.73-5.10, P = 0.048) were significantly associated with a higher likelihood of adherence to antibiotics. Regarding antibiotic practices, half (50. 0%) of the respondents had utilized antibiotics in the previous year while 58.2% had taken antibiotics for addressing a common cold. Furthermore, 74% reported to have bought antibiotics without a prescription. Conclusions This study found that participants attending level-1 hospitals had relatively good knowledge and poor adherence towards antibiotic use. Additionally, the participants demonstrated poor antibiotic use practices in almost all statements related to antibiotic usage.
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Affiliation(s)
- Martin Kampamba
- Department of Pharmacy, School of Health Sciences, University of Zambia, P.O Box 50110, Lusaka, Zambia
| | - Bubala Hamaambo
- Department of Pharmacy, School of Pharmacy, Eden University, Lusaka, Zambia
| | | | - Boris Mwanza
- Department of Pharmacy, School of Pharmacy, Eden University, Lusaka, Zambia
| | - Andrew Bambala
- Department of Pharmacy, University Teaching Hospitals, Lusaka, Zambia
| | - Mukumbi Mutenda
- Department of Pharmacy, University Teaching Hospitals, Lusaka, Zambia
| | - Jean M Mukumbuta
- Department of Pharmacy, Livingstone University Teaching Hospital, Livingstone, Zambia
| | - Steward Mudenda
- Department of Pharmacy, School of Health Sciences, University of Zambia, P.O Box 50110, Lusaka, Zambia
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Wojcik G, Afseth J, Fagan R, Thomson F, Ring N. Patient and public understanding of antimicrobial resistance: a systematic review and meta-ethnography. JAC Antimicrob Resist 2024; 6:dlae117. [PMID: 39114563 PMCID: PMC11303694 DOI: 10.1093/jacamr/dlae117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 07/05/2024] [Indexed: 08/10/2024] Open
Abstract
Objectives To further develop an understanding of laypeople's (adult patients and public) beliefs and attitudes toward antimicrobial resistance (AMR) by developing a conceptual model derived from identifying and synthesizing primary qualitative research. Methods A systematic search of 12 electronic databases, including CINAHL, MEDLINE, PsycINFO, PubMed and Web of Science to identify qualitative primary studies exploring patient and public understanding of AMR published between 2012 and 2022. Included studies were quality appraised and synthesized using Noblit and Hare's meta-ethnographic approach and reported using eMERGe guidance. Results Thirteen papers reporting 12 qualitative studies were synthesized. Studies reported data from 466 participants aged 18-90 years. Five themes were identified from these original studies: the responsible patient; when words become meaningless; patient-prescriber relationship; past experience drives antibiotic use; and reframing public perception. These themes supported the development of a conceptual model that illustrates the tension between two different assumptions, that is, how can antibiotics be used for the collective good whilst balancing the immediate needs of individual patients. Conclusions Findings suggest that AMR is a distinct ethical issue and should not be viewed purely as a prescribing problem. The meta-ethnography-generated conceptual model illustrates many factors affecting the public's perception of AMR. These include laypeople's own knowledge, beliefs and attitudes around antibiotic use, the relationship with the healthcare provider and the wider context, including the overwhelming influence of the media and public health campaigns. Future research is needed to explore effective health messaging strategies to increase laypeople's baseline awareness of AMR as a public threat.
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Affiliation(s)
- Gosha Wojcik
- School of Health and Social Care, Edinburgh Napier University, 9 Sighthill Court, Edinburgh, EH11 4BN, UK
| | - Janyne Afseth
- School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Aberdeen, Garthdee House Garthdee Road, Aberdeen, AB10 7QG, UK
| | - Ross Fagan
- School of Health and Social Care, Edinburgh Napier University, 9 Sighthill Court, Edinburgh, EH11 4BN, UK
| | - Fiona Thomson
- School of Health and Social Care, Edinburgh Napier University, 9 Sighthill Court, Edinburgh, EH11 4BN, UK
| | - Nicola Ring
- School of Health and Social Care, Edinburgh Napier University, 9 Sighthill Court, Edinburgh, EH11 4BN, UK
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Mannan A, Chakma K, Dewan G, Saha A, Chy NUHA, Mehedi HMH, Hossain A, Wnaiza J, Ahsan MT, Rana MM, Alam N. Prevalence and determinants of antibiotics self-medication among indigenous people of Bangladesh: a cross-sectional study. BMJ Open 2024; 14:e071504. [PMID: 38448060 DOI: 10.1136/bmjopen-2022-071504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVES Self-medication with antibiotics (SMA) contributes significantly to the emergence of antimicrobial resistance (AMR), especially in low-income countries including Bangladesh. This study aimed to generate evidence on the self-reported prevalence of antibiotic self-medication and its determinants among indigenous people residing in Bangladesh's Chittagong Hill Tracts (CHT) districts. DESIGN This study used a cross-sectional design with data collected through a survey using a semi-structured questionnaire. SETTING This study was conducted from late January to early July 2021; among different indigenous group populations aged 18 years or more olders residing in the three districts of CHT. PARTICIPANTS A total of 1336 indigenous people residing in Bangladesh's CHT districts were included. PRIMARY OUTCOME AND EXPLANATORY VARIABLES The primary outcome measure was SMA while explanatory variables were socio-demographic characteristics, health status of participants, and knowledge of antibiotics usage and its side effects. RESULTS Among the study participants, more males (60.54%) than females (51.57%) reported using antibiotics. The SMA rate was high among individuals with education levels below secondary (over 50%) and those in the low-income group (55.19%). The most common diseases reported were cough, cold and fever, with azithromycin being the most frequently used antibiotic. Levels of education, family income, having a chronic illness and place of residence were found to be the significant predictors of having good knowledge of antibiotic use as found in the ordered logit model. Findings from a logistic regression model revealed that men had 1.6 times higher odds (adjusted OR (AOR) 1.57; 95% CI 1.12 to 2.19) of SMA than women. Participants with ≥US$893 per month family income had lowest odds (AOR 0.14; 95% CI 0.03 to 0.64) of SMA than those who earned CONCLUSION Male gender, family income, place of residence and knowledge of antibiotics were the significant predictors of antibiotic self-medication. Hence, it is important to streamline awareness-raising campaigns at the community level to mitigate the practice of SMA in indigenous people and ultimately address the devastating effects of Antimicrobial resistance (AMR) in Bangladesh.
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Affiliation(s)
- Adnan Mannan
- Department of Genetic Engineering & Biotechnology, University of Chittagong, Chattogram, Bangladesh
- Disease Biology and Molecular Epidemiology Research Group (dBme), Chattogram, Bangladesh
| | - Kallyan Chakma
- Department of Genetic Engineering & Biotechnology, University of Chittagong, Chattogram, Bangladesh
- Disease Biology and Molecular Epidemiology Research Group (dBme), Chattogram, Bangladesh
| | - Gourab Dewan
- Department of Medicine, Rangamati Medical College, Rangamati, Bangladesh
| | - Ayan Saha
- Department of Bioinformatics & Biotechnology, Asian University for Women, Chattogram, Bangladesh
| | | | | | - Amzad Hossain
- Department of Genetic Engineering & Biotechnology, Jagannath University, Dhaka, Bangladesh
| | - Jannatun Wnaiza
- Department of Biochemistry & Biotechnology, University of Science and Technology Chittagong, Chattogram, Bangladesh
| | - Md Tanveer Ahsan
- Department of Pharmacy, University of Chittagong, Chattogram, Bangladesh
| | - Md Mashud Rana
- Disease Biology and Molecular Epidemiology Research Group (dBme), Chattogram, Bangladesh
- Department of Pharmacology and Therapeutics, Chittagong Medical College, Chattogram, Bangladesh
| | - Nazmul Alam
- Department of Public Health, Asian University for Women, Chattogram, Bangladesh
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Islam MW, Shahjahan M, Azad AK, Hossain MJ. Factors contributing to antibiotic misuse among parents of school-going children in Dhaka City, Bangladesh. Sci Rep 2024; 14:2318. [PMID: 38282010 PMCID: PMC10822859 DOI: 10.1038/s41598-024-52313-y] [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: 09/24/2023] [Accepted: 01/17/2024] [Indexed: 01/30/2024] Open
Abstract
Antimicrobial resistance (AMR) is a pressing global health concern, especially in resource-constrained countries, such as Bangladesh. This study aimed to identify the factors contributing to antibiotic misuse by assessing knowledge, attitude, and practice (KAP). A cross-sectional study was conducted from August 20 to August 30, 2022, among 704 parents of school-going children in Dhaka South City. Descriptive statistics were used to analyze the KAP, and multivariate models, including linear and ordinal logistic regression, were used to explore the associations between these factors. The findings revealed that approximately 22% of the participants were male and 78% were female. Most parents (58%) had completed higher secondary education. Approximately 45% of the respondents demonstrated moderate knowledge, 53% had uncertain attitudes, and 64% exhibited antibiotic misuse. Factors such as parental age, education level, employment status, income, child's age, and family type significantly influenced KAP. These findings emphasize the importance of targeted education and awareness initiatives to enhance knowledge and responsible antibiotic use among parents, contributing to global efforts against antibiotic resistance. The government should enforce laws and regulations regarding the misuse of antibiotics.
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Affiliation(s)
- Md Wahidul Islam
- Population Health Studies Division, Center for Health Innovation, Research, Action, and Learning-Bangladesh (CHIRAL Bangladesh), 9-10 Chittaranjan Ave, Dhaka, 1100, Bangladesh
| | - Muhibullah Shahjahan
- Population Health Studies Division, Center for Health Innovation, Research, Action, and Learning-Bangladesh (CHIRAL Bangladesh), 9-10 Chittaranjan Ave, Dhaka, 1100, Bangladesh
| | - Abul Kalam Azad
- Department of Microbiology, Jagannath University, 9-10 Chittaranjan Ave, Dhaka, 1100, Bangladesh
| | - Md Jubayer Hossain
- Population Health Studies Division, Center for Health Innovation, Research, Action, and Learning-Bangladesh (CHIRAL Bangladesh), 9-10 Chittaranjan Ave, Dhaka, 1100, Bangladesh.
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Bergsholm YKR, Feiring M, Charnock C, Krogstad T, Holm LB. Positioning of community pharmacists in interactions with general practitioners and patients regarding prescribing and using antibiotics. J Interprof Care 2023; 37:886-895. [PMID: 37161732 DOI: 10.1080/13561820.2023.2203698] [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: 03/28/2022] [Revised: 01/12/2023] [Accepted: 04/06/2023] [Indexed: 05/11/2023]
Abstract
Interprofessional collaboration between general practitioners (GPs) and community pharmacists (CPs) is important for ensuring antibiotics are used correctly and combating antibiotic resistance. The study's main objective was to investigate how CPs, GPs and patients, respectively, position CPs in their interactions with patients on antibiotic-related matters in Norwegian pharmacies. Seven focus-group interviews were performed. Data were analyzed using systematic text condensation. Positioning theory was used to identify positions assigned to CPs by themselves, by GPs and by patients. CPs position themselves as helpful, accessible drug specialists responsible for advising on antibiotic use, but also consider themselves dependent on GP-supplied information to do so. GPs position CPs as helpful, responsible businesspeople who, however, lack clinical experience and are overzealous gatekeepers. Patients position CPs as helpful people who supply information in "everyday language" and as the GP's extended arm. Patients utter they are best served when GPs and CPs collaborate. This discrepancy is a barrier to optimal service to patients in general, and to proper antibiotic use in particular.
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Affiliation(s)
| | - Marte Feiring
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Colin Charnock
- Department of Life Sciences and health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Tonje Krogstad
- Department of Life Sciences and health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lene Berge Holm
- Department of Life Sciences and health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Centre for Connected Care, Oslo University Hospital, Oslo, Norway
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Akande-Sholabi W, Oyesiji E. Antimicrobial stewardship: knowledge, perceptions, and factors associated with antibiotics misuse among consumer's visiting the community pharmacies in a Nigeria Southwestern State. J Pharm Policy Pract 2023; 16:120. [PMID: 37821920 PMCID: PMC10566051 DOI: 10.1186/s40545-023-00629-x] [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: 07/28/2023] [Accepted: 09/30/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND In middle-income countries like Nigeria, the misuse of antibiotics by consumers is posing serious threats to public health. This is contributing to the alarming increase in antimicrobial resistance, which is reducing the effectiveness of antibiotics against common infections. This study therefore aimed to assess the knowledge, perceptions, and factors associated with antibiotics misuse among consumers visiting selected community pharmacies. METHODS This cross-sectional study conducted in Ibadan, Nigeria, aimed at determining factors influencing antibiotics misuse among consumers. The questionnaires were completed by 509 consumers. The analysis was done using SPSS version 26 and the results were presented using descriptive statistics. The associations between categorical variables were analysed using Pearson's Chi-square with statistical significance set at p < 0.05. RESULTS Results showed that 95.9% of the consumers believed that antibiotics prevent bacterial growth, and 60.7% thought they treat all infections. However, 57.4% were unaware of antibiotic resistance, while only 14.7% had adequate knowledge about antibiotics. Most of the consumers, 72.5% had used antibiotics in the last 12 months and, amoxicillin 42.4% was the most commonly used with, malaria 38.9% as the primary condition for which antibiotics were used. Some of the significant factors influencing antibiotics misuse included delays in test reports (p-value = 0.007), the belief in antibiotics' quick relief (p-value = 0.001), proximity of the pharmacy to their house or workplace (p-value = 0.028), amongst others. CONCLUSION Most of the consumers had inadequate knowledge about rational antibiotic use which contributed to their misuse of antibiotics. Thus, targeted educational interventions are needed to improve knowledge and promote appropriate antibiotic use among consumers. Policies regulating the dispensing and selling of antibiotics with adequate counselling should be further enforced.
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Affiliation(s)
- Wuraola Akande-Sholabi
- Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria.
| | - Eunice Oyesiji
- Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
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Pennino F, Maccauro ML, Sorrentino M, Gioia M, Riello S, Messineo G, Di Rosa C, Montuori P, Triassi M, Nardone A. Insights from a Cross-Sectional Study on Knowledge, Attitudes and Behaviors Concerning Antibiotic Use in a Large Metropolitan Area: Implications for Public Health and Policy Interventions. Antibiotics (Basel) 2023; 12:1476. [PMID: 37887177 PMCID: PMC10603846 DOI: 10.3390/antibiotics12101476] [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: 08/19/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023] Open
Abstract
The overuse and inappropriate use of antibiotics pose a grave threat to public health, contributing significantly to the accelerated development of antimicrobial resistance (AMR) and increased rates of morbidity and mortality, making it a leading cause of death globally. To examine the relationship between demographic variables and knowledge, attitudes, and behaviors concerning antibiotic use, a survey-based cross-sectional study was conducted involving 1158 individuals. The questionnaire included two sections: in the first section, participants' socio-demographic characteristics were analyzed; the second investigated knowledge, attitudes, and behaviors concerning antibiotics utilization using a total of 36 questions. Descriptive statistics were used, and then a multiple linear regression analysis (MLRA) using three models was carried out. In Model I, knowledge about antibiotics exhibited correlations with smoking habits and educational attainment. In Model II, attitudes were significantly associated with gender, smoking habits, age, education, relationship status, and knowledge. In Model III, behaviors related to antibiotics were correlated with educational attainment, having children, knowledge, and attitudes. Implementing tailored public health programs could be a cost-effective intervention to enhance behaviors associated with antibiotic use in the general population. This study offers valuable insights into the determinants of knowledge, attitudes, and behaviors regarding antibiotics in the general population.
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Affiliation(s)
- Francesca Pennino
- Department of Public Health, “Federico II” University, Via Sergio Pansini nº 5, 80131 Naples, Italy
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Niyomyart A, Chow SKY, Bualoy W, Butsing N, Tao X, Zhu X. Antibiotic Knowledge, Antibiotic Resistance Knowledge, and Antibiotic Use: A Cross-Sectional Study among Community Members of Bangkok in Thailand. Antibiotics (Basel) 2023; 12:1312. [PMID: 37627731 PMCID: PMC10451775 DOI: 10.3390/antibiotics12081312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/05/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
This study aimed to explore antibiotic knowledge, antibiotic resistance knowledge, and antibiotic use among adults in Bangkok, Thailand. This is a secondary analysis of cross-sectional data generated from a sample of 161 individuals living in Bangkok. Participants completed an online self-administered questionnaire developed by the World Health Organization. Descriptive analysis, the chi-square test, and multiple logistic regression analyses were performed. The sample comprised more females (56.5%) than males (42.2%). The majority of responders (67.7%) were between the ages of 18 and 40. More than half of the respondents mistakenly believed that antibiotics could treat colds and flu (54.7% and 47.2%, respectively). About 54.7% were aware that antibiotic resistance could harm them and their families. The chi-square test results showed that the levels of education were associated with antibiotic knowledge (p = 0.012), antibiotic resistance knowledge (p < 0.001), and antibiotic use (p = 0.023). Multiple logistic regressions showed that respondents with at least a bachelor's degree or higher had better knowledge of antibiotics. Respondents who worked in the profession had better knowledge of antibiotic resistance. Respondents with sufficient incomes were more likely to use antibiotics. Baseline data from the study will be useful in antibiotic stewardship and public health campaigns among Bangkok residents.
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Affiliation(s)
- Atsadaporn Niyomyart
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; (W.B.); (N.B.)
| | - Susan Ka Yee Chow
- Faculty of Medicine, Macau University of Science and Technology, Macau SAR, China;
| | - Wunwisa Bualoy
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; (W.B.); (N.B.)
| | - Nipaporn Butsing
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; (W.B.); (N.B.)
| | - Xingjuan Tao
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China;
| | - Xuejiao Zhu
- School of Nursing, Hangzhou Normal University, Hangzhou 311121, China;
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Lajunen TJ, Sullman MJM, Baddal B, Tekeş B, Apostolou M. Antibiotics Knowledge, Attitudes and Behaviours among the Population Living in Greece and Turkey. Antibiotics (Basel) 2023; 12:1279. [PMID: 37627699 PMCID: PMC10451639 DOI: 10.3390/antibiotics12081279] [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: 06/22/2023] [Revised: 07/25/2023] [Accepted: 08/01/2023] [Indexed: 08/27/2023] Open
Abstract
Antimicrobial resistance is one of the largest threats to public health worldwide. As the inappropriate use of antibiotics is one of the leading causes of antibiotic resistance, it is important to have an understanding of the public's knowledge, attitudes and behaviours towards antibiotics and antimicrobial resistance. The present study investigated the knowledge, attitudes and behaviours towards antibiotics among the public living in Greece and Turkey using an online cross-sectional survey, with social media advertising (e.g., Facebook) and snowball sampling. In total, 709 individuals completed the survey (Greece n = 309, Turkey n = 400), with an average age of 34.2 (SD = 13.1) and 40.5 (SD = 14.7), respectively. In Greece, 49.4% of the participants were female, and in Turkey, this figure was 62.4%. The Greek respondents reported that obtaining antibiotics without a prescription was easier (52.6% reported "easy or very easy") than the Turkish (35.6% reported "easy or very easy") respondents did. This study reveals that Greek citizens were more educated and knowledgeable about antibiotics (58.5% of Greeks and 44.2% of Turks identified antibiotics correctly), their effects (20.9% of Greeks and 26.3% of Turks agreed with wrong statements about antibiotics) and the risks of antibiotic resistance, compared to those from Turkey. On the other hand, the Greek respondents were more prone to use leftover antibiotics or to give them to someone else later (p < 0.001). The findings of this study indicate that Greece and Turkey, both countries with high rates of antibiotic usage, exhibit distinct variations in their knowledge, attitudes, and perceptions concerning antibiotic use and antibiotic resistance. Effective countermeasures such as public campaigns should be targeted according to the population and those areas of knowledge, attitudes and behaviours in which the main shortcomings lie.
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Affiliation(s)
- Timo J. Lajunen
- Department of Psychology, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
| | - Mark J. M. Sullman
- Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, Nicosia CY-1700, Cyprus; (M.J.M.S.); (M.A.)
| | - Buket Baddal
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia 99138, Cyprus;
| | - Burcu Tekeş
- Department of Psychology, Başkent University, Ankara 06790, Turkey;
| | - Menelaos Apostolou
- Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, Nicosia CY-1700, Cyprus; (M.J.M.S.); (M.A.)
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Hossain MJ, Jabin N, Ahmmed F, Sultana A, Abdur Rahman SM, Islam MR. Irrational use of antibiotics and factors associated with antibiotic resistance: Findings from a cross-sectional study in Bangladesh. Health Sci Rep 2023; 6:e1465. [PMID: 37520458 PMCID: PMC10375841 DOI: 10.1002/hsr2.1465] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 07/11/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023] Open
Abstract
Background and aims Irrational antibiotic (AB) usage poses a serious concern to third-world countries because of poor surveillance, lack of information, and patients' propensity for self-medication. Additionally, the unpredictability of the coronavirus disease 2019 (COVID-19) pandemic promoted the abuse of ABs, which accelerated the prevalence of antibiotic resistance (ABR). The primary aim of this study was to assess the pattern of AB usage and irrational use of ABs-related potential factors associated with ABR among the students and teachers of a leading public university of Bangladesh. Methods A cross-sectional web-based survey was conducted among the students and teachers (n = 783) of the selected university, from January 1 to February 28, 2022. Descriptive statistics, χ 2 test, and logistic regression analysis were employed to analyze the collected data. Results The regression analysis supported that male participants had a 34% lower experience of acquiring ABR than female respondents (adjusted odds ratio [AOR] = 0.66, 95% confidence interval [CI] = 0.448, 0.973; p = 0.036). The 1st/2nd-year level students had more than two times higher experience with ABR than the master's or higher-class students (AOR = 2.149, 95% CI = 1.047, 4.412; p = 0.037). The participants who took ABs for 4-6 days showed more than two times ABR experience than those who took ABs for above 10 days (AOR = 2.016, 95% CI = 1.016, 4.003; p = 0.045). Respondents who finished their AB medication (dose completion) had a 57% less chance of acquiring ABR than the participants who did not complete their dose. Conclusion This study found that irrational use of ABs is more prevalent among the youth and female participants. At this stage, there is an urgent need for comprehensive statutory AB control rules, as well as measures for appropriate information, education, and surveillance throughout different groups of Bangladesh.
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Affiliation(s)
| | - Nasrin Jabin
- Department of Peace and Conflict StudiesUniversity of DhakaDhakaBangladesh
| | - Foyez Ahmmed
- Department of StatisticsComilla UniversityCumillaBangladesh
| | - Arifa Sultana
- Department of Pharmaceutical Chemistry, Faculty of PharmacyUniversity of DhakaDhakaBangladesh
| | - S. M. Abdur Rahman
- Department of Clinical Pharmacy and Pharmacology, Faculty of PharmacyUniversity of DhakaDhakaBangladesh
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McCammon S, Makarovs K, Banducci S, Gold V. Phage therapy and the public: Increasing awareness essential to widespread use. PLoS One 2023; 18:e0285824. [PMID: 37200291 PMCID: PMC10194857 DOI: 10.1371/journal.pone.0285824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 04/26/2023] [Indexed: 05/20/2023] Open
Abstract
Today, the antimicrobial resistance (AMR) crisis is shaping a world where previously treatable infections can kill. This has revitalised the development of antibiotic alternatives, such as phage therapy. The therapeutic use of phages, viruses that infect and kill bacteria, was first explored over a century ago. However, most of the Western world abandoned phage therapy in favour of antibiotics. While the technical feasibility of phage therapy has been increasingly investigated in recent years, there has been minimal effort to understand and tackle the social challenges that may hinder its development and implementation. In this study, we assess the UK public's awareness, acceptance, preferences and opinions regarding phage therapy using a survey, fielded on the Prolific online research platform. The survey contained two embedded experiments: a conjoint and framing experiment (N = 787). We demonstrate that acceptance of phage therapy among the lay public is already moderate, with a mean likelihood of acceptance of 4.71 on a scale of 1 (not at all likely to accept phage therapy) to 7 (very likely to accept phage therapy). However, priming participants to think about novel medicines and antibiotic resistance significantly increases their likelihood of using phage therapy. Moreover, the conjoint experiment reveals that success and side effect rate, treatment duration, and where the medicine has been approved for use has a statistically significant effect on participants' treatment preferences. Investigations altering the framing of phage therapy, to highlight positive and negative aspects, reveal a higher acceptance of the treatment when described without using perceived harsh words, such as "kill" and "virus". Combined, this information provides an initial insight into how phage therapy could be developed and introduced in the UK to maximise acceptance rate.
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Affiliation(s)
- Sophie McCammon
- Living Systems Institute, University of Exeter, Exeter, United Kingdom
- Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Kirils Makarovs
- The Department of Social and Political Sciences, Philosophy and Anthropology, University of Exeter, Exeter, United Kingdom
| | - Susan Banducci
- The Department of Social and Political Sciences, Philosophy and Anthropology, University of Exeter, Exeter, United Kingdom
| | - Vicki Gold
- Living Systems Institute, University of Exeter, Exeter, United Kingdom
- Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
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Sullman MJM, Lajunen TJ, Baddal B, Apostolou M. Antibiotics Knowledge, Attitudes and Behaviours among the Population Living in Cyprus. Antibiotics (Basel) 2023; 12:antibiotics12050897. [PMID: 37237800 DOI: 10.3390/antibiotics12050897] [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: 03/27/2023] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
This study investigated the knowledge, attitudes and behaviours towards antibiotics among the general public living in the Republic of Cyprus (RoC) and the Turkish Republic of Northern Cyprus (TRNC) by using an online questionnaire. Differences were examined using independent samples t-tests, chi-square tests, Mann-Whitney U tests and Spearman's rho. In total, 519 individuals completed the survey (RoC = 267, TRNC = 252), with an average age of 32.7, and 52.2% were female. Most citizens correctly identified paracetamol (TRNC = 93.7%, RoC = 53.9%) and ibuprofen (TRNC = 70.2%, RoC = 47.6%) as non-antibiotic medications. A substantial proportion thought antibiotics could treat viral infections, such as a cold (TRNC = 16.3%, RoC = 40.8%) or the flu (TRNC = 21.4%, RoC = 50.4%). Most participants understood that bacteria can become resistant to antibiotics (TRNC = 71.4%, RoC = 64.4%), that unnecessary use can lead to drug ineffectiveness (TRNC = 86.1%, RoC = 72.3%) and that they should always complete the course of antibiotics (TRNC = 85.7%, RoC = 64.0%). Positive attitudes towards antibiotics correlated negatively with knowledge in both samples, indicating that the more people know, the less positive their attitudes towards their use. The RoC appears to have tighter controls of over-the-counter (OTC) sales of antibiotics than TRNC. This study reveals that different communities can have varying levels of knowledge, attitudes and perceptions about antibiotic use. Tighter enforcement of the OTC regulations, educational efforts and media campaigns are needed for enhancing prudent antibiotic use on the island.
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Affiliation(s)
- Mark J M Sullman
- Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, Nicosia CY-1700, Cyprus
| | - Timo J Lajunen
- Department of Psychology, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway
| | - Buket Baddal
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia 99138, Cyprus
| | - Menelaos Apostolou
- Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, Nicosia CY-1700, Cyprus
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14
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Muflih SM, Al-Azzam S, Karasneh RA, Bleidt BA, Conway BR, Bond SE, Aldeyab MA. Public knowledge of antibiotics, self-medication, and household disposal practices in Jordan. Expert Rev Anti Infect Ther 2023; 21:477-487. [PMID: 36843495 DOI: 10.1080/14787210.2023.2182770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
BACKGROUND This study aimed to assess public understanding of antibiotics, self-medication, and drug disposal practices. METHODS A cross-sectional self-administered online survey was undertaken in Jordan. RESULTS The study was completed by 1,105 participants. When asked about their knowledge of antibiotics, rational antibiotic use, and disposal practices, 16% percent believed they should discontinue antibiotics once they felt better, and 12% agreed to take the same antibiotics prescribed to others for the same illness. Self-medication with antibiotics was practiced by 44% of the participants. Prior experience, healthcare costs, and pharmacy location were all major determinants of self-medication. Only 6.4% of unneeded antibiotics were returned to the pharmacy, 60% were kept at home, and 26.6% were disposed of at home. Almost half of those who kept the antibiotics said they would use them again, and one-third said they would give them to friends and family. Respondents who had used antibiotics within the previous 6 months (p = 0.052) and relied on medication leaflets (p = 0.031) and physician recommendations (p = 0.001) were less likely to self-medicate with antibiotics. CONCLUSIONS The study highlighted areas of inappropriate use of antibiotics, self-medication and the improper antibiotic disposal that can inform antimicrobial stewardship.
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Affiliation(s)
- Suhaib M Muflih
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Sayer Al-Azzam
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Reema A Karasneh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Barry A Bleidt
- Department of Socio behavioral and Administrative Pharmacy, College of Pharmacy, Nova Southeastern University, Davie-Fl, USA
| | - Barbara R Conway
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK.,Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield, UK
| | - Stuart E Bond
- Pharmacy Department, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
| | - Mamoon A Aldeyab
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
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15
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Glibić M, Bedeković L, Maglica M, Marijanović I, Vukoja D. Behavioral and Knowledge Patterns Regarding the Use of Antibiotics Among Urban and Rural Population in Bosnia and Herzegovina-a Cross-sectional Study. Mater Sociomed 2023; 35:33-41. [PMID: 37095872 PMCID: PMC10122528 DOI: 10.5455/msm.2023.35.33-41] [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: 01/26/2023] [Accepted: 03/16/2023] [Indexed: 04/01/2023] Open
Abstract
Background Antimicrobial resistance imposes one of the leading global health issues and is strongly associated with the overuse and misuse of antimicrobials. Objective The present study aimed to determine the level of knowledge, attitudes, and behavior regarding the use of antibiotics among urban and rural population in the southeastern European country of Bosnia and Herzegovina. Methods A cross-sectional questionnaire-based study was conducted by convenience sampling technique among people who visited health centers, malls, and also online. In total, 1057 questionnaires were completed, of which 920 were completed in the city of Mostar (i.e. urban area), while 137 in the municipality of Grude (i.e., rural area). Descriptive statistical analysis was performed to process the results. Results Participants from Mostar had better knowledge about antibiotics (p = 0.031) and a higher level of education (p = 0.001). Women showed markedly better knowledge in the group of urban area responders (p = 0.004). Improper use of antibiotics was more common among respondents from Grude; they tend to use antibiotics more frequently and almost half of them are prone to self-medication (p = 0.017). Overall, those classified with adequate knowledge showed less tendency to irregular antibiotic intake. Having a medical worker in a family was significantly associated with better knowledge regarding antibiotics, while educational level was not. Conclusion Although a significant number of respondents showed adequate knowledge about the use of antibiotics, there were noticeable irregular behavioral patterns, while significant differences between urban and rural population were detected as well. Further analysis is required to access the whole specter of the issue and to initiate policies directed toward reducing inappropriate use of antibiotics and bacterial resistance to these medications.
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Affiliation(s)
- Monika Glibić
- Health Center Mostar, Mostar, Bosnia and Herzegovina
| | - Leonora Bedeković
- Department of Histology and Embryology, School of Medicine University of Mostar, Mostar, Bosnia and Herzegovina
- Health Center Neum, Neum, Bosnia and Herzegovina
| | - Mirko Maglica
- Department of Human Anatomy, School of Medicine University of Mostar, Mostar, Bosnia and Herzegovina
- Health Center Livno, Livno, Bosnia and Herzegovina
| | | | - Damir Vukoja
- Internal Medicine Clinic, University Hospital Dubrava, Zagreb, Croatia
- Health Center Grude, Grude, Bosnia and Herzegovina
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Mavragani A, Sandsdalen V, Manskow US, Småbrekke L, Waaseth M. Internet Use for Obtaining Medicine Information: Cross-sectional Survey. JMIR Form Res 2023; 7:e40466. [PMID: 36729577 PMCID: PMC9936360 DOI: 10.2196/40466] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The internet is increasingly being used as a source of medicine-related information. People want information to facilitate decision-making and self-management, and they tend to prefer the internet for ease of access. However, it is widely acknowledged that the quality of web-based information varies. Poor interpretation of medicine information can lead to anxiety and poor adherence to drug therapy. It is therefore important to understand how people search, select, and trust medicine information. OBJECTIVE The objectives of this study were to establish the extent of internet use for seeking medicine information among Norwegian pharmacy customers, analyze factors associated with internet use, and investigate the level of trust in different sources and websites. METHODS This is a cross-sectional study with a convenience sample of pharmacy customers recruited from all but one community pharmacy in Tromsø, a medium size municipality in Norway (77,000 inhabitants). Persons (aged ≥16 years) able to complete a questionnaire in Norwegian were asked to participate in the study. The recruitment took place in September and October 2020. Due to COVID-19 restrictions, social media was also used to recruit medicine users. RESULTS A total of 303 respondents reported which sources they used to obtain information about their medicines (both prescription and over the counter) and to what extent they trusted these sources. A total of 125 (41.3%) respondents used the internet for medicine information, and the only factor associated with internet use was age. The odds of using the internet declined by 5% per year of age (odds ratio 0.95, 95% CI 0.94-0.97; P=.048). We found no association between internet use and gender, level of education, or regular medicine use. The main purpose reported for using the internet was to obtain information about side effects. Other main sources of medicine information were physicians (n=191, 63%), pharmacy personnel (n=142, 47%), and medication package leaflets (n=124, 42%), while 36 (12%) respondents did not obtain medicine information from any sources. Note that 272 (91%) respondents trusted health professionals as a source of medicine information, whereas 58 (46%) respondents who used the internet trusted the information they found on the internet. The most reliable websites were the national health portals and other official health information sites. CONCLUSIONS Norwegian pharmacy customers use the internet as a source of medicine information, but most still obtain medicine information from health professionals and packet leaflets. People are aware of the potential for misinformation on websites, and they mainly trust high-quality sites run by health authorities.
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Affiliation(s)
| | - Vilde Sandsdalen
- Department of Pharmacy, UiT The Artic University of Norway, Tromsø, Norway
| | - Unn Sollid Manskow
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Lars Småbrekke
- Department of Pharmacy, UiT The Artic University of Norway, Tromsø, Norway
| | - Marit Waaseth
- Department of Pharmacy, UiT The Artic University of Norway, Tromsø, Norway
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Yan B, He Z, Dong S, Akezhuoli H, Xu X, Wang X, Zhou X. The moderating effect of parental skills for antibiotic identification on the link between parental skills for antibiotic use and inappropriate antibiotic use for children in China. BMC Public Health 2023; 23:156. [PMID: 36690967 PMCID: PMC9872431 DOI: 10.1186/s12889-023-15099-8] [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: 11/25/2022] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Inappropriate antibiotic consumption promotes antibiotic resistance. However, findings on the association between antibiotic-related knowledge and behaviors are inconsistent and contradictory, resulting in unjustified guidance of interventions. The mechanisms between the different kinds of antibiotic-related skills contained in knowledge modules in some previous studies are indistinct and rarely studied. METHODS A cross-sectional survey was conducted between June 2017 and April 2018 in three Chinese provinces, investigating 9526 parents with children aged 0-13 years old. Data from 1944 parents who self-medicated their children and 2478 respondents whose children sought care were analyzed. RESULTS Skills for antibiotic identification were found to be a moderator for the association between skills for antibiotic use and two inappropriate behaviors. Compared with parents with low levels of both skills for antibiotic identification and use, those mastering both skills at either medium (OR = 0.48, 95% CI [0.26-0.88]) or high (OR = 0.15, 95% CI [0.07-0.34]) level were less likely to self-medicate their children with antibiotics. Parents with a medium level of skills for antibiotic identification and high level of skills for antibiotic use (OR = 0.18, 95% CI [0.08-0.44]) and those with a high level of both skills (OR = 0.15, 95% CI [0.05-0.47]) were less likely to ask doctors for antibiotics when seeking care. CONCLUSION Parents' high level of skills for antibiotic identification is revealed to promote inappropriate antibiotic use when parents master a low level of skills for antibiotic use. Conversely, based on excellent skills for antibiotic use, better skill for antibiotic identification is associated with a greater reduction in inappropriate behaviors. We recommend future health education to strengthen skills for antibiotic identification along with guidance on antibiotic use.
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Affiliation(s)
- Bo Yan
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhenke He
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shixin Dong
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hailati Akezhuoli
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xin Xu
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaomin Wang
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China.
| | - Xudong Zhou
- Institute of Social Medicine, School of Medicine, Zhejiang University, Hangzhou, China.
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18
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Pattnaik M, Nayak AK, Karna S, Sahoo SK, Palo SK, Kanungo S, Kshatri JS, Parai D, Walia K, Singh T, Choudhary HR, Pati S, Bhattacharya D. Perception and determinants leading to antimicrobial (mis)use: A knowledge, attitude, and practices study in the rural communities of Odisha, India. Front Public Health 2023; 10:1074154. [PMID: 36711396 PMCID: PMC9880167 DOI: 10.3389/fpubh.2022.1074154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/28/2022] [Indexed: 01/14/2023] Open
Abstract
Background Antimicrobial resistance (AMR) has emerged as one of the major public health issues globally. This cross-sectional study determined knowledge, attitudes and practices (KAP) regarding antimicrobial use and AMR among rural communities of Tigiria (Odisha), India. Methods A semi-structured questionnaire based on socio-demographic characteristics, antibiotics usage, awareness of antimicrobial resistance, healthcare utilization and quality of life were asked to the participants using an electronic device with Open Data Kit. Descriptive statistics, independent t-test and ANOVA were performed to analyze the variables. Results A total of 1,003 participants were surveyed in the study from 25 villages of Tigiria. About 44.47% (95% CI: 41.36-47.60) of study participants have heard about antimicrobial medicines and 14.75% (95% CI: 12.65-17.13) of participants were involved in buying antibiotics without prescription over the counter. Around 20.14% (95% CI: 17.72-22.78) of participants, stopped taking antibiotics before completing the full course. The physical domain was the most affected with low scores compared to other domains of quality of life (QOL). The QOL scores were found significant (p < 0.05) across age, gender, education and ethnicity. Conclusion The study documented a significant level of KAP regarding antimicrobial (mis)use in the study. It is essential that antimicrobial stewardship programs for various stakeholders and educational programmes must be initiated to increase awareness of people on antimicrobial resistance.
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Affiliation(s)
- Matrujyoti Pattnaik
- Department of Microbiology, ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, Odisha, India
| | - Ashish Kumar Nayak
- Department of Microbiology, ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, Odisha, India
| | - Sonam Karna
- Department of Microbiology, ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, Odisha, India
| | - Subrat Kumar Sahoo
- Department of Microbiology, ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, Odisha, India
| | - Subrata Kumar Palo
- Department of Microbiology, ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, Odisha, India
| | - Srikanta Kanungo
- Department of Microbiology, ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, Odisha, India
| | - Jaya Singh Kshatri
- Department of Microbiology, ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, Odisha, India
| | - Debaprasad Parai
- Department of Microbiology, ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, Odisha, India
| | - Kamini Walia
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Taru Singh
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Hari Ram Choudhary
- Department of Microbiology, ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, Odisha, India
| | - Sanghamitra Pati
- Department of Microbiology, ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, Odisha, India
| | - Debdutta Bhattacharya
- Department of Microbiology, ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, Odisha, India
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Matsui H, Abe S, Obara T, Sato T, Yoshimachi S, Nomura K. Patients' Perception in Japan Regarding the Appropriate Use of Antimicrobial Drugs: A Questionnaire Survey. PHARMACY 2023; 11:12. [PMID: 36649022 PMCID: PMC9844386 DOI: 10.3390/pharmacy11010012] [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: 10/04/2022] [Revised: 12/31/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
This study sought to investigate the actual status of awareness regarding the appropriate use of antimicrobial drugs among patients of a wide age range who visit dispensing pharmacies in order to explore more effective intervention methods for improving awareness of the appropriate use of antimicrobial drugs for patients. A questionnaire survey was conducted with 1301 patients who visited different Tsuruha Holdings-operated pharmacies between 1 September 2018 and 31 October 2018. Using multiple regression analysis, we calculated scores based on the patients' answers regarding their knowledge of antimicrobial drugs and antimicrobial resistance and examined factors related to these scores. Of the 1185 respondents who successfully completed the survey (mean age ± SD, 52.5 ± 18.2 years), 37.2% were 60 years old or older, 13.2% had never or were not sure whether they had taken antimicrobial drugs, and 73.2% did not understand the problem of antimicrobial resistance. Older age, the non-usage of drugs and self-reports of the "lack" of knowledge of antimicrobial resistance were identified as the group that needs education regarding the appropriate use of antimicrobial drugs. Intervention studies should be conducted to examine the efficacy of interventions based on these factors.
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Affiliation(s)
- Hikaru Matsui
- Tsuruha Holdings Inc., 20-1-21, Kita24-jo higashi, Higashi-ku, Sapporo 065-0024, Hokkaido, Japan
| | - Shinya Abe
- Tsuruha Holdings Inc., 20-1-21, Kita24-jo higashi, Higashi-ku, Sapporo 065-0024, Hokkaido, Japan
| | - Taku Obara
- Department of Molecular Epidemiology, Tohoku University Graduate School of Medicine, 2-1, Seiryo-cho, Aoba-ku, Sendai 980-8574, Miyagi, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1, Seiryo-cho, Aoba-ku, Sendai 980-8574, Miyagi, Japan
| | - Tasuku Sato
- Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences, 6-3, Aoba, Aramaki, Aoba-ku, Sendai 980-8574, Miyagi, Japan
| | - Shouko Yoshimachi
- Tsuruha Holdings Inc., 20-1-21, Kita24-jo higashi, Higashi-ku, Sapporo 065-0024, Hokkaido, Japan
| | - Kazuhiko Nomura
- Tsuruha Holdings Inc., 20-1-21, Kita24-jo higashi, Higashi-ku, Sapporo 065-0024, Hokkaido, Japan
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Zhu B, Zhao X, Li Y, Wang N, Lambert H, Yan F, Jiang Q, Fu C. Impact of the COVID-19 Outbreak on the Antibiotic Use Patterns among a Rural Community Population in Eastern China. Antibiotics (Basel) 2022; 11:1544. [PMID: 36358199 PMCID: PMC9686520 DOI: 10.3390/antibiotics11111544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/26/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
There are growing concerns that the coronavirus disease of 2019 (COVID-19) pandemic may change antibiotic use patterns and accelerate antibiotic resistance, but evidence from the community level is lacking. This study aims to estimate the impact of the COVID-19 outbreak on the antibiotic use patterns among a community population in Eastern China. A self-administered medicine diary was used to collect information on antibiotic use from July 2019 to June 2021 among a rural community in Eastern China. We analyzed the changes in antibiotic use patterns over five months from August to December 2019 and the corresponding months in 2020. The risk of antibiotic use and its changes were measured with the incidence rate (IR) and relative risk (RR). In total, 1111 participants were eligible for the final analysis (440 in 2019 and 671 in 2020). After the COVID-19 outbreak, antibiotic use increased by 137% (5.43 per 100 person months in the 2019 vs. 12.89 per 100 person months in the 2020), and after the adjustment of covariates, the adjusted RR was 1.72 (95% CI: 1.10~2.34). It was higher among those who were women (RR = 2.62), aged 35−59 years old (RR = 2.72), non-farmers (RR = 2.75), had less than six years of education (RR = 2.61), had an annual household income over CNY 100,000 (USD 14,940) (RR = 2.60), and had no history of chronic diseases (RR = 2.61) (all p < 0.05). The proportion of cephalosporins consumed increased from 54.29% in 2019 to 64.92% in 2020 (p = 0.011). Among those aged 35 years and older, the proportion of antibiotics obtained from medical facilities increased, while the proportion obtained from retail pharmacies, homes, and other sources decreased (all p < 0.05). The COVID-19 outbreak changed antibiotic use patterns in this study population (Eastern China) significantly. More efforts to monitor and enhance antibiotic stewardship activities at the community level are needed in future.
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Affiliation(s)
- Bingbing Zhu
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xinping Zhao
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yurong Li
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai 200032, China
| | - Na Wang
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai 200032, China
| | - Helen Lambert
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
| | - Fei Yan
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai 200032, China
| | - Qingwu Jiang
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai 200032, China
| | - Chaowei Fu
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai 200032, China
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21
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Chan AHY, Beyene K, Tuck C, Rutter V, Ashiru-Oredope D. Pharmacist beliefs about antimicrobial resistance and impacts on antibiotic supply: a multinational survey. JAC Antimicrob Resist 2022; 4:dlac062. [PMID: 36035318 PMCID: PMC9400174 DOI: 10.1093/jacamr/dlac062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/23/2022] [Indexed: 11/30/2022] Open
Abstract
Background Pharmacists have important antimicrobial stewardship (AMS) roles yet limited literature exists on pharmacists' knowledge and beliefs about antimicrobial resistance (AMR) and antimicrobials and how these beliefs influence antimicrobial supply in different countries. Methods A cross-sectional survey was disseminated to pharmacists around the world via the Commonwealth Pharmacists' Association and related networks. Data were collected on demographics, antibiotic supply practices, and knowledge and beliefs about AMR. Results A total of 546 pharmacists responded from 59 countries, most commonly from Africa (41%) followed by Asia (26%) and Oceania (22%). Respondents supplied a mean of 46 ± 81 antibiotic prescriptions/week, 73%±35% of which were given in response to a prescription. Overall, 60.2% dispensed antibiotics at least once without a prescription. Respondents had good knowledge (mean 9.6 ± 1.3 (out of 12), and held positive beliefs about AMR [mean 3.9 ± 0.6 (out of 5)]. Knowledge about antibiotics and beliefs about AMR were positively correlated. The odds of supplying antibiotics without a prescription were 7.4 times higher among respondents from lower income countries [adjusted odds ratio (AOR) = 7.42, 95% CI 4.16-13.24]. Conversely, more positive AMR beliefs were associated with a lower odds of supplying antibiotics without a prescription (AOR = 0.91, 95% CI 0.86-0.95). Conclusions Most pharmacists had the good knowledge about antibiotics and positive beliefs about AMR. These beliefs were influenced by knowledge, work setting, and country income. A proportion of respondents provided antibiotics without a prescription; the likelihood of this occurring was higher in those who held more negative beliefs about AMR.
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Affiliation(s)
- Amy Hai Yan Chan
- Commonwealth Pharmacists’ Association, London, UK
- School of Pharmacy, University of Auckland, Grafton, Auckland, New Zealand
- UCL School of Pharmacy, University College London, London, UK
| | - Kebede Beyene
- School of Pharmacy, University of Auckland, Grafton, Auckland, New Zealand
| | - Chloe Tuck
- Commonwealth Pharmacists’ Association, London, UK
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22
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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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Paul GK, Swapon MS, Kaderi Kibria KM. Knowledge, awareness, and attitudes toward antibiotic resistance and practice of self-medication among university students in Bangladesh: A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:115. [PMID: 35677264 PMCID: PMC9170193 DOI: 10.4103/jehp.jehp_602_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 12/16/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND The prevalence of self-medication is high in Bangladesh due to easy access and poor regulatory controls over these drugs. Our study aimed to assess the attitude of university students in Bangladesh toward antibiotic usage, especially their knowledge and awareness about antibiotics and their resistance. We also evaluated the determinants behind their attempts at drug intake without prescription. MATERIALS AND METHODS A cross-sectional study was conducted in Mawlana Bhashani Science and Technology University that included information from randomly selected 200 students from 15 departments using a structured questionnaire. The statistical analyses were performed by using SPSS software (version 21) and R programming. RESULTS The study revealed that 61.0% of the students use self-medication at different times or always; 32.5% of the respondents keep antibiotics for future use, and 38% of the students think it is right to stop antibiotics when symptoms are improving. Half of the participants (47.5%) use antibiotics based on their previous experience. The criteria of antibiotic selection have a significant relationship with knowledge about antibiotic resistance (P = 0.017) and altered prescribed medicine without doctor's advice (P < 0.001). The multivariate analysis indicates that respondents who know about antibiotic resistance select antibiotics from the community pharmacists with respect to their own experience 5.102 times higher than those who do not know about antibiotic resistance. CONCLUSIONS The study mainly explored the knowledge gaps of the students on the options that are responsible for antibiotic resistance in the community and found that students have mid-level knowledge (66%) about antibiotic resistance.
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Affiliation(s)
- Gowranga Kumar Paul
- Department of Statistics, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Md. Shalauddin Swapon
- Department of Statistics, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - K. M. Kaderi Kibria
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
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24
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McNulty C, Read B, Quigley A, Verlander NQ, Lecky DM. What the public in England know about antibiotic use and resistance in 2020: a face-to-face questionnaire survey. BMJ Open 2022; 12:e055464. [PMID: 35387816 PMCID: PMC8987214 DOI: 10.1136/bmjopen-2021-055464] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To describe public attitudes and knowledge around antibiotic activity, resistance and use. DESIGN Face-to-face household 18 question survey using computer-assisted data collection undertaken by Ipsos Market and Opinion Research International. SETTING Randomly selected households across England, January-February 2020. PARTICIPANTS 2022 adults (aged 15+,) including 521 black, Asian and minority ethnic (BAME) participants, and 406 aged 15-25 years olds. MAIN OUTCOME MEASURES Responses to questions about antibiotic activity, resistance and expectations for antibiotics and trust in healthcare professionals. Analyses were weighted to obtain estimates representative of the population with multivariable analysis undertaken for questions with five or more significant univariate variables. RESULTS 84% stated they would be pleased if their general practitioner (GP) said they did not need antibiotics. Trust in GPs to make antibiotic decisions remains high (89%) and has increased for nurses (76%) and pharmacists (71%). Only 21% would challenge an antibiotic decision; this was significantly greater in BAME participants (OR 2.5; 95% CI 1.89 to 3.35). 70% reported receiving advice when prescribed antibiotics. Belief in benefits of antibiotics for ear infections was very high (68%). Similar to 2017, 81% agreed that antibiotics work for bacterial, 28% cold and influenza viruses. 84% agreed antibiotic resistant bacteria (ARB) are increasing, only 50% agreed healthy people can carry ARB and 39% agreed there was nothing they personally could do about ARB. Social grade DE and BAME participants, and those with less education had significantly less understanding about antibiotics and resistance. CONCLUSIONS As trust in healthcare practitioners is high, we need to continue antibiotic education and other interventions at GP surgeries and community pharmacies but highlight that most ear infections are not benefitted by antibiotics. Targeted interventions are needed for socioeconomic DE, BAME groups and previous antibiotic users. We need to explore if increasing perceived personal responsibility for preventing ARB reduces antibiotic use.
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Affiliation(s)
- Cliodna McNulty
- Primary Care and Interventions Unit, UK Health Security Agency, Gloucester, UK
| | - Brieze Read
- Primary Care and Interventions Unit, UK Health Security Agency, Gloucester, UK
| | - Anna Quigley
- Social Research Institute, Ipsos MORI UK Ltd, London, UK
| | - Neville Q Verlander
- Statistics, Modelling and Economics Department, UK Health Security Agency, London, UK
| | - Donna M Lecky
- Primary Care and Interventions Unit, UK Health Security Agency, Gloucester, UK
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25
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Misconceptions of Antibiotics as a Potential Explanation for Their Misuse. A Survey of the General Public in a Rural and Urban Community in Sri Lanka. Antibiotics (Basel) 2022; 11:antibiotics11040454. [PMID: 35453206 PMCID: PMC9024968 DOI: 10.3390/antibiotics11040454] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/08/2022] [Accepted: 03/22/2022] [Indexed: 11/17/2022] Open
Abstract
Reducing the growth of antimicrobial resistance (AMR) through public understanding is a goal of the World Health Organization. It is especially important in countries where antibiotics are widely available for common ailments without prescription. This study assessed understanding of antibiotics and AMR alongside perception of antibiotic usage among the general public in two diverse Sri Lankan communities: ordinary urban and indigenous rural. A cross-sectional questionnaire survey was conducted, gaining 182 urban and 147 rural responses. The majority of urban respondents (69.2%) believed that they had very good or good knowledge about antibiotics compared to 40.1% of rural respondents. Belief about knowledge and actual knowledge (measured via a test question) were correlated (r = 0.49, p = 0.001) for rural respondents, but not for urban respondents. Several misconceptions about antibiotics were highlighted, including that Paracetamol, a painkiller, was thought to be an antibiotic by more than 50% of both urban and rural respondents. In addition, 18.5% of urban and 35.4% of rural participants would keep and re-use what they perceived as leftover antibiotics. It is urgent that we pay attention to educating the general public regarding the identified misconceptions of these powerful drugs and their appropriate use.
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26
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Schmiege D, Falkenberg T, Moebus S, Kistemann T, Evers M. Associations between socio-spatially different urban areas and knowledge, attitudes, practices and antibiotic use: A cross-sectional study in the Ruhr Metropolis, Germany. PLoS One 2022; 17:e0265204. [PMID: 35271648 PMCID: PMC8912211 DOI: 10.1371/journal.pone.0265204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 02/18/2022] [Indexed: 12/02/2022] Open
Abstract
Inappropriate and excessive antibiotic use fuels the development of antibiotic resistance. Determinants of antibiotic use, including knowledge and attitudes, are manifold and vary on different spatial scales. The objective of this study was to examine the associations between socio-spatially diverse urban areas and knowledge, attitudes, practices and antibiotic use within a metropolitan city. A cross-sectional survey was conducted in the general population in socio-spatially different areas in Dortmund, Germany, in February and March 2020. Three urban areas were chosen to represent diverse socio-spatial contexts (socio-spatially disadvantaged: A, intermediate: B, socio-spatially disadvantaged: C). Participants were selected via simple random sampling. The questionnaire comprised knowledge and attitude statements and questions around antibiotic use and handling practices. Differences between the areas were examined by estimating odds ratios (OR) and corresponding 95% confidence intervals by multiple logistic regression. Overall, 158 participants were included. Participants of Area C showed the lowest proportions of correct knowledge statements, indicated more often attitudes contrary to common recommendations, lower risk awareness and reported more often antibiotic use (C: 40.8%; A: 32.7%; B: 26.5%) and potential mishandling practices (C: 30.4%; A: 9.6%; B: 17.3%). The multiple logistic regression confirmed these differences. Around 42.3% (C), 33.3% (A) and 20.0% (B) of the diseases mentioned for which an antibiotic was used are mainly caused by viral pathogens. A common misconception across all areas was the perception of antibiotic resistance as an individual rather than a universal issue. This study reveals distinct differences between socio-spatially diverse urban areas within a metropolitan city, regarding knowledge, attitudes and practices around antibiotics and ABR. Our findings confirm that enhanced efforts are required to better inform the population about the adequate use and handling of antibiotics. This study emphasizes the need for future interventions to be tailored to the specific local socio-economic context.
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Affiliation(s)
- Dennis Schmiege
- Department of Geography, University of Bonn, Bonn, Germany
- Institute for Hygiene and Public Health, GeoHealth Centre, University Hospital Bonn, Bonn, Germany
- Institute for Urban Public Health, Essen University Hospital, University of Duisburg-Essen, Duisburg, Germany
- Center for Development Research, University of Bonn, Bonn, Germany
- * E-mail:
| | - Timo Falkenberg
- Institute for Hygiene and Public Health, GeoHealth Centre, University Hospital Bonn, Bonn, Germany
- Center for Development Research, University of Bonn, Bonn, Germany
| | - Susanne Moebus
- Institute for Urban Public Health, Essen University Hospital, University of Duisburg-Essen, Duisburg, Germany
| | - Thomas Kistemann
- Department of Geography, University of Bonn, Bonn, Germany
- Institute for Hygiene and Public Health, GeoHealth Centre, University Hospital Bonn, Bonn, Germany
- Center for Development Research, University of Bonn, Bonn, Germany
| | - Mariele Evers
- Department of Geography, University of Bonn, Bonn, Germany
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How Socioeconomic, Health Seeking Behaviours, and Educational Factors Are Affecting the Knowledge and Use of Antibiotics in Four Different Cities in Asia. Antibiotics (Basel) 2021; 10:antibiotics10121522. [PMID: 34943734 PMCID: PMC8698331 DOI: 10.3390/antibiotics10121522] [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: 10/29/2021] [Revised: 11/30/2021] [Accepted: 12/09/2021] [Indexed: 11/17/2022] Open
Abstract
Antibiotic resistance is occurring widely throughout the world and is affecting people of all ages. Socioeconomic factors, education, use of antibiotics, knowledge of antibiotics, and antibiotic resistance were assessed in four cities in Asia, namely Hong Kong, Shanghai, Hangzhou, and Bangkok. A survey using cluster sampling was used in 2021 to collect data on 642 subjects. Hongkongers used less antibiotics and were knowledgeable about using antibiotics to treat diseases, while Shanghainese were knowledgeable about antibiotic resistance. The multi-linear regression model reported that respondents who lived in Hong Kong (β = 0.744 (95% CI: 0.36-1.128), Shanghai (β = 1.65 (95% CI: 1.267-2.032), and Hangzhou (β = 1.393 (95% CI: 0.011-1.775) (reference group: Bangkok), who had higher scores on antibiotics knowledge (β = 0.161 (95% CI: 0.112-0.21)), higher educational attainment (β = 0.46 (95% CI: 0.296-0.625)), and who were more likely to consult a doctor on using antibiotics (β = 1.102 (95% CI: 0.606-1.598)), were more likely to give correct answers about antibiotic resistance, p < 0.001. Older respondents were less likely to answer the items correctly (β = -0.194 (95% CI: -0.333--0.055), p < 0.01. When educating the public on the proper use of antibiotics and antibiotic resistance, multiple strategies could be considered for people from all walks of life, as well as target different age groups.
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Gabriel S, Manumbu L, Mkusa O, Kilonzi M, Marealle AI, Mutagonda RF, Mlyuka HJ, Mikomangwa WP, Minzi O. Knowledge of use of antibiotics among consumers in Tanzania. JAC Antimicrob Resist 2021; 3:dlab183. [PMID: 34859224 PMCID: PMC8634462 DOI: 10.1093/jacamr/dlab183] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/05/2021] [Indexed: 11/14/2022] Open
Abstract
Background Studies assessing consumers' knowledge of the rational use of antibiotics are essential to understand the knowledge gap before intervention strategies are instituted. Objectives To assess the knowledge of rational use of antibiotics among consumers in Dar es Salaam, Tanzania. Methods A cross-sectional study assessing knowledge of rational use of antibiotics among 960 consumers was conducted in Dar es salaam in March 2021. Participants were consecutively enrolled from outpatient pharmacies in selected public and private hospitals and marketplaces in Ilala Municipality. Data were collected using the WHO-validated questions on knowledge of consumers of antibiotic uses. Results Overall, 196 (20.4%) and 503 (52.4%) participants demonstrated good knowledge of rational antibiotic use and conditions that can be treated with antibiotics, respectively. However, 678 (70.6%) responded that they stopped using antibiotics after dose completion, 515 (53.6%) would request the same antibiotic if it had helped to treat a similar condition in the past and 406 (42.3%) are willing to use the same antibiotic if a friend or family member used the medication previously to treat similar signs and symptoms. Besides, the following conditions were mentioned as being treatable with antibiotics: influenza (50.7%), sore throat (61.4%) and urinary tract infection (60.5%). Conclusions The majority of the consumers had poor knowledge of the rational uses of antibiotics and a moderate proportion had good knowledge of the conditions that are treatable with antibiotics. Those with a high level of education and with health insurance had good knowledge of rational uses of antibiotics.
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Affiliation(s)
- Salvador Gabriel
- School of Pharmacy, Muhimbili University of Health & Allied Sciences, PO Box 65013, Dar es Salaam, Tanzania
| | - Loyce Manumbu
- School of Pharmacy, Muhimbili University of Health & Allied Sciences, PO Box 65013, Dar es Salaam, Tanzania
| | - Omary Mkusa
- School of Pharmacy, Muhimbili University of Health & Allied Sciences, PO Box 65013, Dar es Salaam, Tanzania
| | - Manase Kilonzi
- Department of Clinical Pharmacy & Pharmacology, School of Pharmacy, Muhimbili University of Health & Allied Sciences, PO Box 65013, Dar es Salaam, Tanzania
| | - Alphonce Ignace Marealle
- Department of Clinical Pharmacy & Pharmacology, School of Pharmacy, Muhimbili University of Health & Allied Sciences, PO Box 65013, Dar es Salaam, Tanzania
| | - Ritah F Mutagonda
- Department of Clinical Pharmacy & Pharmacology, School of Pharmacy, Muhimbili University of Health & Allied Sciences, PO Box 65013, Dar es Salaam, Tanzania
| | - Hamu J Mlyuka
- Department of Clinical Pharmacy & Pharmacology, School of Pharmacy, Muhimbili University of Health & Allied Sciences, PO Box 65013, Dar es Salaam, Tanzania
| | - Wigilya P Mikomangwa
- Department of Clinical Pharmacy & Pharmacology, School of Pharmacy, Muhimbili University of Health & Allied Sciences, PO Box 65013, Dar es Salaam, Tanzania
| | - Omary Minzi
- Department of Clinical Pharmacy & Pharmacology, School of Pharmacy, Muhimbili University of Health & Allied Sciences, PO Box 65013, Dar es Salaam, Tanzania
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29
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Tangcharoensathien V, Chanvatik S, Kosiyaporn H, Kirivan S, Kaewkhankhaeng W, Thunyahan A, Lekagul A. Population knowledge and awareness of antibiotic use and antimicrobial resistance: results from national household survey 2019 and changes from 2017. BMC Public Health 2021; 21:2188. [PMID: 34844593 PMCID: PMC8630906 DOI: 10.1186/s12889-021-12237-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 11/08/2021] [Indexed: 12/16/2022] Open
Abstract
Background Lack of knowledge and awareness on antimicrobial resistance (AMR) can result in irrational use of antibiotics, which is one of the major drivers of AMR. One goal of the Thailand National Strategic Plan on AMR (2017-2021) is a 20% increase in public knowledge and awareness of antibiotic use and AMR by 2021. This study assesses antibiotic use, level of knowledge and awareness of antibiotic use and AMR and the factors associated with their knowledge and awareness in the Thai population in 2019. It compares findings with a similar national survey in 2017. Methods An AMR module was integrated into the Health and Welfare Survey, a biennial national household survey conducted by the National Statistical Office since 2017. The 2019 survey took place in March, through face-to-face interviews with 27,900 Thai adults aged 15 years or above who participated in the survey and compares 2019 findings with those from 2017. Results One month prior to the survey, 6.3% of population reported use of antibiotics (reduced from 7.9% to 2017), of which 98.1% received antibiotics through healthcare professionals and almost half (43.2%) for flu symptoms. During the last 12 months, 21.5% of Thai adults received information on the appropriate use of antibiotics and AMR (increased from 17.8% to 2017); mostly through health professionals (82.7%). On knowledge, 24.3% of adults gave correct answers to more than three out of six statements (three true and three false statements) (increased from 23.7% to 2017). The overall mean score of awareness of appropriate antibiotic use and AMR is 3.3 out of total score of 5. Conclusions Although progress was made on knowledge and awareness between 2017 and 2019, certain practices, such as use of antibiotics for flu symptoms and receiving information about antibiotic use and AMR, are inappropriate and inadequate. These findings require significant action, notably strengthening health professionals’ ability to prescribe and dispense antibiotics appropriately and effective communication with patients. The government should promote specific information on rational use of antibiotics and AMR to specific target groups.
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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.
| | - Supapat Kirivan
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Apichart Thunyahan
- National Statistical Office, Ministry of Digital Economy and Society, Bangkok, Thailand
| | - Angkana Lekagul
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
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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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Alanizy BA, Masud N, Alabdulkarim AA, Aldihan GA, Alwabel RA, Alsuwaid SM, Sulaiman I. Are patients knowledgeable of medical errors and medical complications? A cross-sectional study at a tertiary hospital, Riyadh. J Family Med Prim Care 2021; 10:2980-2986. [PMID: 34660435 PMCID: PMC8483113 DOI: 10.4103/jfmpc.jfmpc_2031_20] [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: 10/01/2020] [Revised: 12/03/2020] [Accepted: 12/16/2020] [Indexed: 11/04/2022] Open
Abstract
Background Basic understanding of medical errors and medical complications is essential to ensure patient safety. Our aim in this study was to assess whether patients have sufficient knowledge of medical errors and medical complications and to identify the factors that influence their knowledge. Methods A cross-sectional study was conducted with 400 patients with a scheduled appointment at King Abdulaziz Medical City from 2019 to 2020. A self-administered validated questionnaire was developed by the coinvestigators. The first section focused on demographic information, and the second contained 17 scenarios to assess the knowledge of the patients. The data were analyzed with Chi-square test and logistic regression. Results The sample size realized as 346 (n = 346), with the majority (n = 198, 57%) female, and the mean age 39.5 ± 11 years. The mean scores for the medical errors and complications were 5.5 ± 2.10 and 4.8 ± 2.3, respectively. The participants with secondary education were less likely to have sufficient knowledge of both medical complications (OR 0.52, P = 0.016) and errors (OR 0.52, P = 0.016). In terms of age, the older participants, the 38-47 year age group, were less likely to be knowledgeable about medical complications compared to the younger age groups (OR 0.92, P = 0.046). Conclusion The patients had a higher level of knowledge about medical errors compared to medical complications. The level of education and the employment status significantly predicted the knowledge of both medical errors and complications.
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Affiliation(s)
- Butoul Alshaish Alanizy
- Medical Students, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, King Abdullah International Medical Re-Search Center, Riyadh, Saudi Arabia
| | - Nazish Masud
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, King Abdullah International Medical Re-Search Center, Riyadh, Saudi Arabia
| | - Aljawaharah Abdulaziz Alabdulkarim
- Medical Students, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, King Abdullah International Medical Re-Search Center, Riyadh, Saudi Arabia
| | - Ghada Abdulaziz Aldihan
- Medical Students, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, King Abdullah International Medical Re-Search Center, Riyadh, Saudi Arabia
| | - Reema Abdullah Alwabel
- Medical Students, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, King Abdullah International Medical Re-Search Center, Riyadh, Saudi Arabia
| | - Shikah Mohammed Alsuwaid
- Medical Students, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, King Abdullah International Medical Re-Search Center, Riyadh, Saudi Arabia
| | - Ihab Sulaiman
- Department of Car-Diology, Ministry of National Guard Health Affairs- Health Affairs, Riyadh, Saudi Arabia
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Henaine AM, Lahoud N, Abdo R, Shdeed R, Safwan J, Akel M, Fahs I, Zeenny R, Sacre H, Hallit S, Salameh P. Knowledge of Antibiotics Use among Lebanese Adults: A study on the influence of sociodemographic characteristics. Sultan Qaboos Univ Med J 2021; 21:442-449. [PMID: 34522411 PMCID: PMC8407903 DOI: 10.18295/squmj.4.2021.006] [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: 04/27/2020] [Revised: 08/26/2020] [Accepted: 11/10/2020] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aimed to evaluate the association between sociodemographic characteristics and antibiotic knowledge in the Lebanese population. Methods A questionnaire-based survey was conducted in community pharmacies across all Lebanese governorates. Data were collected by well-trained pharmacists through face-to-face interviews from January until March 2017. The survey tool was adapted from a questionnaire developed by the World Health Organization. A knowledge index was computed for comparative purposes and a linear regression model was performed to assess factors associated with knowledge. Results A total of 623 participants were included in the analysis of this study (response rate: 90.6%). The mean antibiotic knowledge index was 12.5 ± 3.2 (minimum score: 3 and maximum score: 19). Higher knowledge score was inversely correlated with age (r = −0.118; P = 0.003), but no gender differences were reported (females: 12.6 versus males: 12.3; P = 0.191). However, statistically significant differences were found for residence type (P = 0.002), educational level (P <0.001) and total household income categories (P <0.001). The linear regression model showed a significant association between residence type and knowledge (urban versus rural: β = 0.793; P = 0.011). Furthermore, a higher knowledge index was significantly associated with a higher income combined with higher education (additive scale/β = 1.590; P = 0.025). Finally, interactions between income and age, gender and residence type were not significant. Conclusion Individuals residing in urban areas, with combined high income and educational levels, are more knowledgeable about antibiotics use and resistance compared to other groups. More studies are needed to assess the interaction of sociodemographic interactions with health literacy.
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Affiliation(s)
| | - Nathalie Lahoud
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon.,INSPECT-LB Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
| | - Rachel Abdo
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon.,INSPECT-LB Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
| | - Ruba Shdeed
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Jihan Safwan
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Marwan Akel
- INSPECT-LB Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.,School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Iqbal Fahs
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Rony Zeenny
- INSPECT-LB Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.,Department of Pharmacy, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Pascale Salameh
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon.,INSPECT-LB Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
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Public Health Literacy, Knowledge, and Awareness Regarding Antibiotic Use and Antimicrobial Resistance during the COVID-19 Pandemic: A Cross-Sectional Study. Antibiotics (Basel) 2021; 10:antibiotics10091107. [PMID: 34572689 PMCID: PMC8472776 DOI: 10.3390/antibiotics10091107] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/29/2021] [Accepted: 09/02/2021] [Indexed: 01/08/2023] Open
Abstract
Multi-drug-resistant (MDR) organisms pose a global threat to modern medicine, which has grown as a result of irrational antibiotic use and misuse. This study aimed to assess general public knowledge in Jordan and awareness of antibiotics and antibiotic resistance during the COVID-19 pandemic. A cross-sectional study was carried out utilizing the WHO multicountry public awareness survey. The study population was composed mainly of social media users, and a total of 1213 participants completed the online survey. According to the findings, more than half of the participants were well versed in antibiotic use and resistance. Those with adequate health literacy were found to better understand antibiotics (OR = 1.37, p = 0.017) and antibiotic resistance (OR = 1.46, p = 0.003). The vast majority (88.5%) recognized at least one antibiotic resistance term; however, 53.2% believed that antibiotic resistance is a problem in other nations. The participants in this study reported using antibiotics incorrectly, believing that they were treating sore throats, colds, and flu. The participants were well aware of antibiotic resistance solutions and their consequences on health. Age, education, health literacy, and antibiotic knowledge were found to be substantially (p < 0.05) associated with greater awareness of antibiotic resistance. The findings highlight the need for antimicrobial resistance education campaigns, health literacy, and antibiotic stewardship initiatives.
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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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Herawati F, Yulia R, Arifin B, Frasetyo I, Setiasih, Woerdenbag HJ, Avanti C, Andrajati R. Educational Video Improves Knowledge about Outpatients' Usage of Antibiotics in Two Public Hospitals in Indonesia. Antibiotics (Basel) 2021; 10:606. [PMID: 34065353 PMCID: PMC8161411 DOI: 10.3390/antibiotics10050606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/12/2021] [Accepted: 05/18/2021] [Indexed: 11/29/2022] Open
Abstract
The inappropriate use or misuse of antibiotics, particularly by outpatients, increases antibiotic resistance. A lack of public knowledge about "Responsible use of antibiotics" and "How to obtain antibiotics" is a major cause of this. This study aimed to assess the effectiveness of an educational video about antibiotics and antibiotic use to increase outpatients' knowledge shown in two public hospitals in East Java, Indonesia. A quasi-experimental research setting was used with a one-group pre-test-post-test design, carried out from November 2018 to January 2019. The study population consisted of outpatients to whom antibiotics were prescribed. Participants were selected using a purposive sampling technique; 98 outpatients at MZ General Hospital in the S regency and 96 at SG General Hospital in the L regency were included. A questionnaire was used to measure the respondents' knowledge, and consisted of five domains, i.e., the definition of infections and antibiotics, obtaining the antibiotics, directions for use, storage instructions, and antibiotic resistance. The knowledge test score was the total score of the Guttman scale (a dichotomous "yes" or "no" answer). To determine the significance of the difference in knowledge before and after providing the educational video and in the knowledge score between hospitals, the (paired) Student's t-test was applied. The educational videos significantly improved outpatients' knowledge, which increased by 41% in MZ General Hospital, and by 42% in SG General Hospital. It was concluded that an educational video provides a useful method to improve the knowledge of the outpatients regarding antibiotics.
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Affiliation(s)
- Fauna Herawati
- Department of Clinical and Community Pharmacy, Faculty of Pharmacy, Universitas Surabaya, Surabaya 60293, Indonesia; (R.Y.); (B.A.); (I.F.)
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Indonesia, Depok 16424, Indonesia;
| | - Rika Yulia
- Department of Clinical and Community Pharmacy, Faculty of Pharmacy, Universitas Surabaya, Surabaya 60293, Indonesia; (R.Y.); (B.A.); (I.F.)
| | - Bustanul Arifin
- Department of Clinical and Community Pharmacy, Faculty of Pharmacy, Universitas Surabaya, Surabaya 60293, Indonesia; (R.Y.); (B.A.); (I.F.)
| | - Ikhwan Frasetyo
- Department of Clinical and Community Pharmacy, Faculty of Pharmacy, Universitas Surabaya, Surabaya 60293, Indonesia; (R.Y.); (B.A.); (I.F.)
| | - Setiasih
- Laboratory for Developmental Psychology, Faculty of Psychology, Universitas Surabaya, Surabaya 60293, Indonesia;
| | - Herman J. Woerdenbag
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, 9713 AV Groningen, The Netherlands;
| | - Christina Avanti
- Department of Pharmaceutics, Faculty of Pharmacy, Universitas Surabaya, Surabaya 60293, Indonesia;
| | - Retnosari Andrajati
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Indonesia, Depok 16424, Indonesia;
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Zawahir S, Lekamwasam S, Halvorsen KH, Rose G, Aslani P. Self-medication Behavior with antibiotics: a national cross-sectional survey in Sri Lanka. Expert Rev Anti Infect Ther 2021; 19:1341-1352. [PMID: 33792479 DOI: 10.1080/14787210.2021.1911647] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Antibiotic self-medication is common in low- and middle-income countries. This study aimed to evaluate the Sri Lankan public's knowledge about and attitudes toward antibiotic use and self-medication, and factors associated with self-medication. METHODS A national cross-sectional, interviewer-administered, survey of a random household sample (N = 1100) was conducted. Factor analysis of the attitudinal items was conducted to investigate the factors associated with antibiotic self-medication. RESULTS A response rate of ninety-one percent (n = 998) responded. Knowledge about antibiotics was poor (mean = 12.5; SD = 3.5; (scale 0-27)). Half had previously used an antibiotic once in the past three months. About 11% (108/998) had self-medicated the last time they took antibiotics; mostly obtained from a pharmacy (82%; 89/108). Three attitudinal factors were obtained, explaining 56.1% of the variance. Respondents were less likely to self-medicate if they did not support ease of access to antibiotics from pharmacies (p< 0.001) and situational use of antibiotics (p= 0.001); supported appropriate use of antibiotics (p= 0.003); and had greater knowledge about prescription requirements for antibiotics (p= 0.004). CONCLUSION There is limited knowledge about, and a high rate of self-medication with antibiotics.Factors contributing to self-medication could be addressed with appropriate public education campaigns, and policy changes.
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Affiliation(s)
- Shukry Zawahir
- , The University of Sydney School of Pharmacy, Faculty of Medicine and Health, NSW, Australia.,Central Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Sarath Lekamwasam
- Population Health Research Centre, Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Kjell H Halvorsen
- Department of Pharmacy, UiT the Arctic University of Norway, Tromsø, Norway
| | - Grenville Rose
- Centre for Social Research in Health, The University of New South Wales, NSW, Australia
| | - Parisa Aslani
- , The University of Sydney School of Pharmacy, Faculty of Medicine and Health, NSW, Australia
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Darwish RM, Baqain GN, Aladwan H, Salamah LM, Madi R, Masri RMA. Knowledge, attitudes, and practices regarding antibiotic use and resistance among community pharmacists: a cross sectional study in Jordan. Int J Clin Pharm 2021; 43:1198-1207. [PMID: 33515133 DOI: 10.1007/s11096-021-01234-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 01/09/2021] [Indexed: 10/22/2022]
Abstract
Background Antibiotic resistance is a global threat and burden on healthcare systems. One major factor contributing to this problem is inappropriate use of antibiotics, which comprises suboptimal use, misuse, abuse, and dispensing errors. Another important factor is dispensing antibiotics without medical prescription. Many studies considered pharmacists as healthcare providers accountable for this malpractice. Objectives To investigate community pharmacists' knowledge, attitudes, and practices in relation to antibiotic dispensing, antibiotic resistance and antibiotic stewardship. Setting Community pharmacists selected from different areas in Amman/Jordan. Subjects were selected based on their availability and accessibility. Methods A descriptive cross-sectional survey of community pharmacists was conducted between May to October 2019, using a structured, validated, and pilot-tested questionnaire. A four-part systematic survey consisting of biography, knowledge, practice and attitude domains was used. Main outcome measure community pharmacist knowledge, practices and attitudes regarding antibiotic use and resistance. Results Of 150 community pharmacists approached, 114 completed and returned the questionnaire (response rate 76%). More than 83.3% perceived antimicrobial resistance as a global problem. A substantial percentage (59.7%) educate patients about issues of inappropriate antibiotics use. Almost half the participants (44.7%) agreed that implementing antimicrobial stewardship would result in better outcomes. Conclusion It is crucial to improve the curriculum in schools of pharmacy, emphasizing on interprofessional education and developing customized interventions. Regulations on dispensing antibiotics without prescription should be enforced. Policy makers need to implement antimicrobial stewardship and encourage the use of public educational interventions in community pharmacy.
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Affiliation(s)
- Rula M Darwish
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, Jordan.
| | - Ghaida N Baqain
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Hala Aladwan
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Lina M Salamah
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Rahaf Madi
- Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, Jordan
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Sagmeister KJ, Schinagl CW, Kapelari S, Vrabl P. Students' Experiences of Working With a Socio-Scientific Issues-Based Curriculum Unit Using Role-Playing to Negotiate Antibiotic Resistance. Front Microbiol 2021; 11:577501. [PMID: 33552005 PMCID: PMC7855855 DOI: 10.3389/fmicb.2020.577501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 12/28/2020] [Indexed: 12/24/2022] Open
Abstract
The emergence and widespread of antibiotic-resistant pathogenic microorganisms are of great individual and societal relevance. Due to the complex and multilayered nature of the topic, antibiotic resistance (ABR) is the object of concern for several scientific fields, such as microbiology or medicine, and encompasses a broad range of political, economic, and social aspects. Thus, the issue related to antibiotic-resistant bacterial diseases offers an excellent platform for designing and implementing the teaching and learning of socio-scientific issues (SSI). We created a SSI-based curriculum unit for use in secondary science classrooms by developing a collaborative partnership between education researchers and microbiologists. This classroom environment allows students to explore and negotiate ABR as a societal and scientific phenomenon. For this purpose, we leveraged role-playing within the SSI-based unit as a productive context for engaging students in learning opportunities that provide multiple perspectives on ABR and the complex interplay of its accelerators. This case-based paper describes Austrian school students' experiences from their participation in a SSI-embedded role-playing classroom environment and subsequent activities that included a mini congress with a poster presentation and a panel discussion. An open-ended questionnaire-based assessment tool was used to examine the situational characteristics of the students' work. To assess students' contributions, we applied a qualitative content analysis design and identified cognitive and affective outcomes. The students' learning experiences demonstrate that they considered the content - the social complexities of antibiotic-resistant bacteria and associated diseases - exciting and very topical. The students perceived that learning about ABR is relevant for their future and involves both individual and societal responsibility for action. Although the curriculum unit and its assignments were described as labor-intensive, it became apparent that the role-playing setting has the potential to inform students about multiple stakeholder positions concerning ABR. Concerning the promotion of science practices, almost all students claimed that they learned to organize, analyze, evaluate, and present relevant information. Moreover, the students affirmed that they learned to argue from the perspective of their assigned roles. However, the students did not clarify whether they learned more through this SSI-based classroom instruction than through conventional science teaching approaches.
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Affiliation(s)
| | | | - Suzanne Kapelari
- Department of Subject-Specific Education, University of Innsbruck, Innsbruck, Austria
| | - Pamela Vrabl
- Department of Microbiology, University of Innsbruck, Innsbruck, Austria
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Sindato C, Mboera LEG, Katale BZ, Frumence G, Kimera S, Clark TG, Legido-Quigley H, Mshana SE, Rweyemamu MM, Matee M. Knowledge, attitudes and practices regarding antimicrobial use and resistance among communities of Ilala, Kilosa and Kibaha districts of Tanzania. Antimicrob Resist Infect Control 2020; 9:194. [PMID: 33287878 PMCID: PMC7720393 DOI: 10.1186/s13756-020-00862-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/22/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) represents one of the biggest threats to health globally. This cross-sectional study determined knowledge, attitudes and practices (KAP) regarding antimicrobial use (AMU) and AMR among communities of Ilala, Kilosa and Kibaha in Tanzania. METHOD A semi-structured questionnaire was used to collect socio-demographic and KAP data through face-to-face interviews. Responses related to the triad of KAP were assigned scores that were aggregated for each participant. Linear regression analysis was conducted to determine predictors of KAP scores. RESULTS The study enrolled 828 participants from the three districts. A total of 816 (98.6%) were aware of antimicrobials, and 808 (99%, n = 816) reported to have used them. Antimicrobials were mainly used to treat cough (68.0%), urinary tract infections (53.4%), diarrhoea (48.5%) and wounds (45.2%). The most frequent sources of antimicrobials were health facility (65.0%, n = 820) and pharmacies/basic drug shops (53.7%). The median AMU knowledge score was 5 (IQR = 4, 7) and that of AMR was 26 (IQR=23, 29). The median AMU attitudes score was 32 (IQR: 29, 35) and that of AMR was 19 (IQR=17, 22). The median AMU practice score was 3 (IQR: 3, 3). The KAP scores were significantly influenced by increased participant's age (βadj=0.10; 95% CI: 0.05, 0.15) and level of education, being lower among those with primary education (βadj=5.32; 95% CI: 3.27, 7.37) and highest among those with college/university education (βadj=9.85; 95% CI: 6.04, 13.67). CONCLUSION The study documented a moderate level of KAP regarding AMU and AMR in the study districts. The participant's age and level of education were significantly associated with participant's KAP scores. The observed inadequate knowledge, inappropriate attitude, and practices of AMU and AMR should be considered as alarming problems that require immediate actions including policy formulation and planning of community-based mitigation measures.
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Affiliation(s)
- Calvin Sindato
- National Institute for Medical Research, Tabora Research Centre, Tabora, Tanzania.
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania.
| | - Leonard E G Mboera
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Bugwesa Z Katale
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania
- Tanzania Commission for Science and Technology, Dar es Salaam, Tanzania
| | - Gasto Frumence
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Sharadhuli Kimera
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania
- College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Taane G Clark
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Stephen E Mshana
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania
- Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Mark M Rweyemamu
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Mecky Matee
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Fletcher-Miles H, Gammon J. A scoping review on the influential cognitive constructs informing public AMR behavior compliance and the attribution of personal responsibility. Am J Infect Control 2020; 48:1381-1386. [PMID: 32067811 DOI: 10.1016/j.ajic.2020.01.007] [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: 09/16/2019] [Revised: 01/06/2020] [Accepted: 01/06/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Antibiotic resistance is a growing threat to public health. Despite various attempts at educating the public on antimicrobial resistance (AMR) and judicial antibiotic use, fallacies and misconceptions remain. To successfully promote behavior change, various cognitive constructs pertaining to antibiotic behavior need to be identified and targeted. METHODS Using the Arksey and O'Malley (2005) methodological framework, a credible reflexive examination of literature was conducted, permitting identification of a breadth of literature that pertained to the influence of cognitive constructs on public antimicrobial behavior. RESULTS From 393 abstracts identified, 67 full articles were screened, and 43 papers were chosen for review. Three themes were identified (1) sociodemographic influences; (2) knowledge, misconceptions, and fallacies; and (3) public attitudes and the social influence of friends and family. Geographical location, education level, cognitive dissonance, and social norms were found to influence AMR cognition, resulting in disproportionate risk assessments that are facilitated by social information brokering. CONCLUSIONS Public AMR resilience, responsibility, and behavior compliance are influenced by cognitive constructs, which are liable to the appropriation of misconceptions, fallacies, and social behavior models obtained via information brokering. A cohesive multidisciplinary participatory approach to AMR management and interventional design that applies the influence of cognitive constructs to inform public AMR behavior compliance is recommended.
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Affiliation(s)
- Hayley Fletcher-Miles
- College of Human and Health Sciences, Swansea University, Swansea, Wales, United Kingdom.
| | - John Gammon
- College of Human and Health Sciences, Swansea University, Swansea, Wales, United Kingdom
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Iramiot JS, Kajumbula H, Bazira J, Kansiime C, Asiimwe BB. Antimicrobial resistance at the human-animal interface in the Pastoralist Communities of Kasese District, South Western Uganda. Sci Rep 2020; 10:14737. [PMID: 32895433 PMCID: PMC7477235 DOI: 10.1038/s41598-020-70517-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/09/2020] [Indexed: 12/17/2022] Open
Abstract
Intensive usage of antimicrobials in the management of animal diseases leads to selection for resistance among microorganisms. This study aimed to assess antimicrobial use and to describe factors associated with the transmission of antimicrobial resistance between humans and animals in pastoralist communities of Kasese district. A mixed-methods approach was employed in this study. Rectal swabs were collected from the participants and cattle and transported in Carry-Blaire transport medium to the laboratory within 24 h of collection for culture and sensitivity to confirm carriage of multi-drug resistant bacteria. In-depth interviews were conducted among veterinary officers, veterinary drug vendors, human health facility in-charges in both public and private health facilities, and operators of human pharmacies and drug shops. Carriage of multi-drug resistant bacteria among humans was 88 (93%) and 76(80%) among cattle. Consumption of lakeshore water and carriage of multi-drug resistant bacteria in cattle were associated with carriage of multi-drug resistant bacteria in the human population. The prevalence of multi-drug resistance among organisms Isolated from both humans and animals was high. There is a high likelihood of transmission of multi-drug resistance between humans and animals.
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Affiliation(s)
- Jacob Stanley Iramiot
- Department of Medical Microbiology, College of Health Sciences, Makerere University School of Biomedical Sciences, P.O Box 7072, Kampala, Uganda
- Department of Microbiology and Immunology, Faculty of Health Sciences, Busitema University, Mbale, Uganda
| | - Henry Kajumbula
- Department of Medical Microbiology, College of Health Sciences, Makerere University School of Biomedical Sciences, P.O Box 7072, Kampala, Uganda
| | - Joel Bazira
- Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Catherine Kansiime
- Department of Medical Microbiology, College of Health Sciences, Makerere University School of Biomedical Sciences, P.O Box 7072, Kampala, Uganda
| | - Benon B. Asiimwe
- Department of Medical Microbiology, College of Health Sciences, Makerere University School of Biomedical Sciences, P.O Box 7072, Kampala, Uganda
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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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Sakr S, Ghaddar A, Hamam B, Sheet I. Antibiotic use and resistance: an unprecedented assessment of university students' knowledge, attitude and practices (KAP) in Lebanon. BMC Public Health 2020; 20:535. [PMID: 32306940 PMCID: PMC7169022 DOI: 10.1186/s12889-020-08676-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 04/07/2020] [Indexed: 12/15/2022] Open
Abstract
Background The emergence and spread of pathogenic bacteria that is resistant to antibiotics has become a major public health concern. The incorrect prescription, inappropriate consumption and excess use of antimicrobial drugs, specifically antibiotics, are possibly the main factors contributing to the widespread of antibiotic resistant bacteria. This study aims to evaluate the knowledge, attitude and practices (KAP) towards the use of antibiotics as well as their resistance among Lebanese university students in health and non-health related majors. Methods This cross-sectional study was conducted between May and June 2019 in Beirut (Lebanon) in which 750 students completed a questionnaire made up of four dimensions: Socio-demographic characteristics, 3 questions; assessment of knowledge, attitude and practices, 7, 10 and 1 question, respectively. The data was collected in spreadsheets and analysed with descriptive statistics. The difference in mean scores in each of the knowledge, attitude and practices dimensions between health and non-health related major students was analysed using t-student tests and the difference in percentages using chi-square tests. Results Almost 78% of respondents from the health related majors scored high knowledge compared to only 41% of non-health related majors (mean = 4.26; standard error = 0.05 versus mean = 3.41; standard error = 0.13, respectively). The attitude score of the health related major students (35.42%) was positive and more satisfactory compared to the non-health related students (7.32%); (mean = 9.34; standard error = 0.05 versus mean = 9.10; standard error = 0.21, respectively). However, the difference in the scores of attitudes was not statistically significant. Conclusions Interventions to promote awareness in this area should focus more students in on non-health related majors.
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Affiliation(s)
- Samer Sakr
- Department of Biological and Chemical Sciences, School of Arts and Sciences, Lebanese International University, Beirut, Lebanon.
| | - Ali Ghaddar
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Beirut, Lebanon
| | - Bassam Hamam
- Department of Biological and Chemical Sciences, School of Arts and Sciences, Lebanese International University, Beirut, Lebanon
| | - Imtithal Sheet
- Department of Biological and Chemical Sciences, School of Arts and Sciences, Lebanese International University, Beirut, Lebanon
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Knowledge, Attitude, and Practices of Antibiotics and Antibiotic Resistance Among Chinese Pharmacy Customers: A Multicenter Survey Study. Antibiotics (Basel) 2020; 9:antibiotics9040184. [PMID: 32316147 PMCID: PMC7235738 DOI: 10.3390/antibiotics9040184] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/02/2020] [Accepted: 04/08/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Resistance to antibiotics is one of the major global health challenges. An adequate understanding of the public regarding rational antibiotic use is a prerequisite to limit progression in antibiotic resistance. This study aimed to investigate the knowledge, attitude, and practices (KAP) of antibiotics and antibiotic resistance among customers visiting community pharmacies. METHODS This study was undertaken in three capital cities in China during March 2019 and July 2019 by using a questionnaire of 28 items. The questionnaire had four parts, including sociodemographic characteristics, KAP about antibiotics, and antibiotic resistance. A systematic random sampling approach was used to recruit the participants. Kruskal-Wallis and Mann-Whitney tests were carried out for data analysis. RESULTS The response rate was 66.7% (1800/2700). Out of the total, only 9.7% of the customers had good knowledge about antibiotics. Nearly half of the participants were unable to differentiate between antibiotics, and anti-inflammatory drugs (n = 820, 45.6%, Median = 2, IQR = 1). Most of the customers were of the view that the use of over the counter antibiotics in pregnant women is unsafe (n = 1307, 72.6%, Median = 2, IQR = 0). Almost half of the participants disagreed that costly antibiotics are more effective and have fewer side effects (n = 897, 49.9%, Median = 3, IQR = 1). Only 22.3% of participants said that they always finish the course of antibiotic treatment (n = 401, 22.3%, Median = 3, IQR = 1). CONCLUSION The knowledge of Chinese pharmacy consumers was inadequate, and a lack of good attitudes and practices in certain aspects of antibiotic use was observed. Educational interventions are needed to increase public knowledge of antibiotics.
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Tsuzuki S, Fujitsuka N, Horiuchi K, Ijichi S, Gu Y, Fujitomo Y, Takahashi R, Ohmagari N. Factors associated with sufficient knowledge of antibiotics and antimicrobial resistance in the Japanese general population. Sci Rep 2020; 10:3502. [PMID: 32103110 PMCID: PMC7044168 DOI: 10.1038/s41598-020-60444-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 02/12/2020] [Indexed: 11/09/2022] Open
Abstract
We conducted two online surveys about antibiotics targeted at the Japanese general population in March 2017 and February 2018. In total, 6,982 participants completed the questionnaire. Factors associated with knowledge of antibiotics, knowledge of antimicrobial resistance (AMR) and appropriate behavioural changes were evaluated by a machine learning approach using DataRobot. Factors strongly associated with three dependent variables in the model were extracted based on permuation importance. We found that the strongest determinant of knowledge of antibiotics and AMR was education level. Knowledge of antibiotics was strongly associated with the frequency of internet use. Exposure to primary information was associated with motivation for appropriate behavioural changes. Improving the availability of primary information would be a beneficial intervention. Individuals lacking higher education and without opportunities to obtain primary information should be considered a target population for effective interventions.
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Affiliation(s)
- Shinya Tsuzuki
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan.
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
| | | | | | | | - Yoshiaki Gu
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yumiko Fujitomo
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Rie Takahashi
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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Kurdi S, Faran A, Eareeni E, Alhalal N, Joseph R, Wali H, Alshayban D. Assessment of knowledge and attitude toward the new antibiotic dispensing law and its effect on antibiotic use in Saudi Arabia. Saudi Pharm J 2019; 28:58-67. [PMID: 31920432 PMCID: PMC6950961 DOI: 10.1016/j.jsps.2019.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 11/02/2019] [Indexed: 12/24/2022] Open
Abstract
Background Antibiotics resistance is a serious problem around the world, which has been increasing in the last century due to misuse of antibiotics. Recently, Saudi Arabia enforced the Executive Regulations of Health Practice Law that prohibits dispensing antibiotics without prescription. Aim (1) To assess the association between the knowledge and attitude toward the recent enforcement of the antibiotic restriction Law and the antibiotic use among Saudi population. (2) To assess the pattern of antibiotic use before and after the enforcement of the Law. Method An online cross-sectional study was conducted among residents of Saudi Arabia. Results The study was carried out among 570 Saudi participants; the result shows no considerable difference before and after law enforcement in purchasing and use of antibiotics. During the six months before the law implementation, antibiotics were obtained by 42 (7%) through purchase from the pharmacy without a prescription, 23 (4%) through remains of previously used containers, and 7 (1%) through a relative or a friend; while during the six months after the law implementation it was 31 (5%), 22 (4%) and 7 (1%), respectively. Only 48% agreed that they always received advice from a doctor, nurse or pharmacist on how to use your antibiotics. 32% have no knowledge about antibiotic resistance or drug resistance or antibiotic-resistant bacteria. More than two third (75%) were aware of the recent enforcement of the law that prohibits dispensing antibiotics without prescription. Among the participants, 91 (16%), 285 (50%) and 194 (34%) were expressed negative, neutral and positive attitude towards the law, respectively. Conclusion In spite of the recent enforcement of the Law, there is still misuse of antibiotics, which indicate need for educational programs and campaigns to improve the knowledge of the population.
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Affiliation(s)
- Sawsan Kurdi
- Imam Abdulrahman bin Faisal University, College of Clinical Pharmacy, Departemnt of Pharmacy Practice, Dammam 34212, Saudi Arabia
| | - Abrar Faran
- Imam Abdulrahman bin Faisal University, College of Clinical Pharmacy, Departemnt of Pharmacy Practice, Dammam 34212, Saudi Arabia
| | - Eman Eareeni
- Imam Abdulrahman bin Faisal University, College of Clinical Pharmacy, Departemnt of Pharmacy Practice, Dammam 34212, Saudi Arabia
| | - Noor Alhalal
- Imam Abdulrahman bin Faisal University, College of Clinical Pharmacy, Departemnt of Pharmacy Practice, Dammam 34212, Saudi Arabia
| | - Royes Joseph
- Imam Abdulrahman bin Faisal University, College of Clinical Pharmacy, Departemnt of Pharmacy Practice, Dammam 34212, Saudi Arabia
| | - Haytham Wali
- King Faisal University, College of Clinical Pharmacy, Departemnt of Pharmacy Practice, Al-Ahsa 36362, Saudi Arabia
| | - Dhafer Alshayban
- Imam Abdulrahman bin Faisal University, College of Clinical Pharmacy, Departemnt of Pharmacy Practice, Dammam 34212, Saudi Arabia
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