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Krolak-Ulińska A, Merks P, Religioni U, Chełstowska B, Drab A, Wdowiak K, Plagens-Rotman K, Doniec Z, Staniszewska A. Opinions of Medical Staff Regarding Antibiotic Resistance. Antibiotics (Basel) 2024; 13:493. [PMID: 38927161 PMCID: PMC11200360 DOI: 10.3390/antibiotics13060493] [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: 04/06/2024] [Revised: 05/22/2024] [Accepted: 05/25/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Antibiotic resistance poses a significant threat to public health, that can lead to reduced effectiveness of many therapies, increased morbidity, longer hospitalization times, increased deaths, and additional costs for health care systems. Unreasonable use of antibiotics may result from a lack of adequate knowledge about antibiotic therapy and a lack of knowledge of the risks associated with antibiotic resistance, both among medical personnel and patients. AIM The primary objective of the study was to verify the opinion of medical personnel on the risks associated with antibiotic resistance. MATERIAL AND METHODS The study was conducted in 2023 among 605 Polish sanitary workers. An anonymous survey designed specifically for the purpose of the study was used. The survey was made available on the Internet through the Trade Unions of Pharmacy Workers and directly to hospitals with the support of local authorities. RESULTS The majority of respondents were women (77.36%). The largest group consisted of individuals over 40 years of age (55.04%). More than half of the respondents were nurses (56.20%), and every fourth of the respondents was a physician (23.64%). Most respondents consider antibiotic resistance to be a very serious (24.13%) or extremely serious (30.75%) problem. The problem of antibiotic resistance on a global scale was mentioned, especially in the opinions of physicians and nurses (p < 0.01), people working in the profession for over a year (p < 0.01), and people with a specialization or undergoing specialist training (p = 0.00). Similarly, these groups most often indicated that antibiotic resistance poses a problem in their workplace. The main problems of antibiotic resistance were the use of antibiotics in farm animals (36.69%), the pressure on patients to take antibiotics (38.84%), and the prophylactic use of antibiotics (43.15%). CONCLUSIONS Medical personnel consider antibiotic resistance a somewhat serious problem, although not all agree in this regard. The risk of antibiotic resistance is much more seriously assessed by physicians and nurses, as well as by people with specializations or undergoing specialization training. Knowledge about antibiotic resistance should be further spread among all groups of medical personnel.
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Affiliation(s)
- Aneta Krolak-Ulińska
- Anestesiology and Intensive Care Unit, Węgrów Regional Hospital, ul. Tadeusza Kościuszki 201, 07-100 Węgrów, Poland;
| | - Piotr Merks
- Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, Wóycickiego 1/3, 01-938 Warsaw, Poland
- The Polish Pharmacy Practice Research Network (PPPRN), ul. Wóycickiego 1/3, 01-938 Warsaw, Poland
| | - Urszula Religioni
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, 01-824 Warsaw, Poland
| | - Beata Chełstowska
- Department of Biochemistry and Laboratory Diagnostics, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, 01-938 Warsaw, Poland
| | - Agnieszka Drab
- Department of Medical Informatics and Statistics with e-Health Laboratory, Medical University of Lublin, 20-059 Lublin, Poland
| | - Krystian Wdowiak
- Faculty of Medicine, Medical University of Lublin, 20-059 Lublin, Poland
| | - Katarzyna Plagens-Rotman
- Center for Sexology and Pediatric, Adolescent Gynecology, Division of Gynecology, Department of Perinatology and Gynecology, Poznan University of Medical Sciences, 61-712 Poznan, Poland
| | - Zbigniew Doniec
- Pneumonology Clinic, Institute of Tuberculosis and Lung Diseases in Rabka-Zdrój, 34-700 Rabka-Zdrój, Poland
| | - Anna Staniszewska
- Department of Pharmacology, Medical University of Warsaw, 01-079 Warsaw, Poland;
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Domínguez-Domínguez L, Castelo Baz P, Cabrera-Fernandez A, Cabanillas-Balsera D, Pabon-Carrasco M, Segura-Egea JJ, Martin-Gonzalez J. Patients' Opinions on Antibiotics in the Treatment of Dental Infections: A Cross-Sectional Survey. J Clin Med 2024; 13:2099. [PMID: 38610864 PMCID: PMC11012582 DOI: 10.3390/jcm13072099] [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: 03/06/2024] [Revised: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
Background: The aim of this study was to evaluate patients' knowledge and perceptions of the use of systemic antibiotics in the treatment of endodontic infections and to determine the possible contribution of patients to the development of bacterial resistance. Methods: A total of 550 patients were asked to respond to a survey on the perception of systemic antibiotic use in the treatment of endodontic infections and antibiotic resistance during January 2022 and March 2023. A bivariate and multivariate analysis was performed to determine possible correlates in the population regarding antibiotic use in the endodontic world. Results: A total of 514 patients were included in the study, 65.9% of whom were women. While 34.6% of the population studied thought that it was always necessary to take antibiotics prior to endodontics, 49.4% considered that they were necessary after endodontics, regardless of the clinical symptoms. The prevalence of self-medication was 17.3%, and women self-medicate more than men, with significant differences (p < 0.05), although they have a greater knowledge of antibiotic resistance than men (p < 0.05). Forty-four percent of the population expected to take antibiotics when faced with dental pain, mainly women (p < 0.05). Conclusions: The general population is contributing to the serious problem of bacterial resistance. It is necessary to promote educational strategies focused on the correct use of antibiotics in the community. The worst results were found mainly in the population with a low level of education. The level of education was the variable that most influenced the knowledge and attitudes of the population, followed by the sex of the participants.
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Affiliation(s)
- Laura Domínguez-Domínguez
- Department of Stomatology, Endodontic Section, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain
| | - Pablo Castelo Baz
- Oral Sciences Research Group, Endodontics and Restorative Dentistry Unit, School of Medicine and Dentistry, Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - Alberto Cabrera-Fernandez
- Department of Stomatology, Endodontic Section, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain
| | - Daniel Cabanillas-Balsera
- Department of Stomatology, Endodontic Section, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain
| | - Manuel Pabon-Carrasco
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, 41004 Sevilla, Spain
| | - Juan Jose Segura-Egea
- Department of Stomatology, Endodontic Section, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain
| | - Jenifer Martin-Gonzalez
- Department of Stomatology, Endodontic Section, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain
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Chalkidou A, Lambert M, Cordoba G, Taxis K, Hansen MP, Bjerrum L. Misconceptions and Knowledge Gaps on Antibiotic Use and Resistance in Four Healthcare Settings and Five European Countries-A Modified Delphi Study. Antibiotics (Basel) 2023; 12:1435. [PMID: 37760731 PMCID: PMC10525245 DOI: 10.3390/antibiotics12091435] [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: 07/14/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Misconceptions and knowledge gaps about antibiotics contribute to inappropriate antibiotic use and antimicrobial resistance. This study aimed to identify and prioritize misconceptions and knowledge gaps about antibiotic use from a healthcare professionals' perspective. A modified Delphi study with a predefined list of statements, two questionnaire rounds, and an expert meeting was conducted. The statements were rated by healthcare professionals from France, Greece, Lithuania, Poland, and Spain, and from general practice, out-of-hour services, nursing homes, and pharmacies. A total of 44 pre-defined statements covered the following themes: (1) antimicrobial resistance in general, (2) use of antibiotics in general, (3) use of antibiotics for respiratory tract infections, and (4) use of antibiotics for urinary tract infections. Consensus was defined as ≥80% agreement between the professionals during the second Delphi round. For 30% of the statements, professionals from the four settings together reached consensus. In each setting individually, at least 50% of the statements reached consensus, indicating that there are still many misconceptions and knowledge gaps that need to be addressed. Six educational tools (leaflets, posters, checklists) were developed to address the knowledge gaps and misconceptions. These can be used by patients and healthcare professionals to improve the use of antibiotics in practice.
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Affiliation(s)
- Athina Chalkidou
- Section and Research Unit of General Practice, Department of Public Health, University of Copenhagen, 1353 Copenhagen, Denmark;
| | - Maarten Lambert
- Unit of PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands; (M.L.); (K.T.)
| | - Gloria Cordoba
- School of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa;
| | - Katja Taxis
- Unit of PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands; (M.L.); (K.T.)
| | - Malene Plejdrup Hansen
- Center for General Practice, Department of Clinical Medicine, Aalborg University, 9220 Aalborg, Denmark;
- Audit Project Odense, Research Unit for General Practice, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Lars Bjerrum
- Section and Research Unit of General Practice, Department of Public Health, University of Copenhagen, 1353 Copenhagen, Denmark;
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Chatterjee S, Hazra A, Chakraverty R, Shafiq N, Pathak A, Trivedi N, Sadasivam B, Kakkar AK, Jhaj R, Kaul R, Kshirsagar N. A multicentric knowledge-attitude-practice survey in the community about antimicrobial use and resistance in India. Trans R Soc Trop Med Hyg 2021; 115:785-791. [PMID: 33216125 DOI: 10.1093/trstmh/traa124] [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: 05/23/2020] [Revised: 09/09/2020] [Accepted: 10/20/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To address the reasons for inappropriate use of antimicrobials, it is important to understand the knowledge, attitude and practices (KAP) of all pertinent stakeholders. This multicentric survey is aimed at understanding the KAP quotients of the community regarding antimicrobial use and antimicrobial resistance (AMR), as such information is lacking in India. METHODS A cross-sectional survey was conducted by face-to-face interviews across five centers in India using a validated, field-tested questionnaire incorporating KAP domain questions. Scores were appropriately assigned to the questions. RESULTS The mean (SD) age of the respondents was 35.2 (12.61) y and 62% had a graduate or higher level of education. The median (IQR) KAP scores were 10 (8-12), 5 (3-5) and 2 (2-3) out of a maximum of 18, 5 and 6, respectively. Higher educational and socioeconomic levels were associated with better attitude scores, but knowledge levels were comparable. Correlations between KAP scores were poor. CONCLUSIONS This study reveals that laypeople have appropriate knowledge and attitude regarding antibiotic use and AMR to some degree but there are important lacunae and practices are often wanting. These issues need to be addressed in sustained public awareness and motivation campaigns to improve the rational use of antibiotics in India.
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Affiliation(s)
- Suparna Chatterjee
- Department of Pharmacology, Institute of Postgraduate Medical Education & Research, Kolkata, India
| | - Avijit Hazra
- Department of Pharmacology, Institute of Postgraduate Medical Education & Research, Kolkata, India
| | - Raja Chakraverty
- Department of Pharmacology, Institute of Postgraduate Medical Education & Research, Kolkata, India
| | - Nusrat Shafiq
- Department of Pharmacology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Ashish Pathak
- Department of Pediatrics, R. D. Gardi Medical College, Ujjain, India
| | - Niyati Trivedi
- Department of Pharmacology, Government Medical College, Baroda, India
| | | | - Ashish Kumar Kakkar
- Department of Pharmacology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Ratinder Jhaj
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India
| | - Rajni Kaul
- Indian Council of Medical Research, New Delhi, India
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Pérez-Amate B, Figueiredo R, Cortés-Peral S, Sánchez-Torres A, Valmaseda-Castellón E. Patient perception about the need for antibiotics after tooth extractions: A cross-sectional study. J Clin Exp Dent 2021; 13:e499-e504. [PMID: 33981398 PMCID: PMC8106931 DOI: 10.4317/jced.57938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 11/02/2020] [Indexed: 01/21/2023] Open
Abstract
Background Although the current scientific literature does not support the routine use of antibiotics after dental extractions, patients believe that these drugs offer clear benefit during the postoperative period. The main objective of this study was to describe patient perception of the need for antibiotics after routine tooth extraction and to assess knowledge about the benefits and adverse effects of antibiotic therapy. Material and Methods A cross-sectional study was carried out. A total of 452 participants requiring tooth extraction and seen in the Dental Clinic of the University of Barcelona (Barcelona, Spain) were given a specific questionnaire on the need for antibiotics after dental treatments or diseases, and on their benefits and adverse effects. Descriptive bivariate and multivariate (logistic regression model) analyses were performed. Results Of the 452 participants, 185 (40.9%) were men and 267 (59.1%) were women, with a mean age of 35.2 ± 15.9 years. Most of the patients (76.6%) expected to take antibiotics after tooth extraction. A higher level of education, older age and knowledge about bacterial resistances were inversely correlated to the perceived need for antibiotic treatment (p<0.05). According to the respondents, the main advantage of antibiotics was the reduction of infection rates, while the most frequently mentioned adverse events were allergic reactions, diarrhea and nausea or vomiting. Conclusions Most patients think that antibiotics are necessary after routine dental extraction to prevent postoperative infection. Younger patients with a low educational level and who are unaware of the problem posed by bacterial resistances seem to be more supportive of antibiotic prophylaxis. Most respondents are familiar with the main benefits and adverse effects of these drugs. Key words:Antibiotic, microbial drug resistance, tooth extraction, oral surgery, survey, postoperative wound infection.
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Affiliation(s)
- Berta Pérez-Amate
- DDS. Fellow of the Master degree program in Oral Surgery and Implantology, School of Medicine and Health Sciences, University of Barcelona. Barcelona, Spain
| | - Rui Figueiredo
- DDS, MS, PhD, Master of Oral Surgery and Implantology. Professor of Oral Surgery and Professor of the Master degree program in Oral Surgery and Implantology, School of Medicine and Health Sciences, University of Barcelona. Researcher at the IDIBELL Institute. Barcelona, Spain
| | - Sergio Cortés-Peral
- DDS. Fellow of the Master degree program in Oral Surgery and Implantology, School of Medicine and Health Sciences, University of Barcelona. Barcelona, Spain
| | - Alba Sánchez-Torres
- DDS, MS, Master of Oral Surgery and Implantology. Associate Professor of Oral Surgery and Professor of the Master degree program in Oral Surgery and Implantology. School of Medicine and Health Sciences, University of Barcelona. Researcher at the IDIBELL Institute. Barcelona, Spain
| | - Eduard Valmaseda-Castellón
- DDS, MS, PhD, EBOS. Professor of Oral Surgery and Director of the Master degree program in Oral Surgery and Implantology, School of Medicine and Health Sciences, University of Barcelona. Researcher at the IDIBELL Institute. Barcelona, Spain
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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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Prescriber Commitment Posters to Increase Prudent Antibiotic Prescribing in English General Practice: A Cluster Randomized Controlled Trial. Antibiotics (Basel) 2020; 9:antibiotics9080490. [PMID: 32784625 PMCID: PMC7569839 DOI: 10.3390/antibiotics9080490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/25/2020] [Accepted: 07/01/2020] [Indexed: 01/21/2023] Open
Abstract
Unnecessary antibiotic prescribing contributes to Antimicrobial Resistance posing a major public health risk. Estimates suggest as many as half of antibiotics prescribed for respiratory infections may be unnecessary. We conducted a three-armed unblinded cluster randomized controlled trial (ISRCTN trial registry 83322985). Interventions were a commitment poster (CP) advocating safe antibiotic prescribing or a CP plus an antimicrobial stewardship message (AM) on telephone appointment booking lines, tested against a usual care control group. The primary outcome measure was antibiotic item dispensing rates per 1000 population adjusted for practice demographics. The outcome measures for post-hoc analysis were dispensing rates of antibiotics usually prescribed for upper respiratory tract infections and broad spectrum antibiotics. In total, 196 practice units were randomized to usual care (n = 60), CP (n = 66), and CP&AM (n = 70). There was no effect on the overall dispensing rates for either interventions compared to usual care (CP 5.673, 95%CI −9.768 to 21.113, p = 0.458; CP&AM, −12.575, 95%CI −30.726 to 5.576, p = 0.167). Secondary analysis, which included pooling the data into one model, showed a significant effect of the AM (−18.444, 95%CI −32.596 to −4.292, p = 0.012). Fewer penicillins and macrolides were prescribed in the CP&AM intervention compared to usual care (−12.996, 95% CI −34.585 to −4.913, p = 0.018). Commitment posters did not reduce antibiotic prescribing. An automated patient antimicrobial stewardship message showed effects and requires further testing.
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Lin Q, Lim JYC, Xue K, Yew PYM, Owh C, Chee PL, Loh XJ. Sanitizing agents for virus inactivation and disinfection. VIEW 2020; 1:e16. [PMID: 34766164 PMCID: PMC7267133 DOI: 10.1002/viw2.16] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/02/2020] [Accepted: 04/05/2020] [Indexed: 01/19/2023] Open
Abstract
Viral epidemics develop from the emergence of new variants of infectious viruses. The lack of effective antiviral treatments for the new viral infections coupled with rapid community spread of the infection often result in major human and financial loss. Viral transmissions can occur via close human-to-human contact or via contacting a contaminated surface. Thus, careful disinfection or sanitization is essential to curtail viral spread. A myriad of disinfectants/sanitizing agents/biocidal agents are available that can inactivate viruses, but their effectiveness is dependent upon many factors such as concentration of agent, reaction time, temperature, and organic load. In this work, we review common commercially available disinfectants agents available on the market and evaluate their effectiveness under various application conditions. In addition, this work also seeks to debunk common myths about viral inactivation and highlight new exciting advances in the development of potential sanitizing agents.
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Affiliation(s)
- Qianyu Lin
- NUS Graduate School for Integrative Sciences and EngineeringNational University of SingaporeSingapore
| | - Jason Y. C. Lim
- Soft Materials DepartmentInstitution of Materials Research and EngineeringAgency for ScienceTechnology and Research (A*STAR)InnovisSingapore
| | - Kun Xue
- Soft Materials DepartmentInstitution of Materials Research and EngineeringAgency for ScienceTechnology and Research (A*STAR)InnovisSingapore
| | - Pek Yin Michelle Yew
- Soft Materials DepartmentInstitution of Materials Research and EngineeringAgency for ScienceTechnology and Research (A*STAR)InnovisSingapore
| | - Cally Owh
- Soft Materials DepartmentInstitution of Materials Research and EngineeringAgency for ScienceTechnology and Research (A*STAR)InnovisSingapore
| | - Pei Lin Chee
- Soft Materials DepartmentInstitution of Materials Research and EngineeringAgency for ScienceTechnology and Research (A*STAR)InnovisSingapore
| | - Xian Jun Loh
- Soft Materials DepartmentInstitution of Materials Research and EngineeringAgency for ScienceTechnology and Research (A*STAR)InnovisSingapore
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Nepal A, Hendrie D, Robinson S, Selvey LA. Knowledge, attitudes and practices relating to antibiotic use among community members of the Rupandehi District in Nepal. BMC Public Health 2019; 19:1558. [PMID: 31771595 PMCID: PMC6880381 DOI: 10.1186/s12889-019-7924-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 11/08/2019] [Indexed: 11/23/2022] Open
Abstract
Background The development of antibiotic resistance is one of the biggest threats to global public health. Inappropriate use of antibiotics is recognised as a leading cause of antibiotic resistance. The aim of this study was to explore the knowledge, attitudes and practices (KAP) towards antibiotic use among adults in Nepal. Methods A quantitative survey was conducted with 220 community members of the Rupandehi district of Nepal, with cluster sampling techniques applied to select households. Interviews were carried out face-to-face using a structured questionnaire. Responses were presented using descriptive analysis, with chi-squared tests and regression analysis applied to identify factors associated with KAP about antibiotic use and the Spearman’s rank order correlation coefficient calculated to examine the relationship between responses to the KAP questions. Results The sample comprised more females (54%) than males, the average age of respondents was 38.5 years and almost 60% of respondents lived in rural areas. Respondents had relatively good knowledge about aspects of antibiotic use other than identifying antibiotics. The concept of antibiotic resistance was well known but imperfectly understood. Half of respondents (50.9%) were unsure whether skipping doses would contribute to the development of antibiotic resistance, 88.2% indicated they would go to another doctor if not prescribed an antibiotic when they thought one was needed and nearly half (47.7%) believed antibiotics helped them get better more quickly if they had a fever. Most respondents reported correct practices accessing and using antibiotics, however, 84.6% at least sometimes preferred an antibiotic when they have a cough and sore throat. Logistic regression showed respondents with higher levels of education tended to have better knowledge, more appropriate attitudes and better practices about antibiotic use. Rural respondents were less likely to have better knowledge about antibiotic use, while females were more likely to report better practices. Conclusion The study provides baseline evidence about the knowledge, attitudes and practices regarding antibiotic use among the population of the Rupandehl district. Its findings will be useful in designing effective and targeted interventions to decrease misconceptions about antibiotic use and to increase awareness about the risks of inappropriate use of antibiotics in the community.
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Affiliation(s)
- Anant Nepal
- School of Public Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Perth, Western Australia, 6102, Australia.
| | - Delia Hendrie
- School of Public Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Perth, Western Australia, 6102, Australia
| | - Suzanne Robinson
- School of Public Health, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Perth, Western Australia, 6102, Australia
| | - Linda A Selvey
- School of Public Health, The University of Queensland, Herston Rd, Herston, Qld, 4006, Australia
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Voidăzan S, Moldovan G, Voidăzan L, Zazgyva A, Moldovan H. Knowledge, Attitudes And Practices Regarding The Use Of Antibiotics. Study On The General Population Of Mureş County, Romania. Infect Drug Resist 2019; 12:3385-3396. [PMID: 31802918 PMCID: PMC6827501 DOI: 10.2147/idr.s214574] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 09/03/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Currently, antibiotic resistance is a complex issue that affects the whole of society. This resistance is influenced by the irrational and excessive use of antibiotics by the general population. This study aimed to gather information about the knowledge, attitudes and behaviours regarding the issues related to antibiotic consumption in the general population of Mureș County in the Central Region of Romania. METHODS This was a cross-sectional study using a questionnaire as its research instrument, which consisted of 33 questions analysing the respondents' attitude and their knowledge about the use of antibiotics and antibiotic resistance. RESULTS A total of 996 respondents were eligible for the study. Of the total respondents, 62.65% (624 respondents) considered that antibiotics are used to treat a bacterial infection and 61.45% (612 respondents) used an antibiotic at least once in the previous year, with a distribution of 68.7% and 56.8% of the respondents from rural and urban areas, respectively. Antibiotics were taken by 10.34% of the respondents, following recommendations from family/friends, and 22.9% used antibiotics left over from their last prescription. Of those who consumed antibiotics (868 respondents), 65.9% consulted their physician every time before taking the medication. Furthermore, 82.3% of the total of 996 respondents considered that the use of non-prescription antibiotics has a negative effect, and 85.14% had heard about the antibiotic resistance of bacteria. CONCLUSION The majority of respondents had adequate knowledge of antibiotics and their use and were aware of the fact that non-prescription antibiotics can have repercussions both on them as individuals and on the population as a whole.
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Affiliation(s)
- Septimiu Voidăzan
- Department of Epidemiology, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, Tîrgu Mureş, Romania
| | - Geanina Moldovan
- Department of Community Nutrition, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, Tîrgu Mureş, Romania
| | | | - Ancuța Zazgyva
- Department of Cell and Molecular Biology, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, Tîrgu Mureş, Romania
| | - Horațiu Moldovan
- Department of Occupational Medicine, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, Tîrgu Mureş, Romania
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Ozturk Y, Celik S, Sahin E, Acik MN, Cetinkaya B. Assessment of Farmers' Knowledge, Attitudes and Practices on Antibiotics and Antimicrobial Resistance. Animals (Basel) 2019; 9:ani9090653. [PMID: 31487911 PMCID: PMC6770244 DOI: 10.3390/ani9090653] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 08/31/2019] [Accepted: 09/02/2019] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Antibiotic resistance is a global problem that threatens human and animal health and has increased in recent years. Although many factors are responsible for the development of resistance, antibiotics used in animals for preventive, therapeutic, and other purposes play a major role. Conscious and rational antibiotic use in animals will contribute to decreases in resistance. It is therefore important to determine knowledge, attitudes, and behaviors of farmers working in the livestock sector with regard to antibiotic knowledge, use, and resistance in order to develop communication strategies accordingly. The aim of this study was to measure the knowledge of livestock farmers about antibiotics by conducting a questionnaire survey. As a result of the survey, it was found that knowledge of the participants on antibiotics and resistance was very low. It was concluded that periodic training programs can be employed to overcome this problem and raise awareness among farmers. Abstract The aim of this study was to determine knowledge, attitudes, and behaviors of farmers dealing with animal husbandry in eastern Turkey with regard to antibiotic knowledge, use, and resistance. A face to face questionnaire survey, consisting of five sections with 42 questions in total, was applied to 360 farmers located in the region. The questions in the first and fifth sections were closed-ended while those in other sections were prepared using the Likert scale. It was determined that knowledge of the farmers about antibiotic use, duration, storage, and resistance was well below desired levels. This was particularly remarkable in the participants with a low level of education, living in rural areas, and those at 48 years of age or over. In contrast, younger and highly educated participants living in urban areas were more knowledgeable about antibiotic use and they were well aware of the fact that resistance might pose a great risk for public health. Providing appropriate antibiotic use in animals through systematic training of livestock farmers is crucial in tackling the resistance problem.
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Affiliation(s)
- Yasin Ozturk
- Department of Pharmacology, Faculty of Veterinary Medicine, University of Bingol, 12000 Bingol, Turkey.
| | - Senol Celik
- Department of Biostatistics, Faculty of Agriculture, University of Bingol, 12000 Bingol, Turkey.
| | - Emre Sahin
- Department of Animal Nutrition, Faculty of Veterinary Medicine, University of Bingol, 12000 Bingol, Turkey.
| | - Mehmet Nuri Acik
- Department of Microbiology, Faculty of Veterinary Medicine, University of Bingol, 12000 Bingol, Turkey.
| | - Burhan Cetinkaya
- Department of Microbiology, Faculty of Veterinary Medicine, University of Firat, 23119 Elazig, Turkey.
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Factors affecting the public awareness and behavior on antibiotic use. Eur J Clin Microbiol Infect Dis 2018; 37:1547-1552. [PMID: 29777487 DOI: 10.1007/s10096-018-3283-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 05/11/2018] [Indexed: 10/16/2022]
Abstract
To evaluate the effects of demographic and perceptive factors on the knowledge, perception, and behavior regarding antibiotic use in the general public, we conducted three serial telephone interview surveys in 2010, 2012, and 2015. Computer-aided telephone interview was conducted, with a predetermined quota stratified by sex, age, and geographic location. Respondents who answered correctly to four or more questions were categorized as having better knowledge. A total of 3013 respondents participated. Better knowledge was associated with age < 60 years (OR 1.37, 95% CI 1.04-1.82), college education (OR 1.57, 95% CI 1.26-1.97), healthcare-related occupation or education (OR 2.26, 95% CI 1.52-3.36), and media exposure (OR 1.25, 95% CI 1.02-1.54). In contrast, correct antibiotic use behavior was associated with male sex (OR 1.48, 95% CI 1.27-1.73), older age (OR 1.63, 95% CI 1.34-1.99), and being married (OR 1.26, 95% CI 1.04-1.52), along with better knowledge (OR 1.43, 95% CI 1.19-1.71). However, multifaceted analysis indicated that better knowledge was associated with correct behavior in all subgroups. Other demographic factors were associated only in respondents with poor knowledge. Various factors other than knowledge on antibiotics, many of them traditionally underappreciated, affect antibiotic use behavior.
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Is the level of knowledge a predictor of rational antibiotic use in Serbia? PLoS One 2017; 12:e0180799. [PMID: 28700631 PMCID: PMC5507268 DOI: 10.1371/journal.pone.0180799] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 06/21/2017] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The objective of this study was to investigate the knowledge, attitudes and behavior regarding antibiotics of the general population. METHODS The study sample consisted of adult subjects who consulted general practitioners at health centers in Serbia and agreed to complete the questionnaire. A total of 668 questionnaires were distributed; 500 respondents completed the entire questionnaire (response rate 74.85%). RESULTS The average age was 51.65 ± 16.56 years, 60.80% of the respondents were women. The median antibiotic knowledge score was 9. Predictors of adequate antibiotic knowledge were higher education level and a family member whose ocuppation was related to health-care. Overall, 58.4% of respondents believed that antibiotics could be used to treat common cold. Around a half of the respondents (47.2%) self-medicated with antibiotics at least once during their life-time, and around a quarter (24.2%) during the last treatment of infection. Patients with inadequate knowledge had 3 times higher chances of self-medicating with antibiotics compared to those with adequate knowledge. Although 98.20% of respondents claimed that antibiotic treatment should be started after a visit to a doctor and receiving a prescription, only 65.8% obtained antibiotics with prescription from a doctor during the last infection. CONCLUSIONS Although these results demonstrate that respondents had a relatively adequate level of knowledge regarding antibiotics use, some areas of misconceptions and improper behavior were identified. Therefore, further rationalization should be focused on educational campaigns targeting the behavior of patients with regard to antibiotic use.
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Kelly M, Sahm LJ, Shiely F, O’Sullivan R, de Bont EG, Mc Gillicuddy A, Herlihy R, Dahly D, McCarthy S. Parental knowledge, attitudes and beliefs on fever: a cross-sectional study in Ireland. BMJ Open 2017; 7:e015684. [PMID: 28694348 PMCID: PMC5541503 DOI: 10.1136/bmjopen-2016-015684] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 04/03/2017] [Accepted: 04/26/2017] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Fever is a common symptom of mostly benign illness in young children, yet concerning for parents. The aim of this study was to describe parental knowledge, attitudes and beliefs regarding fever in children aged ≤5 years of age. DESIGN A cross-sectional study using a previously validated questionnaire. Results were analysed using descriptive statistics and multivariable logistic regression. SETTING Purposively selected primary schools (n=8) in Cork, Ireland, using a paper-based questionnaire. Data were collected from a cross-sectional internet-based questionnaire with a convenience sample of parents via websites and web pages (n=10) previously identified in an interview study. PARTICIPANTS Parents with at least one child aged ≤5 years were invited to participate in the study. MAIN OUTCOME MEASURES Parental knowledge, attitudes and beliefs when managing fever in children. RESULTS One thousand one hundred and four parents contributed to this research (121 parents from schools and 983 parents through an online questionnaire). Almost two-thirds of parents (63.1%) identified temperatures at which they define fever that were either below or above the recognised definition of temperature (38°C). Nearly two of every three parents (64.6%) alternate between two fever-reducing medications when managing a child's fever. Among parents, years of parenting experience, age, sex, educational status or marital status did not predict being able to correctly identify a fever, neither did they predict if the parent alternated between fever-reducing medications. CONCLUSIONS Parental knowledge of fever and fever management was found to be deficient which concurs with existing literature. Parental experience and other sociodemographic factors were generally not helpful in identifying parents with high or low levels of knowledge. Resources to help parents when managing a febrile illness need to be introduced to help all parents provide effective care.
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Affiliation(s)
- Maria Kelly
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
- HRB Clinical Research Facility, Mercy University Hospital, Cork, Ireland
| | - Laura J Sahm
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
- Department of Pharmacy, Mercy University Hospital, Cork, Ireland
| | - Frances Shiely
- HRB Clinical Research Facility, Mercy University Hospital, Cork, Ireland
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Ronan O’Sullivan
- School of Medicine, University College Cork, Cork, Ireland
- National Children’s Research Centre, Dublin, Ireland
| | - Eefje G de Bont
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Aoife Mc Gillicuddy
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - Roisin Herlihy
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - Darren Dahly
- HRB Clinical Research Facility, Mercy University Hospital, Cork, Ireland
- Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Suzanne McCarthy
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
- Department of Pharmacy, Cork University Hospital, Cork, Ireland
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Maltezou HC, Dedoukou X, Asimaki H, Kontou I, Ioannidou L, Mitromara K, Theodoridou K, Katerelos P, Theodoridou M. Consumption of antibiotics by children in Greece: a cross-sectional study. Int J Pediatr Adolesc Med 2017; 4:108-111. [PMID: 30805511 PMCID: PMC6372488 DOI: 10.1016/j.ijpam.2017.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 04/17/2017] [Accepted: 04/18/2017] [Indexed: 11/19/2022]
Abstract
Background Greece is among the European countries with the highest consumption of antibiotics. Objectives To study the rates and characteristics of consumption of antibiotics in the community by children in Greece. Methods Questionnaire-based study of parents of hospitalized children. Results A total of 549 children were studied; 247 (45%) received at least one course of antibiotics the previous year (mean number of antibiotic courses the past year: 1.9), including 427 (91.8%) following examination by a pediatrician, 6 (1.3%) following phone consultation, 2 (0.4%) following suggestion by a pharmacist and 2 (0.4%) as self-medication. Prevalent reasons for antibiotic consumption were acute otitis media (AOM) (27.3%), pharyngotonsillitiss (25.4%), and bronchitis (17.8%). Amoxicillin-clavulanate was the prevalent antibiotic for pharyngotonsillitis, urinary tract infection (UTI) and skin infection (30.5%, 35.7% and 36.4% of cases, respectively), amoxicillin for AOM and pneumonia (32.3% and 36.4% of cases, respectively), and clarithromycin for bronchitis (27.7%). We found 84.3%, 81.9%, 64.3%, 63.7%, and 50% of parents reporting treatment consisted with the national guidelines for AOM, pneumonia, UTI, skin infection, and pharyngotonsillitis, respectively. In the multivariate analysis, an age of 1-5 years and asthma were significantly associated with a higher probability for antibiotic consumption. Conclusions Antibiotic consumption of children in Greece is mainly driven by pediatricians. Continuing medical education is expected to further improve antibiotic prescription practices by pediatricians.
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Affiliation(s)
- Helena C. Maltezou
- Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece
- Corresponding author. Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, 3-5 Agrafon Street, Athens, Greece.
| | - Xanthi Dedoukou
- Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Hara Asimaki
- First Department of Pediatrics, University of Athens, “Aghia Sophia” Children's Hospital, Athens, Greece
| | - Ioanna Kontou
- First Department of Pediatrics, University of Athens, “Aghia Sophia” Children's Hospital, Athens, Greece
| | - Loukia Ioannidou
- First Department of Pediatrics, University of Athens, “Aghia Sophia” Children's Hospital, Athens, Greece
| | - Konstantina Mitromara
- First Department of Pediatrics, University of Athens, “Aghia Sophia” Children's Hospital, Athens, Greece
| | - Kalliopi Theodoridou
- First Department of Pediatrics, University of Athens, “Aghia Sophia” Children's Hospital, Athens, Greece
| | - Panos Katerelos
- Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Maria Theodoridou
- First Department of Pediatrics, University of Athens, “Aghia Sophia” Children's Hospital, Athens, Greece
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Woźniak W, Kozińska A, Ciostek P, Sitkiewicz I. Susceptibility of Vascular Implants to Colonization in vitro by Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis and Pseudomonas aeruginosa. Pol J Microbiol 2017; 66:125-129. [DOI: 10.5604/17331331.1235001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We compared association of Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa and Enterococcus faecalis with nine vascular implants after co-culture. Vascular implants were composed of various materials such as warp knitted polyester (with or without gelatin and silver ions), expanded polytetrafluoroethylene and biological materials – surface treated porcine pericardial patch and Omniflow II. The lowest overall number of associated bacteria was detected for polytetrafluoroethylene implants and porcine pericardial patch. The highest overall number of associated bacteria was detected for Omniflow II implant. The major source of variation, i.e. primary factor influencing colonization, is the implant type (56.22%), bacterial species is responsible for only 1.81%, and interaction of those two factors – 13.09% of variation.
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Affiliation(s)
- Witold Woźniak
- Department of General and Vascular Surgery, Second Faculty of Medicine with the English Division and the Physiotherapy Division, Medical University of Warsaw, Warszawa, Poland
| | - Aleksandra Kozińska
- Department of Epidemiology and Clinical Microbiology, National Institute of Medicines, Warszawa, Poland
| | - Piotr Ciostek
- Department of General and Vascular Surgery, Second Faculty of Medicine with the English Division and the Physiotherapy Division, Medical University of Warsaw, Warszawa, Poland
| | - Izabela Sitkiewicz
- Department of Molecular Microbiology, National Institute of Medicines, Warszawa, Poland
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Mazińska B, Strużycka I, Hryniewicz W. Surveys of public knowledge and attitudes with regard to antibiotics in Poland: Did the European Antibiotic Awareness Day campaigns change attitudes? PLoS One 2017; 12:e0172146. [PMID: 28212400 PMCID: PMC5315279 DOI: 10.1371/journal.pone.0172146] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 01/31/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Antimicrobial resistance is a global public health problem. Monitoring the level of knowledge regarding antibiotics is a part of the European Union Community strategy against antimicrobial resistance. OBJECTIVE To assess knowledge by the general public in Poland regarding antibiotics, AMR, and the impact of the European Antibiotic Awareness Day campaigns. METHODS The repeated cross-sectional study was developed and carried out among the general public in Poland (in 5 waves between 2009 and 2011, embracing a total of 5004 respondents). The survey was based on a self-designed questionnaire, and carried out by Millward Brown SMG/KRC, using Computer Assisted Telephone Interviews (CATI). RESULTS A high percentage of Polish adults had used antibiotics within the 12 months preceding their participation in the study (38%). Statistically relevant differences were observed regarding the respondents' gender, age, education and employment status. The majority of the antibiotics used were prescribed by physicians (90%). In all five waves, 3% of the respondents purchased an antibiotic without a prescription. Prescriptions were mostly obtained from a general practitioner. The prevailing reasons for taking antibiotics were the common cold, sore throat, cough and flu. Approximately 40% of the respondents expected a prescription for an antibiotic against the flu. The vast majority knew that antibiotics kill bacteria (80%) but at the same time 60% of respondents believed antibiotics kill viruses. Physicians, pharmacists, hospital staff and nurses were mentioned as the most trustworthy sources of information. A third of the respondents declared to have come across information on the prudent use of antibiotics in the preceding 12 months. In the fifth wave, nearly half of the participants (48%), who had come across information about antibiotics in the preceding 12 months declared that the information resulted in a change in their attitude towards antibiotic use. CONCLUSION The survey generated information about the knowledge, attitude, and behavior regarding antibiotics among the general population of Poland. Inappropriate antibiotic use is still highly prevalent in Poland, although a positive trend in behavioral change was observed after the educational campaigns. Additional didactic and systematic education campaigns regarding appropriate antibiotic use are needed and the use of the Internet as an education tool should be enhanced.
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Affiliation(s)
- Beata Mazińska
- Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
- * E-mail:
| | - Izabela Strużycka
- Department of Dental Comprehensive Care, Medical University of Warsaw, Warsaw, Poland
| | - Waleria Hryniewicz
- Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
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Maltezou HC, Adamis G, Tsonou P, Moustaka E, Katerelos P, Gargalianos P. Consumption of antibiotics for community-acquired infections by adults in Greece: A cross-sectional study. Am J Infect Control 2016; 44:1741-1743. [PMID: 27424304 DOI: 10.1016/j.ajic.2016.04.242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 04/20/2016] [Accepted: 04/20/2016] [Indexed: 11/28/2022]
Abstract
We studied the rates and characteristics of antibiotics consumption for community-acquired infections in 309 adult patients. Of them, 293 (94.8%) had received at least 1 course of antibiotics during the past year. In total, 419 courses of antibiotics were consumed during the past year, including 285 (68%) following medical examination, 72 (17.2%) following telephone consultation, 30 (7.2%) following suggestion by a pharmacist, and in 16 (3.8%) the antibiotic was available at home. Older age and asthma were significantly associated with a higher risk for antibiotics consumption.
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Affiliation(s)
- Helena C Maltezou
- Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece.
| | - Georgios Adamis
- First Department of Medicine and Infectious Diseases Unit, Athens General Hospital "G. Gennimatas", Athens, Greece
| | - Paraskeui Tsonou
- Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Eleni Moustaka
- Seventh Department of Pulmonary Medicine, Athens Chest General Hospital "Sotiria", Athens, Greece
| | - Panos Katerelos
- Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Panagiotis Gargalianos
- First Department of Medicine and Infectious Diseases Unit, Athens General Hospital "G. Gennimatas", Athens, Greece
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Li R, Xiao F, Zheng X, Yang H, Wang L, Yin D, Yin T, Xin Q, Chen B. Antibiotic misuse among children with diarrhea in China: results from a national survey. PeerJ 2016; 4:e2668. [PMID: 27833822 PMCID: PMC5101618 DOI: 10.7717/peerj.2668] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 10/08/2016] [Indexed: 12/03/2022] Open
Abstract
Background Antibiotic resistance is one of the world’s biggest public health issues, and the situation in China is particularly grave. The objective of this study is to investigate the antibiotics usage pattern among Chinese children and provide further insight in developing strategies for promoting public health education. Methods This is a cross-sectional study, in the study, participants are from 53,665 guardians of children aged 0–6 years, who were recruited with multistage stratified random cluster sampling in 2013/2014 from 46 community health centers in 14 provinces across China Mainland. Children’s guardians completed surveys on their previous experience on using antibiotics in treating diarrhea of their children without a prescription from any pediatrician. Odds ratios (ORs) and 95% confidential intervals (CIs) for the association between antibiotic use and its predictors were estimated using multilevel logistic regression models, with antibiotic rational use group as a reference group. Results The prevalence of antibiotic misuse among children with diarrhea in the eastern, middle and western areas of China and associations between antibiotic misuse and its predictors were studied. The average rate of antibiotic misuse is 35.12%. Multilevel logistic regression revealed that living in urban areas (OR = 0.79 (0.76, 0.83)), female children (OR = 0.92 (0.88, 0.96)), guardians having higher education (OR = 0.60 (0.55, 0.66)), being raised by parents (OR = 0.90 (0.85, 0.94)), guardians having basic health knowledge (OR = 0.82 (0.79, 0.86)) are protective factors and children’s age (1–3 years OR = 1.62 (1.54, 1.71)); 4–6 years OR = 1.90 (1.77, 2.03)) is a risk factor of antibiotic misuse among children aged 0–6 years with diarrhea in China. Conclusions Our findings confirmed that there has been a high rate of antibiotic misuse without a prescription in children with diarrhea in China, which requires considerable attention. Suitable regulations and interventions are needed to solve this problem.
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Affiliation(s)
- Ruili Li
- Children Health and Development Department, Capital Institute of Paediatrics , Beijing , China
| | - Feng Xiao
- Children Health and Development Department, Capital Institute of Paediatrics , Beijing , China
| | - Xiaoguo Zheng
- Children Health and Development Department, Capital Institute of Paediatrics , Beijing , China
| | - Huimin Yang
- Children Health and Development Department, Capital Institute of Paediatrics , Beijing , China
| | - Lihong Wang
- Children Health and Development Department, Capital Institute of Paediatrics , Beijing , China
| | - Delu Yin
- Children Health and Development Department, Capital Institute of Paediatrics , Beijing , China
| | - Tao Yin
- Children Health and Development Department, Capital Institute of Paediatrics , Beijing , China
| | - Qianqian Xin
- Children Health and Development Department, Capital Institute of Paediatrics , Beijing , China
| | - Bowen Chen
- Children Health and Development Department, Capital Institute of Paediatrics , Beijing , China
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Impact of patients' professional and educational status on perception of an antibiotic policy campaign: a pilot study at a university hospital. J Glob Antimicrob Resist 2016; 6:123-127. [PMID: 27530854 DOI: 10.1016/j.jgar.2016.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 04/18/2016] [Indexed: 11/20/2022] Open
Abstract
Antibiotics are overused in many European countries, particularly Greece, leading to emerging antimicrobial resistance with sustained high mortality among hospitalised patients. Limited data are available regarding factors influencing people's knowledge and the impact of public campaigns on antibiotic misuse. Patients' beliefs regarding antibiotics were investigated in the outpatient clinic of a university hospital in Athens, Greece. A questionnaire-based survey was conducted to examine patients' opinions on antibiotic use in the waiting room of the outpatient clinic. All participants read an illustrated pocket-sized leaflet endorsed by official authorities on the European Antibiotic Awareness Day (EAAD). Volunteers then completed a questionnaire containing information on demographics, knowledge on antibiotic use and overuse, and remarks on the quality of the leaflet's content. In a logistic regression analysis including age, sex, educational level and professional status of 605 eligible participants, women were more aware [odds ratio (OR)=3.2, 95% confidence interval (CI) 1.8-5.8; P<0.0001] and people with elementary education were less aware (OR=0.4, 95% CI 0.1-0.9; P=0.04) of antimicrobial misuse. Workers were also more aware than retired or unemployed people (P=0.007). However, only 16.0% of participants knew about the EAAD. All participants agreed on antibiotic misuse in Greece, mentioning patient accountability as the main cause (26.8%), an opinion more pronounced in highly educated individuals. In conclusion, targeted interventions taking into account variations in educational level and employee status should be considered in future scheduled educative campaigns on antibiotic overconsumption in highly prescribing antibiotic countries.
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Agarwal S, Yewale VN, Dharmapalan D. Antibiotics Use and Misuse in Children: A Knowledge, Attitude and Practice Survey of Parents in India. J Clin Diagn Res 2015; 9:SC21-4. [PMID: 26674397 DOI: 10.7860/jcdr/2015/14933.6819] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 09/18/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Antibiotic resistance is a topic of global concern these days. Irrational, excessive use of antibiotics by the general public is one of the key factors responsible for this. AIM Through this study, we aim to analyse the knowledge, attitude and practices of antibiotics use among parents of children presenting to a tertiary care hospital in India. Also, correlate it with the gender, education level and previous use of antibiotics by the parents. MATERIALS AND METHODS A cross sectional study was conducted at a tertiary care hospital in Navi Mumbai, India from September to November 2014 and a total of 1000 parents were interviewed using a questionnaire designed by the authors. Descriptive statistics were used for the analysis of data. RESULTS A total of 872 parents were included in the study. Around one in every four (28%) parents correctly identified that antibiotics are used against bacterial infections while only 15.5% parents knew the meaning of the term antibiotic resistance. Majority of the respondents appreciated that unnecessary use of antibiotics could harm the child (73.6%). It was noteworthy that 85.2% parents stated that they don't use leftover antibiotics from the previous prescription for the next time without doctor's consult. Males, parents with higher level of formal education and use of antibiotics previously were found to have more knowledge regarding antibiotics and lesser misconceptions (p<0.05). CONCLUSION Overall, in this study it was found that misconceptions exist about the use and indications of antibiotics. Lack of knowledge regarding antibiotic resistance was prevalent. But participants were aware of the risks associated with use of excessive antibiotics. More interaction with paediatricians and involvement of mass media may help to improve the antibiotics knowledge and practices among parents and consequently, control the problem of antibiotic resistance.
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Affiliation(s)
- Shreya Agarwal
- Medical Officer and Researcher, Department of Paediatrics, Dr. Yewale's Multispeciality Hospital for Children , Navi Mumbai, India
| | - Vijay N Yewale
- Professor and Head, Department of Paediatrics, Dr. Yewale's Multispeciality Hospital for Children , Navi Mumbai, India
| | - Dhanya Dharmapalan
- Associate Professor and Pediatrician, Department of Paediatrics, Dr. Yewale's Multispeciality Hospital for Children , Navi Mumbai, India
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Public Knowledge, Beliefs and Behavior on Antibiotic Use and Self-Medication in Lithuania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:7002-16. [PMID: 26090612 PMCID: PMC4483745 DOI: 10.3390/ijerph120607002] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 05/26/2015] [Accepted: 05/27/2015] [Indexed: 11/17/2022]
Abstract
Irrational antibiotic use has led society to antibiotic resistance—a serious health problem worldwide. This study aimed to assess public knowledge, beliefs, and behavior concerning antibiotic use and self-medication in Lithuania. The cross-sectional survey method was processed using a validated questionnaire in different regions of Lithuania. In total, 1005 adults completed the questionnaire and were included in the study. More than half of the respondents (61.1%) had poor knowledge of antibiotics. Almost half of the respondents incorrectly identified antibiotics as being effective either against viral (26.0%) or mixed (bacterial and viral) infections (21.7%). The respondents with lower educational qualifications (OR = 2.515; 95% CI 1.464–4.319; p = 0.001) and those from rural areas (OR = 1.765; 95% CI 1.041–2.991; p = 0.035) were significantly less knowledgeable of antibiotics. There was no significant difference between genders, different age groups, or different parenthood status. The determined level of self–medication with antibiotics was 31.0%. The men (OR = 1.650; 95% CI 1.120–2.430; p = 0.011), the respondents from rural areas (OR = 2.002; 95% CI 1.343–2.985; p = 0.001), and those without children (OR = 2.428; 95% CI 1.477–3.991; p < 0.001) were more likely to use antibiotics in self-medication. Lithuanian residents’ knowledge of antibiotics is insufficient. More information about antibiotic use should be provided by physicians and pharmacists. Self-medication with antibiotics is a serious problem in Lithuania and requires considerable attention.
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