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Kabir H, Hasan MK, Akter N, Tassdik DH, Islam DMF, Jannat DH, Tutul AH, Akter O, Ara R, Islam MD, Mahmud S, Akter M, Mitra DK. Antibiotics administration without prescription in Bangladesh. IJID REGIONS 2023; 7:11-17. [PMID: 36941825 PMCID: PMC10023939 DOI: 10.1016/j.ijregi.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 02/12/2023]
Abstract
Background Antibiotic resistance is a global challenge. Therefore, adhering to proper antibiotic administration protocols is essential to mitigating the problem. This study investigated the prevalence, and factors associated with, antibiotics administration without prescription by registered doctors in Bangladesh. Method This cross-sectional survey was carried out among 1102 adults. The outcome variable was antibiotics administration without prescription. The exploratory variables included the those relating to sociodemographics, attitudes, and knowledge (antibiotic-treatable diseases, types of disease specification, and antimicrobial drugs specifications). Descriptive and inferential statistics were performed, with a p-value of 0.05 considered significant with a 95% confidence interval. Results The prevalence of antibiotics administration without prescription was found to be 37.02%. Age was significantly associated with the administration of antibiotics without prescription. Those who had taken antibiotics in the previous 2 months reported a significantly higher prevalence of antibiotics administration without prescription. The participants' attitudes toward antibiotics and knowledge of antibiotic-treatable diseases, types of disease, and antimicrobial drugs were significantly associated with antibiotics administration without prescription. Conclusion These findings may assist in facilitating relevant initiatives to improve the magnitude of antibiotics utilization without prescription, and mitigate the emergence of antibiotic resistance in Bangladesh.
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Affiliation(s)
- Humayun Kabir
- Department of Public Health, North South University, Dhaka-1229, Bangladesh
- Corresponding authors: Humayun Kabir; Md Kamrul Hasan; Department of Public Health, North South University, Dhaka-1229, Bangladesh
| | - Md Kamrul Hasan
- Department of Public Health, North South University, Dhaka-1229, Bangladesh
- Department of Biochemistry and Molecular Biology, Tejgoan College, Dhaka-1215, Bangladesh
- Corresponding authors: Humayun Kabir; Md Kamrul Hasan; Department of Public Health, North South University, Dhaka-1229, Bangladesh
| | - Nahida Akter
- Grameen Caledonian College of Nursing, Dhaka-1216, Bangladesh
- Penn State Ross and Carol Nese College of Nursing, Penn State University, University Park, PA, USA
| | | | - Dr Md Fakrul Islam
- Department of Public Health, North South University, Dhaka-1229, Bangladesh
| | - Dr Hasina Jannat
- Department of Public Health, North South University, Dhaka-1229, Bangladesh
| | | | - Ojifa Akter
- School of Medical Sciences, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
| | - Rawshan Ara
- Prime College of Nursing, Dhaka-1229, Bangladesh
| | - Muhammad Didarul Islam
- School of Medical Sciences, Shahjalal University of Science and Technology, Sylhet-3114, Bangladesh
- Department of Gerontology and Geriatric Welfare, University of Dhaka, Dhaka-1000, Bangladesh
| | - Sohel Mahmud
- Department of Biochemistry and Molecular Biology, Tejgoan College, Dhaka-1215, Bangladesh
| | - Masuda Akter
- Faculty of Medicine, University of Dhaka, Dhaka-1000, Bangladesh
- Saic Nursing College, Dhaka-1216, Bangladesh
| | - Dipak Kumar Mitra
- Department of Public Health, North South University, Dhaka-1229, Bangladesh
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Schramm L, Byrne MK, Sweetnam T. Antibiotic Misuse Behaviours of Older People: Confirmation of the Factor Structure of the Antibiotic Use Questionnaire. Antibiotics (Basel) 2023; 12:antibiotics12040718. [PMID: 37107080 PMCID: PMC10135189 DOI: 10.3390/antibiotics12040718] [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: 12/20/2022] [Revised: 03/22/2023] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
Antibacterial resistance (AR) is responsible for steadily rising numbers of untreatable bacterial infections, most prevalently found in the older adult (OA) population due to age-related physical and cognitive deterioration, more frequent and long-lasting hospital visits, and reduced immunity. There are currently no established measures of antibiotic use behaviours for older adults, and theory-informed approaches to identifying the drivers of antibiotic use in older adults are lacking in the literature. The objective of this study was to identify predictors of antibiotic use and misuse in older adults using the Antibiotic Use Questionnaire (AUQ), a measure informed by the factors of the Theory of Planned Behaviour (TPB): attitudes and beliefs, social norms, perceived behavioural control, behaviour, and a covariate-knowledge. A measure of social desirability was included, and participants scoring highly were excluded to control for social desirability bias. Confirmatory Factor Analyses and regression analyses were conducted to test the hypotheses in a cross-sectional, anonymous survey. A total of 211 participants completed the survey, 47 of which were excluded due to incompletion and high social desirability scores (≥5). Results of the factor analysis confirmed that some (but not all) factors from previous research in the general population were confirmed in the OA sample. No factors were found to be significant predictors of antibiotic use behaviour. Several suggestions for the variance in results from that of the first study are suggested, including challenges with meeting requirement for statistical power. The paper concludes that further research is required to determine the validity of the AUQ in an older adult population.
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Affiliation(s)
- Loni Schramm
- Faculty of Health, Charles Darwin University, Darwin, NT 0909, Australia
| | - Mitchell K Byrne
- Faculty of Health, Charles Darwin University, Darwin, NT 0909, Australia
| | - Taylor Sweetnam
- Faculty of Health, Charles Darwin University, Darwin, NT 0909, Australia
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MohanaSundaram A, Sathanantham ST, Sah R, Apostolopoulos V. Developing bespoke antimicrobials to combat antimicrobial resistance in low- and middle-income countries: A critical appraisal of clinical utility in the elderly. Maturitas 2023; 170:74-75. [PMID: 36494242 DOI: 10.1016/j.maturitas.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 11/20/2022] [Indexed: 12/03/2022]
Affiliation(s)
| | | | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal; Dr. D.Y Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India.
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Victoria University, Melbourne, Australia; The Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, Australia.
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Ragusa FS, Solimando L, Mandalà C, Masnata R, Ciulla G, Ciriminna S, La Blasca F, Mansueto P, Veronese N, Barbagallo M. Association between multidimensional prognostic index (MPI) and infections in a population of older people affected by COVID-19. Aging Clin Exp Res 2023; 35:1139-1143. [PMID: 36964868 PMCID: PMC10039674 DOI: 10.1007/s40520-023-02386-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/06/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Only limited studies analyzed a possible relationship between frailty and infections. Our aim was to investigate the possible association between higher multidimensional prognostic index (MPI) values, a tool for evaluating multidimensional frailty, and the prevalence of infectious diseases, including antibiotics' cost and the prevalence of MDR (multidrug resistance) pathogens. METHODS Older patients, affected by COVID-19, were enrolled in the hospital of Palermo over four months. RESULTS 112 participants (mean age 77.6, 55.4% males) were included. After adjusting for potential confounders, frailer participants had a higher odds of any positivity to pathogens (prevalence: 61.5%, odds ratio = 15.56, p < 0.0001) compared to a prevalence of 8.6% in more robust, including MDR, and a higher costs in antibiotics. CONCLUSIONS Higher MPI values, indicating frailer subjects, were associated with a higher prevalence of infections, particularly of MDR pathogens, and a consequent increase in antibiotics' cost.
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Affiliation(s)
- Francesco Saverio Ragusa
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy.
| | - Luisa Solimando
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Caterina Mandalà
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Roberta Masnata
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Gregorio Ciulla
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Stefano Ciriminna
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Francesco La Blasca
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Pasquale Mansueto
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Nicola Veronese
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | - Mario Barbagallo
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
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Otieku E, Fenny AP, Labi AK, Owusu-Ofori AK, Kurtzhals J, Enemark U. Knowledge, attitudes and practices regarding antimicrobial use and resistance among healthcare seekers in two tertiary hospitals in Ghana: a quasi-experimental study. BMJ Open 2023; 13:e065233. [PMID: 36813487 PMCID: PMC9950892 DOI: 10.1136/bmjopen-2022-065233] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 02/24/2023] Open
Abstract
OBJECTIVE To evaluate knowledge of antimicrobial resistance (AMR), to study how the judgement of health value (HVJ) and economic value (EVJ) affects antibiotic use, and to understand if access to information on AMR implications may influence perceived AMR mitigation strategies. DESIGN A quasi-experimental study with interviews performed before and after an intervention where hospital staff collected data and provided one group of participants with information about the health and economic implications of antibiotic use and resistance compared with a control group not receiving the intervention. SETTING Korle-Bu and Komfo Anokye Teaching Hospitals, Ghana. PARTICIPANTS Adult patients aged 18 years and older seeking outpatient care. MAIN OUTCOME MEASURES We measured three outcomes: (1) level of knowledge of the health and economic implications of AMR; (2) HVJ and EVJ behaviours influencing antibiotic use and (3) differences in perceived AMR mitigation strategy between participants exposed and not exposed to the intervention. RESULTS Most participants had a general knowledge of the health and economic implications of antibiotic use and AMR. Nonetheless, a sizeable proportion disagreed or disagreed to some extent that AMR may lead to reduced productivity/indirect costs (71% (95% CI 66% to 76%)), increased provider costs (87% (95% CI 84% to 91%)) and costs for carers of AMR patients/societal costs (59% (95% CI 53% to 64%)). Both HVJ-driven and EVJ-driven behaviours influenced antibiotic use, but the latter was a better predictor (reliability coefficient >0.87). Compared with the unexposed group, participants exposed to the intervention were more likely to recommend restrictive access to antibiotics (p<0.01) and pay slightly more for a health treatment strategy to reduce their risk of AMR (p<0.01). CONCLUSION There is a knowledge gap about antibiotic use and the implications of AMR. Access to AMR information at the point of care could be a successful way to mitigate the prevalence and implications of AMR.
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Affiliation(s)
- Evans Otieku
- Economics Division, Institute of Statistical, Social, and Economic Research (ISSER), University of Ghana, Legon, Ghana
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Ama Pokuaa Fenny
- Economics Division, Institute of Statistical, Social, and Economic Research (ISSER), University of Ghana, Legon, Ghana
| | - Appiah-Koran Labi
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Alex Kwame Owusu-Ofori
- Laboratory Services Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jørgen Kurtzhals
- ISIM, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Microbiology, Rigshospitalet, Kobenhavn, Denmark
| | - Ulrika Enemark
- Department of Public Health, Aarhus University, Aarhus, Denmark
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Duan L, Liu C, Wang D, Lin R, Qian P, Zhang X, Liu C. The vicious cycle of the public's irrational use of antibiotics for upper respiratory tract infections: A mixed methods systematic review. Front Public Health 2022; 10:985188. [PMID: 36339167 PMCID: PMC9632431 DOI: 10.3389/fpubh.2022.985188] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/27/2022] [Indexed: 01/25/2023] Open
Abstract
Background The public's irrational use of antibiotics for upper respiratory tract infections (URTIs) is prevalent worldwide. This study aims to synthesize evidence on how people use antibiotics to treat URTIs, its prevalence and determinants. Methods A mixed methods systematic review was conducted using a convergent segregated approach. Relevant studies were searched from PubMed, Cochrane Library, Embase, and Web of Science. A qualitative analysis was initiated, exploring the public's antibiotic use experience for URTIS based on the Consumer Behavior Model (CBM). This was followed by a quantitative synthesis, tapping into the prevalence and predictors of public behavior in antibiotic usage for URTIs. The segregated syntheses complemented each other and were further integrated. Results A total of 86 studies were included: 48 quantitative, 30 qualitative, eight mixed methods studies. The included studies were conducted in Europe (n = 29), Asia (n = 27) and North America (n = 21), assessing the behaviors of patients (n = 46), their parents or caregivers (n = 31), or both (n = 9). Eleven themes emerged covering the six CBM stages: need recognition, information searching, alternative evaluation, antibiotic obtaining, antibiotic consumption, and post-consumption evaluation. The six stages reinforce each other, forming a vicious cycle. The high prevalence of the public's irrational use of antibiotics for URTIs is evident despite the high heterogeneity of the studies (ranging from 0.0 to 92.7%). The perceived seriousness of illness and misbelief in antibiotics were identified consistently across the studies as the major motivation driving the public's irrational use of antibiotics for URTIs. However, individual capacity (e.g., knowledge) and opportunity (e.g., contextual restriction) in reducing antibiotic use have mixed effect. Conclusion Systemic interventions concerning both supply and demand sides are warranted. The public needs to be educated about the appropriate management of URTIs and health care providers need to re-shape public attitudes toward antibiotic use for URTIs through communication and prescribing practices. Systematic review registration https://www.crd.york.ac.uk/prospero, identifier: CRD42021266407.
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Affiliation(s)
- Lixia Duan
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Dan Wang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, China
| | - Rujiao Lin
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, China
| | - Pan Qian
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, China
| | - Chenxi Liu
- School of Medicine and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, China
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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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Kong LS, Islahudin F, Muthupalaniappen L, Chong WW. Knowledge and Expectations on Antibiotic Use Among the General Public in Malaysia: A Nationwide Cross-Sectional Survey. Patient Prefer Adherence 2021; 15:2405-2416. [PMID: 34754181 PMCID: PMC8572111 DOI: 10.2147/ppa.s328890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/07/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Identifying knowledge gaps regarding antibiotic use and resistance is important for future interventional strategies. There is limited information on Malaysia's general public's knowledge and expectations on antibiotic use. PURPOSE To assess the knowledge of antibiotic use and resistance, expectations from antibiotic prescription, and identify inappropriate practices related to antibiotic use among Malaysia's general public. MATERIALS AND METHODS A nationwide cross-sectional survey was conducted among Malaysians aged 18 years and above from each state, from May to November 2019. Participants were recruited via quota sampling, followed by convenient sampling. A validated self-administered questionnaire was used to collect data. RESULTS Of the 1971 respondents recruited, 56.6% had engaged in at least one inappropriate practice; particularly, not completing the antibiotic course (48.8%). The mean total knowledge score was 8.57±4.24 (total 20). The majority incorrectly believed that antibiotics work on viral infections (79.1%) and colds and coughs (77.0%). Less than half of them believed that antibiotics could be stopped when symptoms improved (42.8%). Most respondents incorrectly perceived that antibiotic resistance occurs when the body becomes resistant to antibiotics (90.2%) and antibiotic resistance is not an issue in the country (62.9%). More than half the participants expected antibiotics to be prescribed for self-limiting symptoms (fever: 62.9%, sore throat: 57.2%, cold or flu: 50.9%). Respondents with better knowledge were less likely to engage in inappropriate antibiotic use (never engaged: 9.26±4.40 versus had engaged: 8.11±4.00, p<0.001), and expect doctors to discuss with them the need for antibiotics (agree/strongly agree: 9.03±4.25 versus neutral: 6.62±3.91 versus disagree/strongly disagree: 8.29±4.00, p<0.001). CONCLUSION Knowledge gaps in the role of antibiotics and understanding of antibiotic resistance should be considered whtpen designing future educational strategies for the general public.
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Affiliation(s)
- Lai San Kong
- Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, 50300, Malaysia
| | - Farida Islahudin
- Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, 50300, Malaysia
| | - Leelavathi Muthupalaniappen
- Department of Family Medicine, Medical Faculty, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia
| | - Wei Wen Chong
- Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, 50300, Malaysia
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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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Anh HQ, Le TPQ, Da Le N, Lu XX, Duong TT, Garnier J, Rochelle-Newall E, Zhang S, Oh NH, Oeurng C, Ekkawatpanit C, Nguyen TD, Nguyen QT, Nguyen TD, Nguyen TN, Tran TL, Kunisue T, Tanoue R, Takahashi S, Minh TB, Le HT, Pham TNM, Nguyen TAH. Antibiotics in surface water of East and Southeast Asian countries: A focused review on contamination status, pollution sources, potential risks, and future perspectives. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 764:142865. [PMID: 33097262 DOI: 10.1016/j.scitotenv.2020.142865] [Citation(s) in RCA: 133] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/26/2020] [Accepted: 10/03/2020] [Indexed: 05/11/2023]
Abstract
This review provides focused insights into the contamination status, sources, and ecological risks associated with multiple classes of antibiotics in surface water from the East and Southeast Asia based on publications over the period 2007 to 2020. Antibiotics are ubiquitous in surface water of these countries with concentrations ranging from <1 ng/L to hundreds μg/L and median values from 10 to 100 ng/L. Wider ranges and higher maximum concentrations of certain antibiotics were found in surface water of the East Asian countries like China and South Korea than in the Southeast Asian nations. Environmental behavior and fate of antibiotics in surface water is discussed. The reviewed occurrence of antibiotics in their sources suggests that effluent from wastewater treatment plants, wastewater from aquaculture and livestock production activities, and untreated urban sewage are principal sources of antibiotics in surface water. Ecological risks associated with antibiotic residues were estimated for aquatic organisms and the prevalence of antibiotic resistance genes and antibiotic-resistant bacteria were reviewed. Such findings underline the need for synergistic efforts from scientists, engineers, policy makers, government managers, entrepreneurs, and communities to manage and reduce the burden of antibiotics and antibiotic resistance in water bodies of East and Southeast Asian countries.
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Affiliation(s)
- Hoang Quoc Anh
- University of Science, Vietnam National University, 334 Nguyen Trai, Thanh Xuan, Hanoi 10000, Viet Nam; Center of Advanced Technology for the Environment (CATE), Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama 790-8566, Japan.
| | - Thi Phuong Quynh Le
- Laboratory of Environmental Chemistry, Institute of Natural Products Chemistry, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam; Graduate University of Science and Technology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam.
| | - Nhu Da Le
- Laboratory of Environmental Chemistry, Institute of Natural Products Chemistry, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Xi Xi Lu
- Department of Geography, National University of Singapore, Arts Link 1, Singapore 117570, Singapore
| | - Thi Thuy Duong
- Institute of Environmental Technology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Josette Garnier
- Sorbonne University, UMR Metis 7619, 4th floor, Tour 56, 4 Place Jussieu, Paris 75005, France
| | - Emma Rochelle-Newall
- Institute of Ecology and Environmental Sciences of Paris (iEES-Paris), Sorbonne Université, Université Paris-Est Créteil, IRD, CNRS, INRA, Paris, France
| | - Shurong Zhang
- College of Water Sciences, Beijing Normal University, 19 Xinjiekouwai St., Beijing 100875, China
| | - Neung-Hwan Oh
- Graduate School of Environmental Studies, Seoul National University, Seoul 08826, Republic of Korea
| | - Chantha Oeurng
- Institute of Technology of Cambodia, Russian Conference Blvd., Phnom Penh, Cambodia
| | - Chaiwat Ekkawatpanit
- Civil Engineering Department, King Mongkut's University of Technology Thonburi (KMUTT), 126 Pracha Uthit Rd., Thon Buri, Bangkok 10140, Thailand
| | - Tien Dat Nguyen
- Center for Research and Technology Transfer, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Quang Trung Nguyen
- Center for Research and Technology Transfer, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Tran Dung Nguyen
- Institute of Environmental Technology, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Cau Giay, Hanoi 10000, Viet Nam
| | - Trong Nghia Nguyen
- Faculty of Chemical Technology and Environment, Hung Yen University of Technology and Education, Khoai Chau, Hung Yen 17000, Viet Nam
| | - Thi Lieu Tran
- Viet Nam National Institute of Occupational Safety and Health (VNNIOSH), 99 Tran Quoc Toan, Hoan Kiem, Hanoi 10000, Viet Nam
| | - Tatsuya Kunisue
- Center for Marine Environmental Studies (CMES), Ehime University, 2-5 Bunkyo-cho, Matsuyama 790-8577, Japan
| | - Rumi Tanoue
- Center for Marine Environmental Studies (CMES), Ehime University, 2-5 Bunkyo-cho, Matsuyama 790-8577, Japan
| | - Shin Takahashi
- Center of Advanced Technology for the Environment (CATE), Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama 790-8566, Japan; Center for Marine Environmental Studies (CMES), Ehime University, 2-5 Bunkyo-cho, Matsuyama 790-8577, Japan
| | - Tu Binh Minh
- University of Science, Vietnam National University, 334 Nguyen Trai, Thanh Xuan, Hanoi 10000, Viet Nam
| | - Huu Tuyen Le
- University of Science, Vietnam National University, 334 Nguyen Trai, Thanh Xuan, Hanoi 10000, Viet Nam
| | - Thi Ngoc Mai Pham
- University of Science, Vietnam National University, 334 Nguyen Trai, Thanh Xuan, Hanoi 10000, Viet Nam
| | - Thi Anh Huong Nguyen
- University of Science, Vietnam National University, 334 Nguyen Trai, Thanh Xuan, Hanoi 10000, Viet Nam
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Hicks JP, Latham SM, Huque R, Das M, Newell J, Abdullah SM, Al Azdi Z, Jahan I, Rassi C, Hamade P, Shafique M, Islam MS, King R. Antibiotic practices among household members and their domestic animals within rural communities in Cumilla district, Bangladesh: a cross-sectional survey. BMC Public Health 2021; 21:406. [PMID: 33632193 PMCID: PMC7908663 DOI: 10.1186/s12889-021-10457-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/12/2021] [Indexed: 12/19/2022] Open
Abstract
Background Antibiotic resistance is a global threat to human health, and inappropriate use of antibiotics in humans and animals is widely considered to be a key driver of antibiotic resistant infections. Antibiotic use in humans and animals is growing rapidly in low- and, particularly, middle-income countries. However, there is little detailed understanding about practices related to the use of antibiotics in humans and animals within community settings in such countries. Here we aimed to understand the antibiotic practices of rural households across Cumilla district, Bangladesh, in relation to household members and their domestic animals. Methods In 2018 we conducted a cross-sectional survey using representative cluster sampling methods. We collected self-reported information from 682 female and 620 male household heads, with women also asked about their children’s antibiotic practices. Results Only 48% (95% CI: 40, 56%) of women and men had heard of antibiotics, and among those women and men who were aware of antibiotics and the children of those women 70% (95% CI: 64, 76%) reported having previously taken antibiotics, while among these individuals who reported previously taking antibiotics 21% (95% CI: 18, 25%) said they had done so most recently within the last month. Risky/inappropriate antibiotic practices in humans and animals were often reported. For example, among women and men who were aware of antibiotics and the children of those women 52% (95% CI: 40, 63%) reported previously taking antibiotics for a “cough/cold”, despite antibiotics being typically inappropriate for use against viral upper respiratory tract infections. Among poultry-owning respondents who were aware of antibiotics 11% (95% CI: 8, 15%) reported previously giving healthy poultry antibiotics, mainly for growth/prophylaxis, while among cattle-owning respondents who were aware of antibiotics and reported previously giving their cattle feed 20% (95% CI: 9, 37%) said the feed had contained antibiotics at least sometimes. Conclusions Our results highlight the need for context-adapted interventions at both the community level and the health systems level to reduce inappropriate antibiotic use among humans and domestic animals in rural Bangladesh. Successfully reducing inappropriate use of antibiotics among humans and animals is a required and critical step in tackling antimicrobial resistance. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10457-w.
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Affiliation(s)
- Joseph Paul Hicks
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, LS2 9JT, UK.
| | - Sophia M Latham
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, Cheshire, CH64 7TE, UK
| | - Rumana Huque
- ARK Foundation, Suite C-3 & C-4, House # 06, Road # 109, Gulshan-2, Dhaka, 1212, Bangladesh.,Department of Economics, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Mahua Das
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, LS2 9JT, UK
| | - Jane Newell
- University of Liverpool Medical School, Cedar House, Ashton St, Liverpool, L69 3GE, UK
| | - S M Abdullah
- ARK Foundation, Suite C-3 & C-4, House # 06, Road # 109, Gulshan-2, Dhaka, 1212, Bangladesh.,Department of Economics, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Zunayed Al Azdi
- ARK Foundation, Suite C-3 & C-4, House # 06, Road # 109, Gulshan-2, Dhaka, 1212, Bangladesh
| | - Ishrat Jahan
- ARK Foundation, Suite C-3 & C-4, House # 06, Road # 109, Gulshan-2, Dhaka, 1212, Bangladesh
| | - Christian Rassi
- Malaria Consortium, The Green House, 244-254 Cambridge Heath Road, London, E2 9DA, UK
| | - Prudence Hamade
- Malaria Consortium, The Green House, 244-254 Cambridge Heath Road, London, E2 9DA, UK
| | - Muhammad Shafique
- Malaria Consortium, The Green House, 244-254 Cambridge Heath Road, London, E2 9DA, UK
| | - Mohammad Saiful Islam
- Faculty of Surgery and Professor of Paediatric Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Rebecca King
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, LS2 9JT, UK
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Portero de la Cruz S, Cebrino J. Prevalence and Determinants of Antibiotic Consumption in the Elderly during 2006-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093243. [PMID: 32384740 PMCID: PMC7246950 DOI: 10.3390/ijerph17093243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/04/2020] [Accepted: 05/04/2020] [Indexed: 06/11/2023]
Abstract
Elderly people are a particularly important population with regard to antibiotic overuse, using around 50% more antibiotics per capita than younger adults. The aim of this study was to analyze the prevalence, associated factors and evolution over time of antibiotic consumption among the Spanish population aged ≥ 65 years from 2006 to 2017. A descriptive cross-sectional study was conducted using data from the Spanish National Health Survey in 2006, 2011/2012 and 2017, and from the European Health Survey in Spain in 2009 and 2014. The sample consisted of 26,891 non-institutionalized individuals ≥ 65 years. Antibiotic consumption was the dependent variable, and sociodemographic variables, lifestyle habits and health status were analyzed using a logistic regression model. The prevalence of antibiotic consumption was 4.94%, with a marked increase from 2006 (4.64%) to 2017 (5.81%) (p < 0.0001). Higher antibiotic consumption was associated with poor or very poor self-perceived health status, no polypharmacy and not having been in hospital during the previous twelve months, while a lower consumption was linked to being limited but not severely due to a health problem and not being at all limited.
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Affiliation(s)
- Silvia Portero de la Cruz
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba, Avda. Menéndez Pidal, S/N, 14071 Córdoba, Spain
| | - Jesús Cebrino
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Seville, Avda. Doctor Fedriani, S/N, 41009 Seville, Spain;
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