From the other perspective: Behavioural factors associated with UK sheep farmers’ attitudes towards antibiotic use and antibiotic resistance

Research suggests that many sheep farmers continue to carry out traditional antibiotic use practices despite new ’good practice’ recommendations. The aim of this study was to group farmers depending on their attitudes around antibiotic use and antibiotic resistance, and determine the behaviours that are associated with the farmers in these groups. In 2017, a flock health survey was sent to British sheep farmers. K-means cluster analysis was used to identify groups of farmers with similar attitudes towards antibiotic use and resistance. A multivariable logistic regression model was built to determine the associations between farmers’ past behaviours and their antibiotic attitude group. There were 461 responses. Two groups of farmers were identified based on their antibiotic attitudes. Cluster 1 were defined as the "discordant" group who had positive views of using antibiotics prophylactically and negative views of reducing antibiotic use. Cluster 2 were defined as the "concordant" group who were positive about reducing antibiotic use and had negative views about using antibiotics prophylactically. Using antibiotics in all lambs (OR = 2.689, CI = 1.571, 4.603), using antibiotics in all ewes (OR = 3.388, CI = 1.318, 8.706), always trimming diseased feet over the past three years (OR = 2.487, CI = 1.459, 4.238), not using a computer to record information over the past three years (OR = 1.996, CI = 1.179, 3.381), not changing worming practices over the past three years (OR = 1.879, CI = 1.144, 3.087), and farmers’ perceptions that their sheep flock did not make a financial loss in the past three years (OR = 2.088, CI = 1.079, 4.040) were significantly associated with belonging to the discordant group. Talking to their veterinarian about antibiotic use or the frequency of veterinary visits were not associated with antibiotic attitude group. These results suggest that farmers who had attitudes relating to antibiotic use that did not align with current recommendations carried out more traditional practices, which were strengthened by their positive perceptions of profitability.

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Prevalence of and Risk Factors for Nonprescription Antibiotic Use among Individuals Presenting to One Hospital in Saudi Arabia after the 2018 Executive Regulations of Health Practice Law: A Cross-Sectional Study

Antibiotics ◽

10.3390/antibiotics10080923 ◽

2021 ◽

Vol 10 (8) ◽

pp. 923

Author(s):

Ali Mohsen Al-Hazmi ◽

Ahmed Arafa ◽

Haytham Sheerah ◽

Khalid Saeed Alshehri ◽

Khalid Alwalid Alekrish ◽

...

Keyword(s):

Risk Factors ◽

Saudi Arabia ◽

Antibiotic Resistance ◽

Sex Education ◽

Antibiotic Use ◽

Cross Sectional Study ◽

University Hospital ◽

Sectional Study ◽

Cross Sectional ◽

The Past

Antibiotic resistance is a worldwide public health emergency. Nonprescription antibiotic use is a chief cause of antibiotic resistance. The Saudi Government, as a consequence, imposed in 2018 executive regulations to prevent the distribution of antibiotics without a prescription. Herein, we aimed to investigate the prevalence of and risk factors for nonprescription antibiotic use among individuals presenting to one hospital in Saudi Arabia after enacting these regulations. This cross-sectional study was conducted on people, aged ≥18 years, who presented to the primary healthcare clinics of King Khalid University Hospital in Riyadh during the period between 1/1/2019 and 28/2/2019. Participants were asked to fill out a self-administrated questionnaire assessing their nonprescription antibiotic use during the past year in addition to sociodemographic information. Then, logistic regression analyses were performed to calculate the odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for age, sex, education, and nationality of any nonprescription antibiotic use compared with no use within the past year. Out of 463 participants, 62.9% were females, 67.4% were <40 years, and 93.7% were Saudi citizens. Overall, 30.5% of participants reported nonprescription antibiotic use during the past year (19.7% one to two times and 10.8% more than two times). Male and non-Saudi participants were more likely to report any nonprescription antibiotic use, with HRs (95% CIs) of 1.99 (1.30, 3.04) and 3.81 (1.73, 8.35), respectively. The main reasons behind nonprescription antibiotic use were having previous experience with a health condition (69.2%), inaccessibility of healthcare (26.6%), and recommendation from a relative or a friend (16.1%). A major limitation of this study was that it included individuals attending one hospital. Individuals who seek medical consultation could be dissimilar to those who do not see doctors regarding nonprescription antibiotic use.

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Knowledge about infections is associated with antibiotic use: cross-sectional evidence from the health survey Northern Ireland

BMC Public Health ◽

10.1186/s12889-021-11018-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

J. Shebehe ◽

E. Ottertun ◽

K. Carlén ◽

D. Gustafson

Keyword(s):

Antibiotic Resistance ◽

Northern Ireland ◽

Health Survey ◽

Population Sample ◽

Knowledge Score ◽

Antibiotic Use ◽

Age Group ◽

Cross Sectional ◽

Poor General Health ◽

The Past

Abstract Background Antibiotic overuse is the main modifiable driver of antibiotic resistance. Factors associated with overuse have been inconsistently reported and vary across populations. Given the burgeoning occurrence of infectious diseases around the world, there remains a great need to identify barriers and solutions to the control of infections. We examined whether knowledge about infections and antibiotic resistance is associated with antibiotic use in a northern European population sample. Methods The Health Survey Northern Ireland 2014/15 was completed by a cross-sectional sample of 4135 participants aged > 16 years. Participants were asked whether they had taken an antibiotic in the past 12 months; and six questions were asked concerning knowledge about infections and antibiotic resistance. Correct answers to the six knowledge questions defined a knowledge score (score range 0–6 correct answers). We used multivariable logistic regression to estimate odds of self-reported antibiotic use during the last 12 months in association with knowledge score (lowest score, 0/6, as referent), and response to each knowledge question. Covariates included sex, age group, smoking, alcohol drinking, deprivation index, self-rated health, and satisfaction with life. Results were outputted as Odds Ratios (OR) and 95% Confidence Intervals (CI). Results Antibiotic use in the past 12 months was reported by 39.0% (1614/4135); and 84.2% (3482/4135) scored < 6/6 correct on knowledge statements. Compared to the lowest knowledge score (0/6 correct), the highest knowledge score (6/6 correct) was associated with higher odds of antibiotic use (adjusted OR 2.03, 95% CI [1.46, 2.81], p < 0.001), with a P-value < 0.001 for trend with increasing knowledge score. Female sex, age, high deprivation, and poor general health, were independently associated with higher odds of antibiotic use. Stratified analyses showed sex and age group differences. Conclusion Knowledge, and other modifiable and non-modifiable risk factors, were positively associated with antibiotic use in the past 12 months. While the causal direction of these associations could not be determined, given the high prevalence of lesser knowledge, as well as independent contributions of other factors including socioeconomic characteristics, health literacy campaigns to raise awareness of antibiotic resistance should take a multi-pronged approach.

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Infections and use of antibiotics in residents of long-term care facilities in Hungary

Orvosi Hetilap ◽

10.1556/oh.2014.29876 ◽

2014 ◽

Vol 155 (23) ◽

pp. 911-917 ◽

Cited By ~ 1

Author(s):

Rita Szabó ◽

Karolina Böröcz

Keyword(s):

Urinary Tract ◽

Long Term Care ◽

Soft Tissues ◽

Good Practice ◽

Antibiotic Use ◽

Prevalence Survey ◽

Term Care ◽

Care Facilities ◽

Tract Infections

Introduction: Healthcare associated infections and antimicrobial use are common among residents of long-term care facilities. Faced to the lack of standardized data, the European Centre for Disease Prevention and Control funded a project with the aim of estimating prevalence of infections and antibiotic use in European long-term care facilities. Aim: The aim of the authors was to present the results of the European survey which were obtained in Hungary. Method: In Hungary, 91 long-term care facilities with 11,823 residents participated in the point-prevalence survey in May, 2013. Results: The prevalence of infections was 2.1%. Skin and soft tissues infections were the most frequent (36%), followed by infections of the respiratory (30%) and urinary tract (21%). Antimicrobials were mostly prescribed for urinary tract infections (40.3%), respiratory tract infections (38.4%) and skin and soft tissue infections (13.2%). The most common antimicrobials (97.5%) belonged to the ATC J01 class of “antibacterials for systemic use”. Conclusions: The results emphasise the need for a national guideline and education for good practice in long-term care facilities. Orv. Hetil., 2014, 155(23), 911–917.

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Educational Video Improves Knowledge about Outpatients’ Usage of Antibiotics in Two Public Hospitals in Indonesia

Antibiotics ◽

10.3390/antibiotics10050606 ◽

2021 ◽

Vol 10 (5) ◽

pp. 606

Author(s):

Fauna Herawati ◽

Rika Yulia ◽

Bustanul Arifin ◽

Ikhwan Frasetyo ◽

Setiasih ◽

...

Keyword(s):

Antibiotic Resistance ◽

General Hospital ◽

Sampling Technique ◽

Knowledge Score ◽

Antibiotic Use ◽

Public Hospitals ◽

Educational Video ◽

Inappropriate Use ◽

Quasi Experimental ◽

The Difference

The inappropriate use or misuse of antibiotics, particularly by outpatients, increases antibiotic resistance. A lack of public knowledge about “Responsible use of antibiotics” and “How to obtain antibiotics” is a major cause of this. This study aimed to assess the effectiveness of an educational video about antibiotics and antibiotic use to increase outpatients’ knowledge shown in two public hospitals in East Java, Indonesia. A quasi-experimental research setting was used with a one-group pre-test—post-test design, carried out from November 2018 to January 2019. The study population consisted of outpatients to whom antibiotics were prescribed. Participants were selected using a purposive sampling technique; 98 outpatients at MZ General Hospital in the S regency and 96 at SG General Hospital in the L regency were included. A questionnaire was used to measure the respondents’ knowledge, and consisted of five domains, i.e., the definition of infections and antibiotics, obtaining the antibiotics, directions for use, storage instructions, and antibiotic resistance. The knowledge test score was the total score of the Guttman scale (a dichotomous “yes” or “no” answer). To determine the significance of the difference in knowledge before and after providing the educational video and in the knowledge score between hospitals, the (paired) Student’s t-test was applied. The educational videos significantly improved outpatients’ knowledge, which increased by 41% in MZ General Hospital, and by 42% in SG General Hospital. It was concluded that an educational video provides a useful method to improve the knowledge of the outpatients regarding antibiotics.

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Perceptions of Antibiotic Use and Resistance: Are Antibiotics the Dentists’ Anxiolytics?

Antibiotics ◽

10.3390/antibiotics10060735 ◽

2021 ◽

Vol 10 (6) ◽

pp. 735

Author(s):

Julie Dormoy ◽

Marc-Olivier Vuillemin ◽

Silvia Rossi ◽

Jean-Marc Boivin ◽

Julie Guillet

Keyword(s):

Public Health ◽

Antibiotic Resistance ◽

Qualitative Method ◽

Oral Surgery ◽

Antibiotic Use ◽

Public Health Issue ◽

Clinical Factors ◽

Structured Interviews ◽

Health Crisis ◽

The Public

Background: Antibiotic resistance is a global health crisis. The aim of this study was to explore dentists’ perceptions of antibiotic resistance. Methods: A qualitative method was used. Seventeen dentists practising in the Nancy (Lorraine, France) region were surveyed. They were general practitioners or specialised in oral surgery, implantology, or periodontology. The practitioners took part in semi-structured interviews between September 2019 and July 2020. All of the interviews were transcribed in full and analysed thematically. Results: Four major themes have been selected: attitudes of the dentists in regard to the guidelines, clinical factors that influence prescriptions, non-clinical factors that influence prescriptions, and the perception of antibiotic resistance. The dentists stated that they were very concerned regarding the public health issue of antibiotic resistance. However, they often prescribe according to their own interests and habits rather than according to the relevant guidelines. Conclusions: Although dentists are generally well aware of antibiotic resistance, they often do not adequately appreciate the link between their prescribing habits and the phenomenon of antibiotic resistance. Regular updating of practitioners’ knowledge in this regard is necessary, but patients and the general public should also be made more aware of the issue.

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One Health: Farmworker Perceptions of Antibiotic Resistance and Personal Protective Practices on Wisconsin Dairy Farms

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1118 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s448-s449

Author(s):

Ali Konkel ◽

Ashley Kates ◽

Mary Jo Knobloch ◽

Wisconsin ◽

Nasia Safdar ◽

...

Keyword(s):

Antibiotic Resistance ◽

Hand Hygiene ◽

Focus Groups ◽

Systems Engineering ◽

One Health ◽

Dairy Farms ◽

Raw Milk ◽

Antibiotic Use ◽

Farm Workers ◽

Individual Knowledge

Background: Antimicrobials are used on dairy farms for preventing disease and treating common infections such as mastitis. Objective: We aimed to understand farmworker practices that potentially contribute to transmission of antimicrobial resistance bacteria and their genes (ARG) among animals and farm workers, and to identify human behavioral interventions to reduce risk. Methods: Focus groups with farm workers were held at 8 dairy farms across Wisconsin selected to represent a range of antibiotic use in cattle. We explored the nature of potentially high-risk practices and farm-worker knowledge and experiences with antibiotic use and resistance. Farm workers were asked to describe common tasks, including hand hygiene and eating practices, and the policies guiding these practices. Focus groups were conducted in English and Spanish guided by the Systems Engineering in Patient Safety (SEIPS) framework, adapted for an agricultural context. Discussions were recorded, transcribed, and translated. A content analysis was conducted to identify themes. Dedoose version 8.0.35 software was used to organize the data. Results: In total, 10 focus groups were conducted on 8 farms. Knowledge of when to use antibiotics for human health varied; upset stomach, headache, and flu symptoms were suggested as appropriate uses. Few workers had personal experience with antibiotic resistance at home or on the farm. Some displayed knowledge of the role of antibiotic stewardship in preventing the spread of ARG (“I guess all dairy farmers have a responsibility not to overdo it”). Others associated the risk of spread with the consumption of raw milk or meat from cows receiving antibiotics. Knowledge of personal protective equipment was stronger among workers who commonly reported glove use. Some perceived glove use to be mandatory, and others chose to wear gloves in the perceived absence of written rules. Some workers reported changing gloves numerous times throughout the day, and others did so less frequently or “only when they rip.” In general, hand hygiene practices are guided by individual knowledge of established rules, beliefs about risk, and personal discretion. Conclusions: Knowledge about mechanisms of spread of ARGs varies among workers on Wisconsin dairy farms and reflects a combination of farm-level rules, experience, individual knowledge, and beliefs. Applying knowledge from the healthcare setting to reduce ARG spread into agriculture is crucial to the tenets of One Health. Programs to reduce ARG spread on dairy farms should focus on proper hand hygiene and PPE use at the level of knowledge, beliefs, and practices.Funding: Funding: was provided by the USDA-NIFA Food Safety Challenge (grant no. 2017-68003-26500).Disclosures: None

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Prescribers’ Knowledge, Attitudes and Behaviors on Antibiotics, Antibiotic Use and Antibiotic Resistance in Jordan

Antibiotics ◽

10.3390/antibiotics10070858 ◽

2021 ◽

Vol 10 (7) ◽

pp. 858

Author(s):

Reema A. Karasneh ◽

Sayer I. Al-Azzam ◽

Mera Ababneh ◽

Ola Al-Azzeh ◽

Ola B. Al-Batayneh ◽

...

Keyword(s):

Antibiotic Resistance ◽

Antibiotic Use ◽

Cross Sectional Study ◽

Antibiotic Prescribing ◽

Prescribing Practices ◽

Online Questionnaire ◽

Cross Sectional ◽

Attitudes And Behaviors ◽

And Behaviors ◽

Ease Of Access

More research is needed on the drivers of irrational antibiotic prescribing among healthcare professionals and to ensure effective prescribing and an adequate understanding of the issue of antibiotic resistance. This study aimed at evaluating prescribers’ knowledge, attitudes and behaviors about antibiotic use and antibiotic resistance. A cross-sectional study was conducted utilizing an online questionnaire and included physicians and dentists from all sectors in Jordan. A total of 613 prescribers were included (physicians n = 409, dentists n = 204). Respondents’ knowledge on effective use, unnecessary use or associated side effects of antibiotics was high (>90%), compared with their knowledge on the spread of antibiotic resistance (62.2%). For ease of access to the required guidelines on managing infections, and to materials that advise on prudent antibiotic use and antibiotic resistance, prescribers agreed in 62% and 46.1% of cases, respectively. 28.4% of respondents had prescribed antibiotics when they would have preferred not to do so more than once a day or more than once a week. Among respondents who prescribed antibiotics, 63.4% would never or rarely give out resources on prudent use of antibiotics for infections. The findings are of importance to inform antibiotic stewardships about relevant interventions aimed at changing prescribers’ behaviors and improving antibiotic prescribing practices.

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Interventions for prudent antibiotic use in primary healthcare: an econometric analysis

BMC Health Services Research ◽

10.1186/s12913-020-05732-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Elina Lampi ◽

Fredrik Carlsson ◽

Pär-Daniel Sundvall ◽

Marcela Jaime Torres ◽

Peter Ulleryd ◽

...

Keyword(s):

Antibiotic Resistance ◽

Primary Healthcare ◽

Optimal Strategies ◽

Antibiotic Use ◽

Educational Interventions ◽

Dynamic Panel Data ◽

Public Healthcare ◽

Antibiotic Prescribing ◽

Self Evaluation ◽

Healthcare Data

Abstract Background Rational antibiotic prescribing is crucial to combat antibiotic resistance. Optimal strategies to improve antibiotic use are not known. Strama, the Swedish strategic program against antibiotic resistance, has been successful in reducing antibiotic prescription rates. This study investigates whether two specific interventions directed toward healthcare centers, an informational visit and a self-evaluation meeting, played a role in observed reduction in rates of antibiotic prescriptions in primary healthcare. Methods The study was a retrospective, observational, empirical analysis exploiting the variation in the timing of the interventions and considering past prescriptions through use of estimations from dynamic panel data models. Primary healthcare data from 2011 to 2014 were examined. Data were from public and private primary healthcare centers in western Sweden. The key variables were prescription of antibiotics and indicator variables for the two interventions. Results The first intervention, an educational information intervention, decreased the number of prescriptions among public healthcare centers, but this effect was only temporary. We found no proof that the second intervention, a self-evaluation meeting at the healthcare center, had an impact on the reduction of prescriptions. Conclusions Single educational interventions aimed at influencing rates of antibiotic prescriptions have limited impact. A multifaceted approach is needed in efforts to reduce the use of antibiotics in primary health care.

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Cannabis Growers in the United States: Findings From a National Household Survey 2010−2014

Journal of Drug Issues ◽

10.1177/00220426211000457 ◽

2021 ◽

pp. 002204262110004

Author(s):

Alejandro Azofeifa ◽

Rosalie L. Pacula ◽

Margaret E. Mattson

Keyword(s):

Logistic Regression Model ◽

Geographical Location ◽

Household Survey ◽

The United States ◽

Multivariable Logistic Regression Model ◽

Chi Square ◽

Prevention Education ◽

The Past ◽

National Household Survey ◽

Using Data

Given the rapidly changing U.S. cannabis legislation landscape, the aim of this article is to describe individuals who self-reported growing cannabis in the past year by selected characteristics and geographical location. Using data from 2010 to 2014 National Survey on Drug Use and Health, we conducted bivariate chi-square tests and ran a multivariable logistic regression model to examine the indicators associated with growing cannabis. Approximately, 484,000 individuals aged 12+ self-reported growing cannabis in the past year (1.6% of marijuana users). Predictors of growing cannabis included being male and self-reported reporting using cannabis for a greater number of days. Data showed differences in the proportion of cannabis growers by the state of residence. Obtaining a baseline estimate of cannabis growing practices prior to recreational cannabis markets emerging (2014) is important because such practices may undermine efforts to discourage diversion to youth. Tracking these acquisition patterns will better inform content for public health messaging and prevention education, particularly those targeting youth.

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Identity crime and misuse in Australia: Results of the 2021 online survey

10.52922/sb78467 ◽

2021 ◽

Author(s):

Merran McAlister ◽

Christie Franks

Keyword(s):

National Identity ◽

Online Survey ◽

Personal Information ◽

Financial Loss ◽

Security Strategy ◽

The Past ◽

Australian Institute

This bulletin presents the findings of the latest survey of identity crime and misuse undertaken by the Australian Institute of Criminology as part of the Australian Government’s National Identity Security Strategy. In 2021, 9,956 people across Australia were surveyed about their experience of victimisation over their lifetime and during 2020. Nineteen percent of respondents had experienced misuse of their personal information in their lifetime and seven percent experienced it in the past year—a decline from 2019. Seventy-eight percent of respondents who reported victimisation in the past year experienced a financial loss as a result.

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