Culture of antibiotic use in Kosovo - an interview study with patients and health professionals

Abstract Background Lack of knowledge and awareness on antimicrobial resistance (AMR) can result in irrational use of antibiotics, which is one of the major drivers of AMR. One goal of the Thailand National Strategic Plan on AMR (2017-2021) is a 20% increase in public knowledge and awareness of antibiotic use and AMR by 2021. This study assesses antibiotic use, level of knowledge and awareness of antibiotic use and AMR and the factors associated with their knowledge and awareness in the Thai population in 2019. It compares findings with a similar national survey in 2017. Methods An AMR module was integrated into the Health and Welfare Survey, a biennial national household survey conducted by the National Statistical Office since 2017. The 2019 survey took place in March, through face-to-face interviews with 27,900 Thai adults aged 15 years or above who participated in the survey and compares 2019 findings with those from 2017. Results One month prior to the survey, 6.3% of population reported use of antibiotics (reduced from 7.9% to 2017), of which 98.1% received antibiotics through healthcare professionals and almost half (43.2%) for flu symptoms. During the last 12 months, 21.5% of Thai adults received information on the appropriate use of antibiotics and AMR (increased from 17.8% to 2017); mostly through health professionals (82.7%). On knowledge, 24.3% of adults gave correct answers to more than three out of six statements (three true and three false statements) (increased from 23.7% to 2017). The overall mean score of awareness of appropriate antibiotic use and AMR is 3.3 out of total score of 5. Conclusions Although progress was made on knowledge and awareness between 2017 and 2019, certain practices, such as use of antibiotics for flu symptoms and receiving information about antibiotic use and AMR, are inappropriate and inadequate. These findings require significant action, notably strengthening health professionals’ ability to prescribe and dispense antibiotics appropriately and effective communication with patients. The government should promote specific information on rational use of antibiotics and AMR to specific target groups.

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GPs’ perspectives on acne management in primary care: a qualitative interview study

British Journal of General Practice ◽

10.3399/bjgp20x713873 ◽

2020 ◽

Vol 71 (702) ◽

pp. e78-e84

Author(s):

Duncan Platt ◽

Ingrid Muller ◽

Anicka Sufraz ◽

Paul Little ◽

Miriam Santer

Keyword(s):

Antibiotic Use ◽

Qualitative Interview ◽

Skin Condition ◽

Interview Study ◽

Oral Antibiotics ◽

Telephone Interviews ◽

Qualitative Interview Study ◽

Common Skin ◽

Topical Treatments ◽

Perceived Pressure

BackgroundAcne is a common skin condition, affecting most adolescents at some point. While guidelines recommend topical treatments first-line, long courses of oral antibiotics are commonly prescribed.AimTo explore GPs’ perspectives on managing acne.Design and settingQualitative interview study with GPs in South West England.MethodGPs were invited to participate via existing email lists used by GP educators to disseminate information. Purposive sampling was used to recruit a range of participants by sex, number of years in practice, and whether their practice was rural or urban. Semi-structured telephone interviews followed an interview guide and were audiorecorded and transcribed. Data were explored using inductive thematic analysis facilitated by NVivo software (version 11).ResultsA total of 102 GPs were invited, of whom 20 participated. Analysis revealed uncertainties regarding topical treatments, particularly around available products, challenges regarding side effects, and acceptability of topical treatments. GPs generally either perceived topical treatments to be less effective than oral antibiotics or perceived pressure from patients to prescribe oral antibiotics due to patients’ views of topical treatments being ineffective. GPs described a familiarity with prescribing oral antibiotics and expressed little concern about antimicrobial stewardship in the context of acne. Some seemed unaware of guidance suggesting that antibiotic use in acne should not exceed 3 months, while others spoke about avoiding difficult conversations with patients regarding discontinuation of antibiotics.ConclusionGPs expressed uncertainty about the use of topical treatments for acne and either felt that treatments were of low effectiveness or perceived pressure from patients to prescribe oral antibiotics.

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Understanding Antibiotic Use for Pig Farming in Thailand: A Qualitative Study

10.21203/rs.3.rs-71593/v1 ◽

2020 ◽

Author(s):

Angkana Lekagul ◽

Viroj Tangcharoensathien ◽

Marco Liverani ◽

Anne Mills ◽

Jonathan Rushton ◽

...

Keyword(s):

Health Professionals ◽

Professional Training ◽

Central Government ◽

Animal Health ◽

Antibiotic Use ◽

Economic Incentives ◽

Antibiotic Prescribing ◽

Pig Production ◽

Factors Influencing ◽

Pig Farming

Abstract Background: Antimicrobial resistance (AMR), recognised as a serious and growing threat to global health, is driven by antibiotic use. Understanding factors influencing antibiotic use is essential to design and implement effective interventions to reduce unnecessary antibiotic use and AMR. This study aims to explore the practices and views of the key actors associated with the use of antibiotics for pig farming in Thailand, from local farmers to officers in central government institutions. Methods: A total of 31 in-depth interviews were conducted with pig farmers (n=13), drug retailers (n=5), veterinarians (n=7), and government officers (n=3) and representatives of health professional councils (n=2). Direct observations were conducted in pig farms. Thematic analysis based on practices, views and interests of actors regarding antibiotic use in pig production in Thailand. Results: There are various factors influencing the use of antibiotics. The factors may trigger greater antibiotic use including lack of knowledge and awareness about antibiotics and AMR, economic incentives, and loose regulatory frameworks. Farmers considered that antibiotics are necessary to maintain animal health, prevent and control diseases, and ensure economic gains, so using antibiotics was considered a worthwhile investment in pigs. There was limited information about antibiotic use in the curriculum and lack of clinical practice guidelines for health professionals. Veterinarians faced challenges in diagnosis and lacked antibiotic prescribing guidelines. Pharmaceutical companies applied market promotion strategies to increase sales; and used professionals as mediators with farmers. There was no control of antibiotic sale and prescription via the regulatory environment. The national policy on AMR could be facilitating factor to optimise use of antibiotics but its influence was weak relative to other influences which favoured antibiotic use. Conclusions: Our study highlights the need to improve antibiotic use in pig production in Thailand. Access to veterinary services and reliable information about animal health needs to be improved among farmers. Innovative low-cost investment in biosecurity could improve farm management and decrease reliance on antibiotics. Developing professional training and clinical guidelines, and establishing a code of conduct, are needed to improve practices in antibiotic prescription and sale amongst health professionals and industry.

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