Antibiotic misuse and improper practices in India: Identifying the scope to improve through a narrative review

2021 ◽  
pp. 1-8
Author(s):  
Brinal Pereira ◽  
Shruti Kulkarni
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Use ◽  
Narrative Review ◽  
Research Articles ◽  
Adherence To Treatment ◽  
Cross Sectional ◽  
Treatment Regimens ◽  
Search Terms ◽  
Antibiotics Use ◽  
The Common

BACKGROUND: In India, antibiotic resistance is high and by 2050, two million people will be affected. OBJECTIVE: To review antibiotic practices in India and the variables that impact them. METHODS: For this narrative review, research articles on antibiotic awareness, perception and practices were retrieved from PubMed and Google Scholar using search terms such as ‘India AND antibiotic use AND cross sectional AND awareness’. A total of 1730 results were found on 30 June 2020, of which 35 articles were eligible for summarizing the common antibiotic practices. RESULTS: We found that there are deficiencies in the implementation of existing policies in India. Several issues such as overprescribing of antibiotics, use without prescription and non-adherence to treatment regimens are contributing to irrational antibiotic practices in the country. CONCLUSION: There is a need for policies at the institute level to help curb the problem of antibiotic resistance.

scholarly journals Are Antibiotics Prescribed to Inpatients According to Recommended Standard Guidelines in Juba Teaching Hospital, South Sudan? A Retrospective Cross-sectional Study

2021 ◽  
Author(s):  
Michael Ekubu Otim ◽  
Desmond Kabuya Demaya ◽  
Amina M Al-Marzouqi ◽  
Jean P. Mukasa
Keyword(s):  
Antibiotic Resistance ◽  
Teaching Hospital ◽  
South Sudan ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hospitalised Patients ◽  
Antibiotics Use ◽  
High Level

Abstract Background: The emergence and spread of antibiotic resistance occurred at an alarming rate globally, and has limited the use of antibiotics for preventing and treating infectious diseases. Failure to follow guidelines and protocols for antibiotic use for rational therapeutics and infection control has led to overuse and misuse of antibiotics. However, there is paucity of data on the current pattern of antibiotics prescribing for hospitalised patients in South Sudan, which is among the youngest countries in the world. Therefore, this study aimed to explore the prescription and use of antibiotics at Juba Teaching Hospital (JTH) in South Sudan.Methods:A retrospective cross-sectional study was conducted among JTH inpatients between January and December 2016. A sample of 316 files from the medical and surgical wards were extracted using probability sampling proportional to ward size. Extracted files were reviewed to determine the pattern of antibiotics administration. Data on indications for antibiotic use were also collected. All data were entered twice and analysed using STATA version 13.0.Results: In all reviewed files, patients received treatment with antibiotics. Antibiotic use was highest in the medical ward (75.4%). Conditions in which antibiotic use was most prevalent were infectious and parasitic diseases (23.7%) and diseases of the digestive system (19.9%). The top three antibiotics prescribed were ceftriaxone (21.2%), metronidazole (20.0%) and amoxicillin (11.5%). The majority of patients (40.2%) were treated with two antibiotics. Conclusions: This study revealed a high level of inappropriate antibiotics use at JJTH. Furthermore, there is non-adherence to national/international guidelines in administration of these antibiotics among doctors. It is necessary to introduce antibiotic stewardship activity, along with continuous national surveillance and enforcement to reduce irrational antibiotics use and the associated risk for antibiotic resistance.

scholarly journals Awareness of Antibiotic Use and Resistance in Jordanian Community

2020 ◽  
Vol 11 ◽  
pp. 215013272096125 ◽  
Author(s):  
Derar H. Abdel-Qader ◽  
Abdullah Albassam ◽  
Najlaa Saadi Ismael ◽  
Asma’ A. El-Shara’ ◽  
Aisha Shehri ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Public Awareness ◽  
Antibiotic Use ◽  
Cross Sectional ◽  
Middle Income ◽  
The Public ◽  
Inappropriate Use ◽  
Middle Income Countries ◽  
Antibiotics Use ◽  
Deprived Areas

Background The public awareness toward the causes and consequences of antibiotic resistance (AR) is crucial to mitigate the inappropriate use of antibiotics (ABs), particularly in the low- and middle-income countries. There was no previous study that assessed the awareness, attitude, and knowledge about antibiotic use and AR among the Jordanian public in affluent and deprived areas. Objective This study aimed to assess the awareness, attitude, and knowledge about antibiotic use and AR in affluent and deprived areas in Jordan. Setting The survey was conducted in November 2019 in Amman, the capital of Jordan. Method A cross-sectional questionnaire was used to survey households in their areas in each of West Amman (affluent region) and East Amman (deprived region), Households were selected using proportionate random sampling method. Results A total of 620 householders (310 per area) completed the questionnaire. Pharmacists were perceived as strong influencers on householders’ decision, as 80.32% (n = 465/580) of those who used antibiotics in the last year follow pharmacists’ advice. Our results showed poor understanding of antibiotic usage among the Jordanian public, as only 14.2% (n = 44/310) of the sample in West Amman and 2.9% (n = 9/310) in East Amman disagreed with the statement “ Antibiotics work on most coughs and colds.” Householders in West Amman showed much better understanding of AR compared to those in East Amman; 82.3% (n = 255/310) of West Amman respondents agreed with the statement “ Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of the antibiotic.” compared to 31.9% (n = 99/310) of East Amman respondents on the same statement ( P  < .05). Conclusion The Jordanian community generally had poor knowledge and awareness toward antibiotics use and AR. Socio-economic factors could influence the public’s attitude toward antibiotics use and AR.

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

Antibiotics ◽  
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.

scholarly journals Antibiotics stewardship in Ghana: a cross-sectional study of public knowledge, attitudes, and practices

2020 ◽  
Author(s):  
Tamara Jimah ◽  
Ama P. Fenny ◽  
Oladele Ogunseitan
Keyword(s):  
Antibiotic Resistance ◽  
Inappropriate Medication ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Individual Knowledge ◽  
Knowledge Attitudes And Practices

Abstract Background Antibiotic resistance is a major contributing factor to global morbidity and mortality and is associated with inappropriate medication use. However, the level of antibiotic consumption and knowledge about antibiotic resistance in Ghana is inadequately quantified. Our study identifies strategies for improved stewardship of antibiotics to prevent the proliferation of resistant pathogens by assessing the level of antibiotic knowledge, attitudes, and consumption behaviors by region, gender, age, and education in rural and urban Ghana. Methods A cross-sectional study was conducted in 12 communities in the urban Greater Accra and rural Upper West regions of Ghana. A questionnaire survey was administered to 400 individuals aged 18 years and older in selected locations during September-October 2018 to gather data on individual knowledge, attitudes, and practices concerning antibiotics and antibiotic resistance. Multivariate analysis was used to investigate the association between demographic characteristics and knowledge, attitudes, and related behaviors. Results Over 30% (125/400) had not received a doctor’s prescription during their last illness. Seventy percent (278/400) had taken at least one antibiotic in the year prior to the survey. The top five frequently used antibiotics were Amoxicillin , Amoxicillin-clavulanic acid , Ampicillin , Ciprofloxacin , and Metronidazole . Women and older adults had higher knowledge compared to their respective counterparts (p<0.01). Furthermore, prudent antibiotic use was significantly more prevalent in women than men (p<0.05). Although no regional differences were found in overall knowledge, compared to urban residents, individuals residing in rural settings exhibited higher knowledge about the ineffectiveness of antibiotics for viruses like the cold and HIV/AIDS (p<0.001). Two hundred and fifty-two (63%) respondents were unaware of antibiotic resistance. There was generally a low level of self-efficacy among participants regarding their role in preserving the effectiveness of antibiotics. Conclusion Antibiotic knowledge, attitudes, and use varied significantly across demographics, suggesting a context-specific approach to developing effective community interventions.

scholarly journals Public awareness regarding the use and resistance of antibiotics: A cross-sectional study among Nepalese adults in Kathmandu valley

2018 ◽  
Vol 6 (3) ◽  
pp. 96-101
Author(s):  
Satish Kumar Deo ◽  
Sita Rijal ◽  
Tulza K.C
Keyword(s):  
Antibiotic Resistance ◽  
Public Awareness ◽  
Study Finding ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Public Health Issue ◽  
Sectional Study ◽  
Cross Sectional ◽  
Interview Method ◽  
Drug Classes

Background: Antibiotics are considered to be among the most commonly sold drug classes globally. Antibiotic resistance is a recognized public health issue at the local, national and global levels.Objectives: The aim of this study was to identify awareness of general public regarding the use and resistance of antibiotics.Methodology: A descriptive cross-sectional study was conducted in Kathmandu in November 2016 using a quantitative questionnaire among 120 adult people aged 20–60 years. Convenience sampling method was used and information on use of antibiotics and resistance was obtained using semi-structured questionnaire through interview method. Descriptive statistics was done to describe the respondent’s level of awareness regarding use of antibiotics and resistance.Results: Among the total respondents, majority had incorrect awareness as regards to action, reasons for using antibiotics, possible side effects of the antibiotic. Seventy one percent of the respondents had not heard about antibiotic resistance. The study finding showed that about 66.7% of the participants had inadequate awareness towards use and resistance of antibiotics.Conclusion: The findings demonstrate that the overall awareness on antibiotic use and resistance is poorly understood among our respondents. This information can be utilized in future educational and antibiotic resistance awareness raising campaigns.

scholarly journals Young doctors’ perspectives on antibiotic use and resistance: a multinational and inter-specialty cross-sectional European Society of Clinical Microbiology and Infectious Diseases (ESCMID) survey

2019 ◽  
Vol 74 (12) ◽  
pp. 3611-3618 ◽  
Author(s):  
Bojana Beović ◽  
May Doušak ◽  
Céline Pulcini ◽  
Guillaume Béraud ◽  
Jose Ramon Paño Pardo ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Principal Component ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Self Assessment ◽  
Cross Sectional ◽  
Web Based ◽  
Five Dimensions ◽  
And Gender

Abstract Background Postgraduate training has the potential to shape the prescribing practices of young doctors. Objectives To investigate the practices, attitudes and beliefs on antibiotic use and resistance in young doctors of different specialties. Methods We performed an international web-based exploratory survey. Principal component analysis (PCA) and bivariate and multivariate [analysis of variance (ANOVA)] analyses were used to investigate differences between young doctors according to their country of specialization, specialty, year of training and gender. Results Of the 2366 participants from France, Greece, Italy, Portugal, Slovenia and Spain, 54.2% of young doctors prescribed antibiotics predominantly as instructed by a mentor. Associations between the variability of answers and the country of training were observed across most questions, followed by variability according to the specialty. Very few differences were associated with the year of training and gender. PCA revealed five dimensions of antibiotic prescribing culture: self-assessment of knowledge, consideration of side effects, perception of prescription patterns, consideration of patient sickness and perception of antibiotic resistance. Only the country of specialization (partial η2 0.010–0.111) and the type of specialization (0.013–0.032) had a significant effect on all five identified dimensions (P < 0.01). The strongest effects were observed on self-assessed knowledge and in the perception of antibiotic resistance. Conclusions The country of specialization followed by the type of specialization are the most important determinants of young doctors’ perspectives on antibiotic use and resistance. The inclusion of competencies in antibiotic use in all specialty curricula and international harmonization of training should be considered.

scholarly journals Knowledge of antibiotics and antibiotic usage behavior among the people of Dhaka, Bangladesh

2020 ◽  
Vol 6 (3) ◽  
pp. 519-524
Author(s):  
Iftekhar Ahmed ◽  
Md Bodiuzzaman Rabbi ◽  
Marufa Rahman ◽  
Rehnuma Tanjin ◽  
Sharmin Jahan ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Use ◽  
Antibiotic Usage ◽  
Cross Sectional Survey ◽  
Self Medication ◽  
Cross Sectional ◽  
The People ◽  
Usage Behavior ◽  
Educational Campaigns ◽  
Adherence To Therapy

Bangladesh is a developing country with a very high prevalence of antibiotic resistance where irrational use of antibiotics is very common. This cross-sectional survey was conducted to assess the knowledge of antibiotics and antibiotic usage behavior (Antibiotic use, self-medication, adherence to therapy) among the people of Bangladesh. The association between participants’ knowledge of antibiotics and their antibiotic usage behavior was also analyzed. A cross-sectional survey based on a structured questionnaire was conducted in the Dhaka district. The questionnaire included questions about demographic information, participants’ knowledge of antibiotics, and their recent antibiotic usage. The data analysis involved the use of descriptive statistics and multivariable logistic regression. Very few participants knew that antibiotics are not effective against most common colds (16.8%), viruses (22.5%), and pains (41.7%). Most respondents (>75%) knew that excessive use of antibiotics and failing to complete a course may render antibiotics less effective in the future. However, only 56.1% were aware of antibiotic resistance. About half (46.6%) of the participants took antibiotics in the last six months, 20.5% of whom resorted to self-medication and 23.1% reported non-adherence to therapy. Greater knowledge of antibiotics was significantly associated with lower rates of self-medication (p=0.037). Misconceptions about antibiotics and antibiotic misuse are very common in Bangladesh. The findings suggest that misconceptions about antibiotics and antibiotic misuse are very common in Bangladesh. To mitigate these problems, interventions comprised of educational campaigns and redesigning of the healthcare system and policies should be undertaken. Asian J. Med. Biol. Res. September 2020, 6(3): 519-524

scholarly journals The Depiction of Antibiotic Use without Presciption and Community Attitudes Towards Drugstores that Refused to Sell Antibiotic without Prescription

2019 ◽  
Vol 9 (2) ◽  
Author(s):  
M Rifqi Rokhman ◽  
Satibi Satibi
Keyword(s):  
Antibiotic Resistance ◽  
Family Income ◽  
Antibiotic Use ◽  
Cross Sectional ◽  
Community Attitudes ◽  
Community Needs ◽  
Education Degree ◽  
Education Needs ◽  
Relationship Of ◽  
The Relationship

Antibiotic resistance causes reduced therapeutic effectiveness. Understanding of people's behavior plays an important role in countering antibiotic resistance especially by preventing irrational use of antibiotics. The purpose of the study was to depict the experience of respondents in using antibiotics without prescription and the relationship of characteristics of respondents with unwillingness to remain a customer at a pharmacy that had refused to provide antibiotics without a prescription. The study design applied cross-sectional using a questionnaire, and sampling was done by purposive sampling. Respondents were people who used antibiotics without a doctor's prescription. The survey was conducted in Yogyakarta in September-October 2018. The data were analyzed descriptively and used multivariate logistic regression. As many as 44.2% of the total 670 respondents used antibiotics the last time more than a year ago; 69.5% received information about antibiotics from previous treatments; 93.4% received antibiotics from pharmacies, and 69.2% stated that the most used antibiotic was amoxicillin. More than half (62.2%) of respondents were still willing to become customers at a pharmacy that had refused to provide antibiotics without a prescription. Respondents with high school education or lower as the latest education degree (OR = 1.513; 95% CI 1.017-2.252); from family income below the regional minimum wage (OR = 1.858; 95% CI 1.302-2.651), and from Sleman Regency (OR = 1.457; 95% CI 1.016-2.089) became a predictor of the unwillingness of respondents to become customers at a pharmacy who had refused to provide antibiotics without a prescription. Supervision of antibiotic (especially amoxicillin) in pharmacies and education to the community needs to be used as part of a strategy against irrational use of antibiotics. In addition, education needs to be given to pharmacists to reduce fears of decreased in the number of their customers because they refuse to deliver antibiotics without a prescription.

scholarly journals Study on knowledge, attitude and practices with respect to antibiotic use among medical students

2019 ◽  
Vol 8 (7) ◽  
pp. 1628
Author(s):  
Bhavika D. ◽  
A. Naga Teja Pavani ◽  
G. Meghavani ◽  
Aditya Jillella ◽  
Sameer Uz Zaman
Keyword(s):  
Antibiotic Resistance ◽  
Medical Students ◽  
Antibiotic Use ◽  
Educational Strategies ◽  
Key Factors ◽  
Cross Sectional ◽  
Response Options ◽  
Rational Use ◽  
Global Problem ◽  
Rational Use Of Antibiotics

Background: Antibiotic resistance has emerged as a serious global problem. Irrational prescribing of antibiotics is one of the key factors responsible for the development of antibiotic resistance. As today’s medical students will be the future prescribers their awareness regarding antibiotic resistance and rational prescribing of antibiotics is very much important. The main objective of the study was to evaluate the knowledge, attitude and practices of the medical students towards antibiotic use.Methods: A cross-sectional questionnaire-based study was conducted involving the medical students from all the semesters. A predesigned questionnaire was used to evaluate the knowledge, attitude and practices of the respondents. The response options were ‘yes’ or ‘no’ for some questions, and a 5 point Likert scale used to assess some questions. The data was analyzed using MS office Excel.Results: A total of 457 fully completed questionnaires from the respondents were evaluated. Majority of the respondents (70%) were females, and 91% of the respondents were aware of antibiotic resistance as a global problem. On analysis of score of questions assessing knowledge, 91% of respondents had attained a score in the range of 5-7. Majority (83%) of the respondents used antibiotics only on doctor’s prescription and 74% of the respondents had completed the prescribed course.Conclusions: The present study gives an insight on the knowledge, attitude and practices of medical students on antibiotic use, and can be used as a tool to plan educational strategies to improve the knowledge of the students regarding rational use of antibiotics.

scholarly journals Antibiotic resistance and usage, a survey on the knowledge, attitude and practices among the medical students of a southern Indian teaching hospitals

2019 ◽  
Vol 8 (5) ◽  
pp. 1083
Author(s):  
Swathi Ratnam Regidi ◽  
Billa S. B. Mallika
Keyword(s):  
Antibiotic Resistance ◽  
Medical Students ◽  
Teaching Hospital ◽  
Antibiotic Use ◽  
Educational Interventions ◽  
Teaching Hospitals ◽  
Public Health Issue ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test

Background: Examining the knowledge, attitude and practices (KAP) of the medical students regarding antibiotic resistance (ABR) and use can help us in devising suitable educational interventions for them, tailored according to their earlier held knowledge, beliefs, capabilities and experience.Methods: A cross sectional, questionnaire based survey was conducted among medical students of a teaching hospital, whereby their KAP regarding antibiotic use and resistance was assessed by using a questionnaire, whose responses ranged from ‘agree’ to ‘disagree,’ ‘always to never’ and true / false. The data was analysed by using simple descriptive statistics. Wherever it was relevant, the Chi-square test was used to determine any significant difference.Results: The number of medical students who agreed that ABR was an important and a serious public health issue in this teaching hospital was 76 percent (n = 325). But, only 54.3% (n = 233) of the students were aware that bacteria were not responsible for causing cold and flu, while the remaining 37.2 percent (n = 22) were not knowledgeable about this fact. More than 80% rated the adverse effect profile of the antibiotic and the risk of a super infection as the important factors which deserved consideration. Cost of the antibiotic was considered to be an important factor deserving consideration by only 65.5% (n=277) of the participants.Conclusions: Our survey revealed that most of the students were aware of the antimicrobial resistance and its consequences. The only concern was their casual attitude regarding the antibiotic use. Further educational interventions are necessary to improve their understanding and perceptions on antibiotic resistance, as well as their attitude towards antibiotic use.

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