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

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

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Risk Perceptions of Antibiotic Usage and Resistance: A Cross-Sectional Survey of Poultry Farmers in Kwara State, Nigeria

10.20944/preprints202006.0121.v1 ◽

2020 ◽

Author(s):

Al-Mustapha A. Ibrahim ◽

Victoria O. Adetunji ◽

Annamari Heikinheimo

Keyword(s):

Antibiotic Resistance ◽

Risk Perceptions ◽

Antibiotic Use ◽

Antibiotic Usage ◽

Flock Size ◽

Knowledge Level ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Increased Risk ◽

Poultry Farmers

There are overwhelming empirical evidences highlighting the contribution of indiscriminate antibiotic usage (ABU) in food animals to the overall burden of antibiotic resistance (ABR) in humans, thus making antibiotic use the main selective pressure driving antibiotic resistance. Social and behavioral perspective on antibiotic use and resistance in poultry is limited. Our study therefore aimed at obtaining information on antibiotic usage, awareness of ABR, and the attitude and perceptions towards prudent antibiotic usage and ABR. A cross-sectional survey using a structured questionnaire was conducted in 125 poultry farms in Kwara state in December 2019. Most farmers (69.6%, n=87/125) were aware of ABR and had satisfactory knowledge about ABR with a mean knowledge score of 3.16±1.47. The age, gender, level of education of farmers, and their flock size were significantly associated with a satisfactory knowledge of ABR (p<0.05). Tertiary education was significantly associated with ABR awareness (OR: 4.7; 95% CI: 0.0690, 0.654; p=0.007) and the ABR knowledge level (OR: 7.8269; 95% CI: 3.2693, 18.7381; p < 0.01). Higher flock size was significantly associated with a satisfactory knowledge of ABR (OR: 9.4551; 95%CI: 3.7928, 23.5707; p<0.01). Most of the poultry farmers (68%) had positive attitudes towards prudent antibiotic use with a mean score of 2.75±0.89. On the contrary, only 32.8% of poultry farmers had a good perception of ABR with a mean perception score of 4.95±1.12. The ABR knowledge level was significantly associated with the perceptions of farmers (p<0.05) but not their attitudes toward ABU and ABR (P=0.083). There was evidence of unprescribed use of antibiotics in poultry and a failure to observe antibiotic withdrawal periods. These constitute a risk of exposure to unacceptable levels of drug residues from poultry products and an increased risk of ABR. Improving education and communication on antibiotic stewardship programs are crucial to prevent the looming antibiotic apocalypse.

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Risk Perceptions of Antibiotic Usage and Resistance: A Cross-Sectional Survey of Poultry Farmers in Kwara State, Nigeria

Antibiotics ◽

10.3390/antibiotics9070378 ◽

2020 ◽

Vol 9 (7) ◽

pp. 378 ◽

Cited By ~ 1

Author(s):

Ahmad I. Al-Mustapha ◽

Victoria O. Adetunji ◽

Annamari Heikinheimo

Keyword(s):

Antibiotic Resistance ◽

Risk Perceptions ◽

Antibiotic Use ◽

Antibiotic Usage ◽

Flock Size ◽

Knowledge Level ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Increased Risk ◽

Poultry Farmers

Overwhelming empirical evidence has highlighted the contribution of indiscriminate antibiotic usage (ABU) in food animals to the overall burden of antibiotic resistance (ABR) in humans, thus making antibiotic use the main selective pressure driving antibiotic resistance. The social and behavioral perspective on antibiotic use and resistance in poultry is limited. Our study therefore aimed at obtaining information on antibiotic usage, awareness of ABR, and the attitude and perceptions towards prudent antibiotic usage and ABR. A cross-sectional survey using a structured questionnaire was conducted in 125 poultry farms in Kwara state in December 2019. Most farmers (69.6%, n = 87/125) were aware of ABR and had satisfactory knowledge about ABR with a mean knowledge score of 3.2 ± 1.5. Age (older farmers; OR: 1.1, 95% CI: 1.0, 1.2) and gender (male respondents, OR: 8.5, 95% CI: 3.0, 23.9; p < 0.01) were more likely to have satisfactory knowledge of ABR. Tertiary education was significantly associated with ABR awareness (OR: 4.7; 95% CI: 0.1, 0.7; p = 0.007) and the ABR knowledge level (OR: 7.8; 95% CI: 3.3, 18.7; p < 0.01). Higher flock size was significantly associated with a satisfactory knowledge of ABR (OR: 9.5; 95% CI: 3.8, 23.6; p < 0.01). Most of the poultry farmers (68%) had positive attitudes towards prudent antibiotic use with a mean score of 2.7 ± 0.9. On the contrary, only 32.8% of poultry farmers had a desirable perception of ABR with a mean perception score of 4.9 ± 1.1. The ABR knowledge level was significantly associated with the perceptions of farmers (p < 0.05) but not their attitudes toward ABU and ABR (p = 0.083). There was evidence of unprescribed use of antibiotics in poultry and a failure to observe antibiotic withdrawal periods. These constitute a risk of exposure to unacceptable levels of drug residues from poultry products and an increased risk of ABR. Improving education and communication on antibiotic stewardship programs are crucial to prevent the looming antibiotic threat.

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Parental self-medication with antibiotics for children promotes antibiotic over-prescribing in clinical settings in China

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-020-00811-9 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Jiayao Xu ◽

Xiaomin Wang ◽

Kai Sing Sun ◽

Leesa Lin ◽

Xudong Zhou

Keyword(s):

Antibiotic Use ◽

Antibiotic Prescribing ◽

Clinical Settings ◽

Cross Sectional Survey ◽

Self Medication ◽

Cross Sectional ◽

Prescribing Behavior ◽

The Past ◽

Outpatient Settings ◽

The Impact

Abstract Background Self-medication with antibiotics (SMA) is one of the most dangerous inappropriate antibiotic use behaviors. This study aims to investigate the impact of parental SMA for children before a consultation on their doctor’s subsequent antibiotic prescribing behavior, including intravenous (IV) antibiotic use in the clinical setting of China. Methods A cross-sectional survey was conducted between June 2017 and April 2018 in three provinces of China. A total of 9526 parents with children aged 0–13 years were investigated. Data from 1275 parents who had self-medicated their children and then visited a doctor in the past month were extracted and analyzed. Results One-third (410) of the studied children had parental SMA before the consultation and 83.9% of them were subsequently prescribed antibiotics by doctors. Children with parental SMA were more likely to be prescribed antibiotics (aOR = 7.79, 95% CI [5.74–10.58]), including IV antibiotics (aOR = 3.05, 95% CI [2.27–4.11]), and both oral and IV antibiotics (aOR = 3.42, 95% CI [2.42–4.84]), than children without parental SMA. Parents with SMA behaviors were more likely to request antibiotics (aOR = 4.05, 95% CI [2.59–6.31]) including IV antibiotics (aOR = 2.58, 95% CI [1.40–4.76]), and be fulfilled by doctors (aOR = 3.22, 95% CI [1.20–8.63]). Conclusions Tailored health education for parents is required in both community and clinical settings to discourage parental SMA for children. The doctors should not prescribe unnecessary antibiotics to reinforce parents’ SMA behaviors. We recommend expanding the current IV antibiotics ban in outpatient settings of China to cover outpatient pediatrics.

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Knowledge, Attitude and Practices of Clinicians, Nurses and Pharmacists Regarding Antimicrobial Stewardship: A Five Centre Survey from India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/47651.15203 ◽

2021 ◽

Author(s):

Akshata Mane ◽

Shweta Kamat ◽

Harish Thanusubramanian

Keyword(s):

Antimicrobial Stewardship ◽

Bacterial Infections ◽

Descriptive Analysis ◽

Healthcare Providers ◽

Antibiotic Use ◽

Antibiotic Usage ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Kap Survey ◽

Wide Range

Introduction: Increasing awareness and practice of Antimicrobial Stewardship (AMS) has gained immense importance in Indian hospitals for preventing the irrational use of antibiotics. India is one of the world’s largest consumers for antibiotics. Assessment of the local Knowledge, Attitude and Practices (KAP) of Antimicrobial Resistance (AMR) and AMS among Healthcare Providers (HCPs) will help in designing effective public health policies and engaging the community in campaigns against increasing microbial resistance. Aim: To understand the status of AMS programs and practices in five private sector multispecialty hospitals situated in the East, West, North and South zones of the country and to assess the KAP of HCPs regarding AMR and AMS. Materials and Methods: The cross-sectional survey was conducted to assess the implementation of AMS in five hospitals among clinicians, nurses and pharmacists across India using a predeveloped AMS checklist between June 2019 and October 2019. The analysis was done between July and August 2020. Responses were collected using a five-point Likert scale, with choices ranging from ‘strongly agree’ to ‘strongly disagree’.Descriptive analysis was done for the KAP survey to determine the percentages of participants under each response category. Results: Total 32 clinicians, 55 nurses and eight pharmacists responded to the KAP survey (100% response rate). The clinicians were aware that AMR is caused by irrational prescribing of antimicrobials (n=31, 96.87%) and improper diagnosis of infective conditions (n=27, 84.37%). However, knowledge of clinicians on infection control practices (n=6, 18.75% disagreed) in controlling AMR and practice of referring local epidemiology before prescribing antimicrobials (n=7, 21.87% did not follow routinely) could be improved. The knowledge and practice of nurses and pharmacists on antibiotic use were spread over a wide range. According to the nurses, AMR was mainly caused by using antimicrobials for non bacterial infections (n=30, 54.54%) and deviations from their standard duration (~63.64%-72.73%). As per pharmacists, the lack of restrictions on antimicrobial usage and widespread use or overuse of antibiotics were major contributors to AMR (n=3, 37.5% strongly agreed). Both nurses and pharmacists could benefit from reinforced training on antibiotic usage. Conclusion: Implementation of AMS was not adequate in private Indian hospitals. Although clinicians have good knowledge on antibiotic use, it was not equally reflected in their practice. The KAP data of nurses and pharmacists suggest that training and education on appropriate antibiotic usage should be emphasised. More efforts are required to improve AMS practices in hospitals.

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Antibiotic Use and Antibiotic Resistance: Public Awareness Survey in the Republic of Cyprus

Antibiotics ◽

10.3390/antibiotics9110759 ◽

2020 ◽

Vol 9 (11) ◽

pp. 759

Author(s):

Mikaela Michaelidou ◽

Spyridon A. Karageorgos ◽

Constantinos Tsioutis

Keyword(s):

Antibiotic Resistance ◽

Viral Infections ◽

Public Awareness ◽

Antibiotic Use ◽

World Health ◽

Resistant Bacteria ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Awareness Campaigns ◽

Local Evidence

We aimed to assess the knowledge and understanding of antibiotic use and resistance in the general population of Cyprus, in order to inform future antibiotic awareness campaigns with local evidence. Cross-sectional survey following the methodology of the “Antibiotic resistance: Multi-country public awareness survey” of the World Health Organization, during December 2019–January 2020. A total of 614 respondents participated: 64.3% were female and most were aged 35–44 years (33.2%) or 25–34 years (31.8%). One-third had used antibiotics >1 year ago and 91.6% reported receiving advice on appropriate use from a medical professional. Despite high awareness on correct use of antibiotics, lack of knowledge was noted for specific indications, where approximately one-third believed that viral infections respond to antibiotics and 70.7% lack understanding of how antibiotic resistance develops. Higher education graduates exhibited significantly higher knowledge rates. As high as 72.3% were informed about “antibiotic resistant bacteria” from healthcare professionals or social media. Most agreed on the usefulness of most suggested actions to address antibiotic resistance, with higher proportions acknowledging the role of prescribers. Up to 47% could not identify their role in decreasing antibiotic resistance. Our study provides local evidence to inform future efforts in a country characterized by high antibiotic consumption rates.

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Medicine Usage Behavior among Common People of Bangladesh: A Cross-Sectional Analysis

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2021/v42i1630522 ◽

2021 ◽

pp. 1-6

Author(s):

Md. Monirul Islam ◽

Md. Imran Nur Manik ◽

Abu Zobayed ◽

Fatema Tabassum ◽

Furhatun Noor

Keyword(s):

Dosage Regimen ◽

Cross Sectional Study ◽

Online Questionnaire ◽

Self Medication ◽

Common People ◽

Cross Sectional ◽

Educational Qualification ◽

Health Authorities ◽

The People ◽

Usage Behavior

Medication usage behavior of people is an important concern for health authorities worldwide. This study was aimed to find the prevalence of self-medication, perception about drug storage, dosage regimen, side effects and missing doses of prescribed medications among people of Bangladesh. The study also aimed at the different factors that regulate the above-mentioned behavior of people from different regions of the country. This cross-sectional study was performed using an online questionnaire form that was distributed randomly among the people. A total of 1028 respondents took part in the survey. Different statistical operations were done on the responses and the results were presented were using tables and graphs. Among the participants, 31.52% often practiced self-medication and 26.94% did it rarely. There was a significant correlation between self-medication and educational qualification (p=0.023) and residence (p<0.001) variables. The tendency to not completing the dosage regimen is high in villages (44%) than urban (35%) and semi-urban (38%) areas. The rate of not recovering the missing doses is higher (40%) among the people with a low level of education than the educated people (27%). This study showed a significant correlation among medicines usage behavior and educational qualification and residential area of the participants. The policymakers should take steps to increase awareness about the safe use of medicines among common people of rural area.

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Awareness of antibiotic use and antibiotic resistance amongst dental students

Brazilian Dental Science ◽

10.14295/bds.2021.v24i3.2470 ◽

2021 ◽

Vol 24 (3) ◽

Author(s):

Khaloud Tariq ◽

Muhammad Hassan ◽

Mehreen Wajahat ◽

Nadia Muneer ◽

Eisha Imran

Keyword(s):

Public Health ◽

Antibiotic Resistance ◽

Antibiotic Use ◽

Dental Students ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Prescription Practices ◽

Validated Questionnaire ◽

Dental Practitioners ◽

Knowledge And Attitude

Objective: Antibiotic resistance is one of the most threatening public health problems of 20th century. Along with physicians, dental practitioners also routinely prescribe medications for oral and dental infections. However, previous studies have shown that dental surgeons often prescribe antibiotics where new evidence have suggested other treatment measures. Since students in their clinical year prescribe antibiotics under supervision, it is important to understand if they are aware of severity of antibiotic resistance and its impact. Hence, the study aimed to assess awareness of antibiotic use and resistance amongst dental students. Material and Methods: Cross-sectional survey was conducted amongst 3rd and 4th year dental students of 4 colleges of Pakistan. A validated questionnaire was adopted from WHO and PHE (Public Health England). It included true or false and Likert scale questions relating to knowledge and attitude of antibiotic use and antibiotic resistance. Results: Out of 396 responses, majority students were not aware of the terms superbugs (69.7%) and AMR (79%). 89.6% thought that humans can become resistant to antibiotics. 88.6% agreed that antibiotic resistance is a major threat. 61.4% thought they couldn’t do much to stop antibiotic resistance. 87.6% agreed that doctors should only prescribe antibiotics when needed. Conclusion: Overall dental students were aware of antibiotic use and importance of antibiotic resistance although their knowledge associated with antibiotic resistance was not satisfactory. It is vital that students must be taught about mechanism of antibiotic resistance and good prescription practices. Keywords Antibiotic resistance; Knowledge; Attitude; Dental students.

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Inappropriate habits of antibiotic use among medical specialists and students in Vilnius

Acta medica Lituanica ◽

10.6001/actamedica.v23i2.3330 ◽

2016 ◽

Vol 23 (2) ◽

pp. 135-141

Author(s):

Artūras Barkus ◽

Ingrida Lisauskienė

Keyword(s):

Medical Care ◽

Drug Prescription ◽

Medical Personnel ◽

Antibiotic Use ◽

Cross Sectional Survey ◽

Self Medication ◽

Cross Sectional ◽

Antibacterial Drugs ◽

Medical Specialists ◽

At Home

Introduction. The resistance to antibacterial drugs is an emerging worldwide problem. Numbers of inappropriate ways to use antibiotics contribute to this issue. Self-medication is one of them. This study seeks to find out how prevalent the self-medication with antibiotics, their storage at home and the inappropriate acquisition of antibacterial drugs are among medical specialists in Vilnius, Lithuania. Methods. A cross-sectional survey was conducted. To better identify the potential target groups, the respondents were classified according to their relation to medical care: physicians, other medical personnel, medical students and people, directly not related to medical care. Results. The overall actual self-medication with antibiotics rate was 4.0%. And, although the actual self-medication rate might seem rather low, the intended self-medication rate was 51.4%. Also, a prevalent antibacterial drugs storage at home (45.8%) with a wide variety of preparations was reported. Only 61.9% respondents received prescriptions for antibiotics from their treating physician. 7.6% used the non-prescribed medicines and 22.0% received a prescription from a physician, who was either their colleague or a familiar person. Conclusions. Inappropriate habits of antibiotic use are prevalent. While there were some differences between the research groups, most of them were not statistically significant. It means that measures should be taken targeting health care givers as well as the general population. Educational programs about the rational use of antibiotics may help reducing the improper habits of antibacterial drugs usage, including self-medication. Encouraging the electronic drug prescription may be beneficial while reducing the prevalent inappropriate acquisition of antibiotics.

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Antibiotic Self-Medication and Antibiotic Resistance: Multilevel Regression Analysis of Repeat Cross-Sectional Survey Data in Europe

REGION ◽

10.18335/region.v8i2.339 ◽

2021 ◽

Vol 8 (2) ◽

pp. 121-145

Author(s):

Alistair Anderson

Keyword(s):

Antibiotic Resistance ◽

Survey Data ◽

Antibiotic Stewardship ◽

Social Issues ◽

Antibiotic Consumption ◽

Cross Sectional Survey ◽

Self Medication ◽

Cross Sectional ◽

Individual Level ◽

The Relationship

Antibiotic resistance is a global public health issue with several anthropogenic drivers, including antibiotic consumption. Recent studies have highlighted that the relationship between antibiotic consumption and antibiotic resistance is contextualised by a variety of socioeconomic, cultural, and governance-related drivers of consumption behaviour and contagion that have been underexamined. A potential complication for research and policy is that measures of antibiotic consumption are often reliant on prescribing or sales data which may not easily take into account the dynamics of community consumption that include self-medication; for example, the preservation and use of leftover medication or the obtaining of antibiotics without a prescription. This study uses repeated cross-sectional survey data to fulfil two core aims: firstly, to examine the individual-level and national-contextual determinants of self-medication among antibiotic consumers in European countries, and secondly, to examine the relationship between self-medication behaviour and antibiotic resistance at the national level. This study is particularly novel in its application of a multilevel modelling specification that includes individual-level factors with both time-variant and persistent national characteristics to examine antibiotic consumption behaviours. The key findings of the study are that survey respondents in countries with persistently higher levels of inequality, burdens of out-of-pocket health expenditure, and corruption have an increased probability of self-medicating with antibiotics. The study also highlights that overall levels of antibiotic consumption and antibiotic self-medication do not correlate and are associated heterogeneously with changes in different pathogen/antibiotic pairs. In summary, the study emphasises that antibiotic stewardship and antibiotic resistance, whilst related by biological mechanisms, are also inherently social issues. Attempts to improve antibiotic stewardship and address the challenge of antibiotic resistance should also attend to structural challenges that underlie challenges to antibiotic stewardship in the community, such as the effects of inequality and reduced access to healthcare services.

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Knowledge of Antimicrobial Resistance among Veterinary Students and Their Personal Antibiotic Use Practices: A National Cross-Sectional Survey

Antibiotics ◽

10.3390/antibiotics8040243 ◽

2019 ◽

Vol 8 (4) ◽

pp. 243 ◽

Cited By ~ 6

Author(s):

Ismail A. Odetokun ◽

Uduak Akpabio ◽

Nma B. Alhaji ◽

Khalid T. Biobaku ◽

Nurudeen O. Oloso ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Antimicrobial Stewardship ◽

Antibiotic Use ◽

Antibiotic Usage ◽

Descriptive Statistics ◽

Antimicrobial Use ◽

Cross Sectional Survey ◽

Veterinary Students ◽

Cross Sectional ◽

Contributory Factors

The challenge of antimicrobial resistance (AMR) is grave in developing countries. Antimicrobials are misused yet stakeholders’ contribution to antimicrobial stewardship is low. Veterinary students are future prescribers and their knowledge could influence progress in combating AMR; hence, there is a need to assess their knowledge, attitude, and awareness of AMR. A multi-institutional questionnaire was administered to undergraduates in Nigerian veterinary schools. It comprised demographics, own personal antibiotic usage, and knowledge, attitude, and awareness of AMR in humans and animals. Descriptive statistics and logistic regression were used for analyses. Of the 426 respondents, 39.2% reported personal antimicrobial use in the previous six months. Over 60% received knowledge scores lower than average and >87% requested more education on clinical use and prescriptions pre-graduation, monitored dispensing of antimicrobials, conducting AMR research, and confirmed link among human, animal, and environmental health. Less than 25% of respondents were aware of antimicrobial stewardship and global efforts/organizations for AMR. Final year students have 9-fold and 14-fold more satisfactory knowledge on antimicrobials in humans and animals compared with other students, respectively (p = 0.001). Final year students also have more knowledge (13×) and awareness of contributory factors (3×) on AMR (p = 0.001) than other students. Unsatisfactory knowledge on AMR issues exists among veterinary students yet willingness to improve was observed. Identified knowledge, attitude, and gaps in AMR awareness should be targeted by veterinary schools in Nigeria.

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