Knowledge, Perceptions, and Attitudes Regarding Antibiotic Use for Lower Respiratory Tract Infections: Insights from Patients in Sri Lanka

Antibiotic resistance is an emerging global public health threat. One of the main drivers of this threat is the inappropriate use of antibiotics. In Sri Lanka, antibiotic consumption is increasing, but little is known locally about how patients perceive antibiotics. We conducted a qualitative study to gain a better understanding of the knowledge, perceptions, and attitudes of patients regarding antibiotics and antibiotic resistance. Semi-structured interviews involving 18 patients with lower respiratory tract infection (LRTI) admitted to a large, public tertiary care hospital in southern Sri Lanka were conducted. Interviews were analyzed to identify themes regarding the patients’ knowledge of LRTI etiology and treatment, perceptions and attitudes toward LRTI treatment, including antibiotics, and patient–physician communication. Most patients mentioned multiple care visits and the use of multiple pharmaceuticals prior to admission. Patients sought a quick resolution to their ailments and frequently visited several private physicians to obtain a satisfying answer. Self-medication was also common. Patients reused prescriptions for antibiotics, kept antibiotics for later use after prematurely stopping their course of treatment, and bought over-the-counter antibiotics. Patients’ knowledge of disease etiology and antibiotics was poor. Only a few patients were aware of antibiotic resistance. Despite the desire to receive more information regarding disease and treatment, patient–provider communication was limited and mainly confined to prescription instructions. This qualitative study performed in Sri Lanka suggests that inappropriate use of antibiotics is a multifactorial problem. To improve antibiotic use, a multifactorial approach that includes educating the public, increasing awareness among physicians, and implementing systems-level changes to restrict access to antibiotics is urgently needed.

Download Full-text

1637. Antibiotic Use in Lower Respiratory Tract Infections: Insights From Patient Interviews in Sri Lanka

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1501 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S597-S597

Author(s):

David T van Melle ◽

Guus H A ten Asbroek ◽

Sky Vanderburg ◽

Yohana W Abeysinghe ◽

Chathurangi Halloluwa ◽

...

Keyword(s):

Antibiotic Resistance ◽

Sri Lanka ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Antibiotic Use ◽

Lower Respiratory Tract Infections ◽

Self Medication ◽

Disease Etiology ◽

Inappropriate Use ◽

Tract Infections

Abstract Background Antibiotic resistance is an emerging global public health threat with inappropriate use of antibiotics as one of the major drivers. In Sri Lanka, antibiotic consumption is increasing, while little is known about how patients perceive antibiotics. We conducted a qualitative study to better understand patients’ knowledge, perceptions, and attitudes toward antibiotics. Methods Semi-structured interviews were conducted in the local language (Sinhala) and audio recorded for 18 patients with lower respiratory tract infections (LRTI) admitted to a large, public tertiary care hospital in southern Sri Lanka. Interviews were transcribed and then translated into English. Translated interviews were analyzed for themes regarding care-seeking behavior, patients’ knowledge of disease etiology and treatment of LRTI. Results Almost all patients mentioned multiple care visits and polypharmacy prior to admission. When seeking care, patients mainly focused on finding a quick cure, mostly by visiting several different private physicians. However, self-medication was also common. Patients reused prescriptions for antibiotics, kept antibiotics for later use after prematurely stopping their course of treatment and bought antibiotics over-the-counter. Patients’ knowledge of disease etiology and antibiotics was poor. Most patients described non-microbial causes such as exposure to dust and cold weather for their illness. Only a few patients were aware of antibiotic resistance. Despite the desire to receive more information regarding disease and treatment, transfer of information between patients and physicians was limited and mainly confined to prescription instructions. Conclusion This qualitative study in Sri Lanka suggests inappropriate use of antibiotics is a multifactorial problem. Patients’ poor knowledge of disease and treatment, poor information transfer between physicians and patients, high demand for medicines, overprescribing by physicians, and self-medication were found as possible obstructive factors to improve antibiotic usage. To improve antibiotic use, a multifaceted approach is needed with improvement of awareness by patients, public, and physicians regarding antibiotic use and antibiotic resistance. Disclosures All authors: No reported disclosures.

Download Full-text

Evaluation of Parental Knowledge, Attitudes and Practices Regarding Antibiotic Use in Acute Upper Respiratory Tract Infections in Children in a Tertiary Care Hospital in Turkey

10.21203/rs.3.rs-518954/v1 ◽

2021 ◽

Author(s):

Aslınur Albayrak ◽

Nazmi Mutlu Karakaş ◽

Bensu Karahalil

Keyword(s):

Antibiotic Resistance ◽

Respiratory Tract ◽

Respiratory Tract Infections ◽

Tertiary Care ◽

Antibiotic Use ◽

Upper Respiratory Tract Infections ◽

Care Hospital ◽

Upper Respiratory Tract ◽

Upper Respiratory ◽

Tract Infections

Abstract BackgroundUpper respiratory tract infections (URTIs) are common in children. Most URTIs have been shown to be of viral origin. Inappropriate use of antibiotics is one of the main causes of antibiotic resistance. The problem of unnecessary antibiotic use among children is a concern for antibiotic resistance in low- and middle-income developing countries.MethodsOur study is a cross-sectional survey study. It was carried out between 14 December 2020 and 1 April 2021 for parents over 18 years of age with a child under 18 years’ old who applied to the general pediatrics outpatient clinics of Gazi University Faculty of Medicine Hospital Department of Pediatrics.Results554 parents responded to the questionnaire. A total of 15.7% of parents stated to use antibiotics in any child with fever. 37% of parents believed that antibiotics could cure infections caused by viruses. 6.3% of parents declared that they put pressure on pediatricians to prescribe antibiotics. 85.6% of the parents stated that they never gave their children non-prescription antibiotics when they had a high fever. 80.9% of them declared that they never used past antibiotics in the presence of a new infection. Female gender, high level of education, high income level and low number of antibiotics used in the last 1 year were found to be statistically significant with the better knowledge level of the parents (p <0.05).ConclusionAccording to the results of our study of parents' lack of knowledge about antibiotics in Turkey, though generally it shows proper attitude and behavior. It shows that some of the restrictions imposed by the National Action Plan are partially working. However, it is still necessary to continue to inform parents, pediatricians and pharmacists about the use of antibiotics, and to be more sensitive about the prescribing of antibiotics, and if necessary, sanctions should be imposed by the state in order to prevent unnecessary antibiotic prescriptions.

Download Full-text

Evaluation of parental knowledge, attitudes and practices regarding antibiotic use in acute upper respiratory tract infections in children under 18 years of age: a cross-sectional study in Turkey

BMC Pediatrics ◽

10.1186/s12887-021-03020-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Aslınur Albayrak ◽

Nazmi Mutlu Karakaş ◽

Bensu Karahalil

Keyword(s):

Antibiotic Resistance ◽

Respiratory Tract ◽

Respiratory Tract Infections ◽

Antibiotic Use ◽

Upper Respiratory Tract Infections ◽

Care Hospital ◽

Upper Respiratory Tract ◽

Cross Sectional ◽

Upper Respiratory ◽

Tract Infections

Abstract Background Upper respiratory tract infections (URTIs) are common in children. Antibiotics still continue to be prescribed although most URTIs are of viral origin. This is inappropriate use and this unnecessary administration contributes or may cause antibiotic resistance. The problem of unnecessary antibiotic use among children is a concern for antibiotic resistance in low- and middle-income developing countries. This study aims to evaluate the knowledge and attitudes of parents of children with upper respiratory tract infections regarding antibiotic use and their antibiotic administration practices in a tertiary care hospital in Turkey. Methods Our study is a cross-sectional survey study. It was carried out between 14 December 2020 and 1 April 2021 for parents over 18 years of age with a child under 18 years’ old who applied to the general pediatrics outpatient clinics of Gazi University Faculty of Medicine Hospital Department of Pediatrics. Results Five hundred fifty-four parents responded to the questionnaire (93.2% rate of response). A total of 15.7% of parents stated to use antibiotics in any child with fever. 37% of parents believed that antibiotics could cure infections caused by viruses. 6.3% of parents declared that they put pressure on pediatricians to prescribe antibiotics. While 28% of the parents who thought that the use of inappropriate antibiotics would not change the effect and resistance of the treatment, 41% thought that new antibiotics could be developed continuously. 85.6% of the parents stated that they never gave their children non-prescription antibiotics when they had a high fever. 80.9% of them declared that they never used past antibiotics in the presence of a new infection. Conclusion According to the results of our study of parents’ lack of knowledge about antibiotics in Turkey, though generally it shows proper attitude and practices. It shows that some of the restrictions imposed by the National Action Plan are partially working. However, it is still necessary to continue to inform parents, pediatricians and pharmacists about the use of antibiotics, and to be more sensitive about the prescribing of antibiotics, and if necessary, sanctions should be imposed by the state in order to prevent unnecessary antibiotic prescriptions.

Download Full-text

A prospective study of prevalence of anti-microbial susceptibility of bacterial isolates in lower respiratory tract infections

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20212917 ◽

2021 ◽

Vol 10 (8) ◽

pp. 915

Author(s):

Ajaz Husaain ◽

Qursheed Sultana ◽

M. Abdur Rab Ansari

Keyword(s):

Antibiotic Resistance ◽

Respiratory Tract ◽

Antibiotic Susceptibility ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Tertiary Care ◽

Care Hospital ◽

Lower Respiratory Tract Infections ◽

Mortality And Morbidity ◽

Tract Infections

Background: Lower respiratory tract infections (LRTIs) is one of the most common causes of mortality and morbidity across all age groups. In recent years, antibiotic resistance is constantly increasing. Thus, there is a need to monitor the bacteriological profile of pathogenic organisms. The present study aims to identify bacterial pathogens and their antibiotic susceptibility pattern.Methods: A prospective, observational, single centered study was conducted at tertiary care hospital for a period of 1 year i.e. from March 2016 to March 2017. A total of 733 sputum samples were collected and analyzed in microbiology lab. The samples went subjected to microscopy testing, culture and antibiotic sensitivity using suitable bacteriological methods.Results: From 733 sputum samples, about 51.34% were males and 48.56% were females. Approximately 49.65% of total samples were growth positive. Klebsiella was found to be the predominant microorganism followed by Methicillin sensitive Staphylococcus aureus (MSSA) and streptococcus. The gram-negative bacteria showed highest sensitivity for piperacillin/tazobactam, imipenem and ciprofloxacin. The gram-positive bacteria were found to be more susceptible for vancomycin, teicoplanin and amikacin.Conclusions: LRTIs are contagious form of disease and can rapidly disseminate among community. The irrational use of antibiotics complicates the management due to the antibiotic resistance. Local trend of antibiotic susceptibility pattern should be known as it helps in increasing the appropriate use of the antibiotics, decreasing the mortality and morbidity and reduces the anti-microbial resistance.

Download Full-text