Search

Wenjie Qu,1,2,* Xinyu Wang,1,* Yufei Liu,3 Jinfeng Mao,2 Mengchi Liu,4 Yaqin Zhong,1,2 Bella Gao,5 Miaomiao Zhao,1 Yuexia Gao1,2 1Department of Health Management, School of Public Health, Nantong University, Nantong, People’s Republic of China; 2Institute for Health Development, Nantong University, Nantong, People’s Republic of China; 3Faculty of Health Sciences, University of Macau, Macau, People’s Republic of China; 4National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China; 5Ulink College of Suzhou Industrial Park, Suzhou, Jiangsu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Miaomiao Zhao; Yuexia Gao, Department of Health Management, School of Public Health, Nantong University, 9 Seyuan Road, Jiangsu, 226019, People’s Republic of China, Tel +86150 0450 1812 ; +86139 6296 8819, Email zhaomiaomiao@ntu.edu.cn; yxgao@ntu.edu.cnBackground: Self-medication with antibiotics (SMA) among children is a common practice in low-income and middle-income countries, which has accelerated antibacterial abuse.Objective: This study aimed to estimate the prevalence and associated factors of SMA among children in China, including parents’ knowledge, attitudes, and practices towards antibiotic use.Methods: A cross-sectional study based on a structured questionnaire survey of parents was conducted in Nantong between July and September 2020. A total of 1699 respondents participated. Information on participants’ demographic and family characteristics, knowledge, attitudes, and practices towards antibiotics use was collected. Hierarchical binary logistic regression was used to examine the predictors of SMA among children.Results: Among 1699 participants, 23.31% practiced SMA to their children in the past year. Cough (59.6%) was the most common symptom leading to self-medication and penicillins (85.4%) were the most commonly used drugs. Hierarchical regression indicated that parents with higher level of antibiotic knowledge scores (OR=1.163, 95% CI: 1.067– 1.268) and buying antibiotics without a prescription from pharmacy (OR=1.475, 95% CI: 1.097– 1.983) were more likely to practice SMA to their children both in urban and in rural areas. Storing antibiotics at home resulted in an increased likelihood of self-medication in urban areas but not in rural areas. In addition, there was also a higher probability of non-prescribed antibiotics in children without chronic diseases (OR=1.959, 95% CI:1.072– 3.578).Conclusion: The prevalence of SMA in children is high in China. Higher knowledge scores and practices of buying and storing non-prescribed antibiotics behaviors increased parents’ antibiotic self-medication in their children. Practical and effective education intervention for children’s rational use of antibiotics is urgently strengthened.Keywords: antibiotic, self-medication, children, China, antibiotic knowledge, attitude

Introduction: Inappropriately prescribed antibiotics accelerate the formation of antibiotic-resistant bacteria. This circumstance creates a problematic situation in terms of public health. This study aims to measure dentists' antibiotic/prophylaxis knowledge and awareness of antibiotic resistance in Turkey based on two case scenarios. Materials Methods: Dentists in Turkey are invited by open invitation posts on various social media applications for our twelve-question online survey. The scoring was shaped based on answers to measure antibiotic/prophylaxis knowledge. The collected data were statistically analyzed by SPSS Statistics 22. Results: 321 participants answered all questions included in the study. The statistical analyses showed a significant difference in the evaluations according to gender, title, graduation time, and workplace. Conclusion: Inappropriate antibiotic prescription by dentists is common in Turkey. Dentists should receive more undergraduate lessons, and taking reminder antibiotic courses at regular intervals after graduation can contribute to keeping their knowledge up to date.

Abstract Background Public health strategies to improve patient adherence to antibiotics rely mostly on raising awareness of the threat of antimicrobial resistance (AMR) and improving knowledge about antibiotics. We aimed to evaluate how adherence to antibiotics relates to knowledge and the threat perceptions proposed by the Protection Motivation Theory (PMT). Method A cross-sectional online survey was conducted in September-December 2020 with 1002 participants aged 21-70 years in Singapore. Two items, which were reverse coded, evaluated adherence to antibiotics: ‘how often do you obtain antibiotics that were left over from the previous prescription’ and ‘how often did you treat yourself with antibiotics in the past year’. Questions about the PMT-related constructs, and knowledge regarding antibiotics and AMR knowledge were also included. Hierarchical regression models were performed at a 5% significance level. Results Adherence to antibiotics was associated with knowledge level (β = 0.073, p

This study aimed to explore antibiotic knowledge, antibiotic resistance knowledge, and antibiotic use among adults in Bangkok, Thailand. This is a secondary analysis of cross-sectional data generated from a sample of 161 individuals living in Bangkok. Participants completed an online self-administered questionnaire developed by the World Health Organization. Descriptive analysis, the chi-square test, and multiple logistic regression analyses were performed. The sample comprised more females (56.5%) than males (42.2%). The majority of responders (67.7%) were between the ages of 18 and 40. More than half of the respondents mistakenly believed that antibiotics could treat colds and flu (54.7% and 47.2%, respectively). About 54.7% were aware that antibiotic resistance could harm them and their families. The chi-square test results showed that the levels of education were associated with antibiotic knowledge (p = 0.012), antibiotic resistance knowledge (p < 0.001), and antibiotic use (p = 0.023). Multiple logistic regressions showed that respondents with at least a bachelor's degree or higher had better knowledge of antibiotics. Respondents who worked in the profession had better knowledge of antibiotic resistance. Respondents with sufficient incomes were more likely to use antibiotics. Baseline data from the study will be useful in antibiotic stewardship and public health campaigns among Bangkok residents. [ABSTRACT FROM AUTHOR]

Copyright of Selcuk Dental Journal is the property of Selcuk Dental Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Public health strategies to improve patient adherence to antibiotics rely mostly on raising awareness of the threat of antimicrobial resistance (AMR) and improving knowledge about antibiotics. We aimed to evaluate how adherence to antibiotics relates to knowledge and the threat perceptions proposed by the Protection Motivation Theory (PMT). Method: A cross-sectional online survey was conducted in September-December 2020 with 1002 participants aged 21-70 years in Singapore. Two items, which were reverse coded, evaluated adherence to antibiotics: 'how often do you obtain antibiotics that were left over from the previous prescription' and 'how often did you treat yourself with antibiotics in the past year'. Questions about the PMT-related constructs, and knowledge regarding antibiotics and AMR knowledge were also included. Hierarchical regression models were performed at a 5% significance level. Results: Adherence to antibiotics was associated with knowledge level (β = 0.073, p < 0.05), education level (β = − 0.076, p < 0.01), and four of the five PMT constructs: "perceived response cost" (β = 0.61, p < 0.01), "perceived response efficacy of adherence to antibiotic" (β = 0.096, p < 0.01), "perceived susceptibility to AMR" (β = 0.097, p < 0.01), and "perceived severity of AMR" (β = − 0.069, p < 0.01). Knowledge about AMR, perceived self-efficacy in adhering to antibiotics, age, and sex were not associated with adherence. Conclusions: In Singapore, patient adherence to antibiotics appear to be driven by the perceived costs of visiting a doctor to obtain antibiotics, followed by perceptions of AMR as a threat and to a lesser extent, knowledge about antibiotics. Public health strategies to mitigate antibiotic misuse should consider these patient barriers to medical care. [ABSTRACT FROM AUTHOR]

Knowledge of antibiotics and awareness of microbial resistance are essential for appropriate antibiotic consumption. This study aimed to develop and validate a measure of antibiotic knowledge and consumption (AKCT) and to make it available in the Arabic language and context. The tool was developed and applied on individuals ≥ 18 years, with mastery of Arabic or English. Exploratory factor analysis using principal-component analysis tested the psychometric properties of the items. AKCT scores were compared with the Infectious Numeracy Test (INT) scores to establish convergent validity. Cronbach's α > 0.7 measured reliability. Three hundred-eighty-six participants completed the questionnaire, achieving a 95.3% response rate. Five components were retained after factor analysis: Side-effects and resistance, Access to antibiotics, Recovery after use, Antibiotics use indications, and Body response. Cronbach's α = 0.85. The mean ± SD of AKCT = 9.82 ± 3.85 (range = 7–20); lowest scores were related to "Side-effects and resistance" (2.32 ± 2.00, max = 7) and "Antibiotic use indications" (1.61 ± 1.29, max = 5). Scores on the AKCT and INT positively correlated. The AKCT is a valuable, valid, and reliable tool developed for measurement of antibiotic knowledge and consumption behaviors to identify specific areas needing improvements; hence, targeted interventions are devised. [ABSTRACT FROM AUTHOR]

Abstract Background Self-medication is one of the most common forms of inappropriate use of antibiotics. This study aimed to assess the prevalence of self-medication with antibiotics (SMA) in China and evaluate the related factors. Methods A cross-sectional survey was conducted in Wuhan, Hubei, China from July 1, 2019 to July 31, 2019. Participants were recruited in public places to answer a structured questionnaire. The information of participants’ social demographic characteristics, antibiotic knowledge and health beliefs were collected. Binary Logistics regression analysis was used to examine the associated factors of SMA. Results Of the 3206 participants, 10.32% reported SMA in the past 6 months. Participants who with middle or high perceived barriers to seek health care services showed a higher likelihood of SMA (P

This study aimed to explore antibiotic knowledge, antibiotic resistance knowledge, and antibiotic use among adults in Bangkok, Thailand. This is a secondary analysis of cross-sectional data generated from a sample of 161 individuals living in Bangkok. Participants completed an online self-administered questionnaire developed by the World Health Organization. Descriptive analysis, the chi-square test, and multiple logistic regression analyses were performed. The sample comprised more females (56.5%) than males (42.2%). The majority of responders (67.7%) were between the ages of 18 and 40. More than half of the respondents mistakenly believed that antibiotics could treat colds and flu (54.7% and 47.2%, respectively). About 54.7% were aware that antibiotic resistance could harm them and their families. The chi-square test results showed that the levels of education were associated with antibiotic knowledge (p = 0.012), antibiotic resistance knowledge (p < 0.001), and antibiotic use (p = 0.023). Multiple logistic regressions showed that respondents with at least a bachelor’s degree or higher had better knowledge of antibiotics. Respondents who worked in the profession had better knowledge of antibiotic resistance. Respondents with sufficient incomes were more likely to use antibiotics. Baseline data from the study will be useful in antibiotic stewardship and public health campaigns among Bangkok residents.

Self-medication is an important issue, especially in developing countries. Self-medication is the concept in which individuals use medicine to ease and manage their minor illnesses. The current survey was designed to conduct interviews at different universities based on the availability of the students from August 2021 to October 2021 in Hazara region of Khyber Pakhtunkhwa (KPK), Pakistan. Overall, 1250 questionnaires were distributed to students from various departments. Students of microbiology (n = 305, 24.4%) and agriculture 236 (n = 18.8%) were the most elevated members in this study, while other participants were from medical lab technology (n = 118, 9.4%), chemistry (n = 103, 8.2%), food science (n = 92, 7.3%), business administration (n = 83, 6.6%), sociology (n = 78, 6.2%), math/physics (n = 6, 14.8%), Pak study (n = 58, 4.6%), English (n = 47, 3.7%), and psychology (n = 19, 1.5%). Students working towards their Bachelor numbered (n = 913, 73.0%), Master (minor) numbered (n = 80, 6.4%), Master (major) numbered (n = 221, 17.6%), and Doctorate numbered (n = 36, 2.8%). The age group of participants was majorly 20–25 years (61.0%), while others belonged to the age groups 25–30 years (20.6%), 30–35 years (9.8%), and 35–40 years (8.4%). The mean and standard deviation of daily practices of self-medication were observed (M = 416.667, SD = 1,026,108.667) and p = 0.002. The mean and standard deviation of daily practices of antibiotic knowledge was (M = 431.5, SD = 1,615,917) and p = 0.002. Antimicrobial agents were leading over others with 631 (50.4%), followed by anti-inflammatory with 331 (26.4%), multivitamins with 142 (11.3%), gynecological purpose with 59 (4.7%), and analgesic with 72 (5.7%), while the lowest frequency rate was observed against herbal remedies with 15 (1.2%). The results of the current study concluded that students practiced self-medication for reasons such as convenience to obtain these medications from cheap sources and to avoid the fee of a physician. They searched for the medicine on social media platforms and purchased it blindly from the pharmacy without any prescription from a physician. [ABSTRACT FROM AUTHOR]

Knowledge of antibiotics and awareness of microbial resistance are essential for appropriate antibiotic consumption. This study aimed to develop and validate a measure of antibiotic knowledge and consumption (AKCT) and to make it available in the Arabic language and context. The tool was developed and applied on individuals ≥ 18 years, with mastery of Arabic or English. Exploratory factor analysis using principal-component analysis tested the psychometric properties of the items. AKCT scores were compared with the Infectious Numeracy Test (INT) scores to establish convergent validity. Cronbach’s α > 0.7 measured reliability. Three hundred-eighty-six participants completed the questionnaire, achieving a 95.3% response rate. Five components were retained after factor analysis: Side-effects and resistance, Access to antibiotics, Recovery after use, Antibiotics use indications, and Body response. Cronbach’s α = 0.85. The mean ± SD of AKCT = 9.82 ± 3.85 (range = 7–20); lowest scores were related to “Side-effects and resistance” (2.32 ± 2.00, max = 7) and “Antibiotic use indications” (1.61 ± 1.29, max = 5). Scores on the AKCT and INT positively correlated. The AKCT is a valuable, valid, and reliable tool developed for measurement of antibiotic knowledge and consumption behaviors to identify specific areas needing improvements; hence, targeted interventions are devised.

Abstract Background The increase of antimicrobial resistance, mainly due to increased antibiotic use, is worrying. Preliminary evidence suggests that antibiotic use differs across ethnic groups in the Netherlands, with higher use in people of non-Dutch origin. We aimed to determine whether appropriate knowledge and use of antibiotics differ by ethnicity and whether knowledge on antibiotics is associated with antibiotic use. Methods We performed a cross-sectional study analyzing baseline data (2011–2015) from a population-based cohort (HELIUS study), which were linked to data from a health insurance register. We included 21,617 HELIUS participants of South-Asian Surinamese, African-Surinamese, Turkish, Moroccan, Ghanaian, and Dutch origin. Fifteen thousand seven participants had available prescription data from the Achmea Health Data-base (AHD) in the year prior to their HELIUS study visit. Participants were asked five questions on antibiotic treatment during influenza-like illness, pneumonia, fever, sore throat and bronchitis, from which higher versus lower antibiotic knowledge level was determined. Number of antibiotic prescriptions in the year prior to the HELIUS study visit was used to determine antibiotic use. Results The percentage of individuals with a higher level of antibiotic knowledge was lower among all ethnic minority groups (range 57 to 70%) compared to Dutch (80%). After correcting for baseline characteristics, including medical conditions, first-generation African Surinamese and Turkish migrants received a significantly lower number of antibiotic prescriptions compared to individuals of Dutch origin. Only second-generation Ghanaian participants received more prescriptions compared to Dutch participants (aIRR 2.09, 95%CI 1.06 to 4.12). Higher level of antibiotic knowledge was not significantly associated with the number of prescriptions (IRR 0.92, 95%CI 0.85 to 1.00). Conclusions Levels of antibiotic knowledge varied between ethnic groups, but a lower level of antibiotic knowledge did not correspond with a higher number of antibiotic prescriptions.

Background and Aim: The misuse and abuse of antibiotics by human and in animal production are leading to serious threats to global health. This study aimed to assess the dietary exposure of Lebanese consumers to antibiotic residues from the consumption of meat and compare it to that from medication intake. Materials and Methods: Beef samples (n=61) were collected and analyzed for penicillin residues using enzyme-linked immunosorbent assay and high-performance liquid chromatography. A cross-sectional study recruited 500 participants living in Mount Lebanon, using an interviewer-based questionnaire. The dietary exposure assessment was calculated following the tiered assessment approach. Results: The results showed that only 44% of the participants reported using antibiotic on doctor's prescription. Participants with good antibiotic knowledge (6-7/7) are significantly less likely to change antibiotic during treatment and would better use them as compared to those with lower knowledge (p=0.000). Those with lower education and monthly household income are more likely to improperly use antibiotics as compared to those with higher education and income. Penicillin -containing antibiotics were among the most used medications. On the other hand, the prevalence of penicillin residues in the meat samples was 21.3%, though none was above the maximum residue level. The dietary exposure to penicillin through meat consumption was equivalent to 88.3%, 31.9%, and 5.7% of the acceptable daily intake, using Tier 1, 2, and 3 approaches, respectively. Males, single, obese participants, and those with household income below 999,000 Lebanese pound were significantly more exposed to penicillin as compared to other participants due to their high meat consumption. Conclusion: These findings will provide insight into designing future targeted awareness interventions and adapted policies as efforts toward improving rational use and intake of antibiotics for preventing the development of antibiotic resistance.

Background: Self-medication is one of the most common forms of inappropriate use of antibiotics. This study aimed to assess the prevalence of self-medication with antibiotics (SMA) in China and evaluate the related factors. Methods: A cross-sectional survey was conducted in Wuhan, Hubei, China from July 1, 2019 to July 31, 2019. Participants were recruited in public places to answer a structured questionnaire. The information of participants' social demographic characteristics, antibiotic knowledge and health beliefs were collected. Binary Logistics regression analysis was used to examine the associated factors of SMA. Results: Of the 3206 participants, 10.32% reported SMA in the past 6 months. Participants who with middle or high perceived barriers to seek health care services showed a higher likelihood of SMA (P < 0.05). Participants who with middle or high perceived threats of self-medication, and who with middle or high self-efficacy to overcome obstacles showed a lower likelihood of SMA (P < 0.05). Conclusions: Compared with developed countries, the prevalence of SMA in China is still higher. Measures to conduct public health education and improve the accessibility of health services are crucial to decrease the overall self-medication rate in China. [ABSTRACT FROM AUTHOR]

Self-medication is an important issue, especially in developing countries. Self-medication is the concept in which individuals use medicine to ease and manage their minor illnesses. The current survey was designed to conduct interviews at different universities based on the availability of the students from August 2021 to October 2021 in Hazara region of Khyber Pakhtunkhwa (KPK), Pakistan. Overall, 1250 questionnaires were distributed to students from various departments. Students of microbiology (n = 305, 24.4%) and agriculture 236 (n = 18.8%) were the most elevated members in this study, while other participants were from medical lab technology (n = 118, 9.4%), chemistry (n = 103, 8.2%), food science (n = 92, 7.3%), business administration (n = 83, 6.6%), sociology (n = 78, 6.2%), math/physics (n = 6, 14.8%), Pak study (n = 58, 4.6%), English (n = 47, 3.7%), and psychology (n = 19, 1.5%). Students working towards their Bachelor numbered (n = 913, 73.0%), Master (minor) numbered (n = 80, 6.4%), Master (major) numbered (n = 221, 17.6%), and Doctorate numbered (n = 36, 2.8%). The age group of participants was majorly 20–25 years (61.0%), while others belonged to the age groups 25–30 years (20.6%), 30–35 years (9.8%), and 35–40 years (8.4%). The mean and standard deviation of daily practices of self-medication were observed (M = 416.667, SD = 1,026,108.667) and p = 0.002. The mean and standard deviation of daily practices of antibiotic knowledge was (M = 431.5, SD = 1,615,917) and p = 0.002. Antimicrobial agents were leading over others with 631 (50.4%), followed by anti-inflammatory with 331 (26.4%), multivitamins with 142 (11.3%), gynecological purpose with 59 (4.7%), and analgesic with 72 (5.7%), while the lowest frequency rate was observed against herbal remedies with 15 (1.2%). The results of the current study concluded that students practiced self-medication for reasons such as convenience to obtain these medications from cheap sources and to avoid the fee of a physician. They searched for the medicine on social media platforms and purchased it blindly from the pharmacy without any prescription from a physician.

Abstract Background Antibiotic resistance is a global health threat. Public knowledge is considered a prerequisite for appropriate use of antibiotics and limited spread of antibiotic resistance. Our aim was to examine the level of knowledge of antibiotics and antibiotic resistance among Norwegian pharmacy customers, and to assess to which degree beliefs, attitudes and sociodemographic factors are associated with this knowledge. Methods A questionnaire based, cross-sectional study was conducted among pharmacy customers in three Norwegian cities. The questionnaire covered 1) knowledge of antibiotics (13 statements) and antibiotic resistance (10 statements), 2) the general beliefs about medicines questionnaire (BMQ general) (three subdomains, four statements each), 3) attitudes toward antibiotic use (four statements), and 4) sociodemographic factors, life style and health. High knowledge level was defined as > 66% of maximum score. Factors associated with knowledge of antibiotics and antibiotic resistance were investigated through univariate and multiple linear regression. Hierarchical model regression was used to estimate a population average knowledge score weighted for age, gender and level of education. Results Among 877 participants, 57% had high knowledge of antibiotics in general and 71% had high knowledge of antibiotic resistance. More than 90% knew that bacteria can become resistant against antibiotics and that unnecessary use of antibiotics can make them less effective. Simultaneously, more than 30% erroneously stated that antibiotics are effective against viruses, colds or influenza. Factors positively associated with antibiotic knowledge were health professional background, high education level, and a positive view on the value of medications in general. Male gender, a less restrictive attitude toward antibiotic use, and young age were negatively associated with antibiotic knowledge. The mean overall antibiotic knowledge score was relatively high (15.6 out of maximum 23 with estimated weighted population score at 14.8). Conclusions Despite a high level of knowledge of antibiotics and antibiotic resistance among Norwegian pharmacy customers, there are obvious knowledge gaps. We suggest that action is taken to increase the knowledge level, and particularly target people in vocational, male dominated occupations outside the health service, and primary/secondary school curricula.

Background: Recent studies shows lack of knowledge concerning health literacy relatively microorganism/disease and the correct use of antibiotics. These facts lead to the spreading of resistant strains bacteria. Aims: The overarching goals of this study were a) to promote health literacy predominantly in respect to microorganism/disease, diseases transmission, antibiotic target and adequate antibiotic use; b) to show the importance of the transmission of health information in different environments; c) to motivate students for science research. Methods: Students' knowledge was evaluated with a survey instrument. Responses were analyzed before and after the implementation of the activity. The activity consists of an interactive lecture, slide show presentation and some practical activities. The sample includes 25 Portuguese students, 13–17 years old who attended the activity in Palácio de Cristal (Porto) and 66 students from D. Maria II School, V.N. Famalicão. Results: In this study, significant increase in knowledge about all the topics evaluated were observed both in formal and informal environments between the pre and post-test; however the best results were detected in informal contexts. Conclusion: The findings showed the importance of the implementation of scientific activities to middle-school students. This experience was valuable and helped to improve student knowledge on heath topics. [ABSTRACT FROM AUTHOR]

Background: Antimicrobials are drugs that were once lifesavers and mainly curative. Nowadays their value is increasingly under pressure because of the rapid and worldwide emergence of antimicrobial resistance, which, in low-resource settings, frequently occurs in microorganisms that are likely to be transmitted in the community. Methods: This was a cross-sectional pilot study including 102 households within the 10th Health and Demographic Surveillance System round in Dande, Bengo Province, Angola. Results: Of the total 102 households piloted, 79 (77.45%) were urban. Fifty-seven respondents were female (56.44%), and the mean age of the respondents was 39.70 ± 15.35 years. Overall, storage of antimicrobials was found in 55/102 households (53.92%). More than 66% of the antimicrobials stored were prescribed by a health professional and the majority of antimicrobials were bought at pharmacies or at a street market. Penicillin and its derivatives, antimalarial drugs, and metronidazole were the antimicrobials most frequently stored. Households with female respondents reported storing any drugs at home more frequently (82.50%; p = 0.002) and also storing antimicrobials more frequently (64.91%; p = 0.016) as compared to households with male respondents. Reported use of antimicrobials was significantly higher in urban households (60.76%, 48/79) as compared to rural households (30.43%, 7/23) (p = 0.010). Overall, 74 of 101 respondents (73.26%) reported having already heard about antibiotics. The common reasons given for their use were cough and other respiratory symptoms, wounds, flu and body muscle pain, fever, bladder complaints, and diarrhoea and/or presumed typhoid fever. Nearly 40% (28/74) of the respondents thought that antibiotics should be stopped as soon as the person does not feel sick anymore. Conclusions: Community interventions for appropriate use of antibiotics should be designed with a special focus on women. This should be done through public awareness campaigns and improving access to reliable medical services. Drug prescribers are key not only to appropriate antimicrobial prescription, but also to adequate dispensing, and are strong advocates for the possible misconceptions on antimicrobial usage by lay people.

Background The inappropriate use of antimicrobials is a problem worldwide. To target future interventions, a thorough understanding of the reasons behind this current behaviour is needed. Within the EU, the culture of antimicrobial use has been intensely studied, but this is not the case in non-EU southeastern European countries, despite the frequent use of (broad-spectrum) antibiotics (ABs) in this region. The aim of this study was to explore AB knowledge, attitudes and behaviours of health care professionals (HCPs) and patients in one southeastern European country, Albania. Methods In total, 16 semi-structured interviews were carried out with four groups of interviewees: physicians, community pharmacists, and patients with and without AB prescriptions. Interviews were used to investigate participants’ recent practices with four specific antibiotics for upper respiratory tract infections, along with their typical behaviours, knowledge and attitudes towards the use of antimicrobials. A directed content analysis was applied. Results The patients showed little awareness of the differences between viruses and bacteria; however, they often self-diagnosed, which led them to request ABs from pharmacies without a prescription. Pharmacists felt pressured to give in to patients’ demands. All of the participants (including HCP) showed suboptimal beliefs about illness severity as they all believed that ‘flu complications’, i.e. flu/cold symptoms that persisted after 2–3 days, should be treated with ABs. Physicians usually had no rapid tests to guide them in their practice; however, they were not concerned about this fact. HCPs acknowledged AMR, but only a few of them seemed to consider its risk in their daily practice. Conclusions Patients had high levels of trust in and desire for ABs, and HCPs did not often negotiate with patients’ demands. Suggested initiatives to improve the prudent use of ABs in Albania include higher reimbursement for prescribed antibiotics (to reduce illegal sales), academic detailing as well as implementing public awareness campaigns.

Introduction: Knowledge and attitudes towards proper antibiotic usage among students in medical and other health allied fields play a vital role in limiting the pandemic of antibiotic resistance. This study aimed to assess knowledge and attitudes toward antibiotic usage among pre-professional students at King Saud bin Abdulaziz University for Health Sciences on Jeddah Campus, Saudi Arabia. Methods: A self-administered cross-sectional survey of 347 first year students was conducted at the College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences using a validated questionnaire. Results: Nearly 63% of the students had a moderate level of knowledge. Two third of the students (69.7%) correctly knew that antibiotics are indicated for the treatment of bacterial infections. However, about 36% of the students incorrectly thought that antibiotics are also used to treat viral infections, while 28.5% were not sure. Only 38.8% of the students were aware of antibiotic resistance phenomena in relation to the overuse of antibiotics. Furthermore, only 27.3% correctly knew that penicillin is an antibiotic, and 74.4% were not sure if Paracetamol is an antibiotic. With regard to attitudes, 25.7% believed that taking antibiotics when having cold symptoms could help them to recover faster, while 39.6% expected antibiotics to be prescribed for common cold symptoms. Conclusion: The students have misconception regarding antibiotic use indications. Therefore, awareness campaigns are needed to promote student’s use of antibiotics in young generations particularly among the pre-professional health sciences students.

Objective Antibiotic misuse contributes to antibiotic-resistant bacterial infections. Patient and prescriber knowledge and behaviors influence antibiotic use. Past research has focused on describing and influencing prescriber behavior with less attention to the patient role in antibiotic use. This study seeks to: (1) develop and deploy a program to enhance patient knowledge about antibiotic use; (2) evaluate whether providing patient education is associated with improvements in antibiotic knowledge in a community-based sample; and (3) explore whether health literacy may be associated with knowledge of appropriate antibiotic use. Method This study developed, deployed, and evaluated whether community-based educational seminars enhance patient knowledge about antibiotic use. Key findings Twenty-eight participants from five locations completed the seminar. The antibiotic knowledge index score significantly increased by 2.0 points on the 14 point knowledge index from 10.95 (±2.88) to 12.95 (±1.72) ( P = 0.0011) for the 19 participants completing both the pre and post-test. Conclusion A community-based educational seminar on appropriate antibiotic use can effectively increase patient understanding of their role in antibiotic stewardship and combat the inappropriate use of antibiotics. [ABSTRACT FROM AUTHOR]

Background: The inappropriate use of antimicrobials is a problem worldwide. To target future interventions, a thorough understanding of the reasons behind this current behaviour is needed. Within the EU, the culture of antimicrobial use has been intensely studied, but this is not the case in non-EU southeastern European countries, despite the frequent use of (broad-spectrum) antibiotics (ABs) in this region. The aim of this study was to explore AB knowledge, attitudes and behaviours of health care professionals (HCPs) and patients in one southeastern European country, Albania. Methods: In total, 16 semi-structured interviews were carried out with four groups of interviewees: physicians, community pharmacists, and patients with and without AB prescriptions. Interviews were used to investigate participants' recent practices with four specific antibiotics for upper respiratory tract infections, along with their typical behaviours, knowledge and attitudes towards the use of antimicrobials. A directed content analysis was applied. Results: The patients showed little awareness of the differences between viruses and bacteria; however, they often self-diagnosed, which led them to request ABs from pharmacies without a prescription. Pharmacists felt pressured to give in to patients' demands. All of the participants (including HCP) showed suboptimal beliefs about illness severity as they all believed that 'flu complications', i.e. flu/cold symptoms that persisted after 2-3 days, should be treated with ABs. Physicians usually had no rapid tests to guide them in their practice; however, they were not concerned about this fact. HCPs acknowledged AMR, but only a few of them seemed to consider its risk in their daily practice. Conclusions: Patients had high levels of trust in and desire for ABs, and HCPs did not often negotiate with patients' demands. Suggested initiatives to improve the prudent use of ABs in Albania include higher reimbursement for prescribed antibiotics (to reduce illegal sales), academic detailing as well as implementing public awareness campaigns. [ABSTRACT FROM AUTHOR]

Background Self-medication is identified by the World Health Organization as a major factor leading to antibiotics overuse, misuse and resistance. This study's objectives were to evaluate the knowledge and self-medication with antibiotics in a sample of the population of Lebanon. Methods This study surveyed a sample of adults (over 18 years of age) residing in 2 major cities in Lebanon about their knowledge and self-medication with antibiotics. Health care professionals were excluded from the study. Results Four hundred questionnaires were completed. Of the responders, 72% were between 18 and 45 years of age with an overall 86% having completed at least high school. For their knowledge about antibiotics, 61% thought that antibiotics should be taken for common cold and 83% knew that misuse of antibiotics could result in microbial resistance. Self-medication significantly correlated with a lower educational level ( P  = .036). Those with lower knowledge about antibiotics stopped antibiotics at the inappropriate time ( P  = .002). Socioeconomic status, gender and age did not correlate with self-medication. Conclusion Self-medication was associated with a person's educational level and knowledge of antibiotics. Awareness campaigns and enforcing medication dispensing laws are needed in to avoid self-medication with antibiotics. [ABSTRACT FROM AUTHOR]

Background Antibiotic overuse is a critical global health issue, and patient attitudes and expectations play a significant role in the inappropriate use of antibiotics. Limited research has been conducted on patient knowledge, attitudes, and perceptions of antibiotic use in Saudi Arabia. This survey aimed to assess patients' knowledge and attitudes related to antibiotic use in Jeddah, Saudi Arabia. Methods A cross-sectional survey using a convenience sampling method was conducted in Saudi Arabia. An online self-administered questionnaire was used to collect demographic data, antibiotic knowledge, and attitudes. Results The study included 400 patients, with a mean age of 39 years and an equal gender distribution (54% female). Most participants (75%) had not used antibiotics in the past year. Patients demonstrated moderate knowledge about antibiotics, with 81% recognizing that antibiotics can cause side effects and 69% knowing that overuse can lead to resistance. However, only 44% knew that antibiotics are not effective for all infections, and only half (50%) knew that antibiotics work against bacteria, not viruses. Patients held mixed attitudes toward antibiotic prescribing, with 25% believing it was essential to take antibiotics for every infection and 44% believing healthcare providers should prescribe antibiotics for respiratory tract infections. Logistic regression analyses showed that patient expectations for antibiotic prescribing were strongly associated with inappropriate antibiotic use. In contrast, patient satisfaction with antibiotic prescribing was negatively associated with inappropriate antibiotic use. Lower health literacy levels were also associated with inappropriate antibiotic use. Conclusion The study underscores the need for interventions that promote patient education and communication to ensure appropriate antibiotic use in primary care. Patient attitudes and beliefs, such as their expectations for antibiotic prescribing and health literacy levels, were identified as significant predictors of inappropriate antibiotic use., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Fallatah et al.)

Misconceptions about antibiotics among the public can potentially lead to their inappropriate use. Currently, there is no antibiotic knowledge assessment tool to address this issue. This study aimed to develop and validate an antibiotic knowledge scale (AKS) and apply this scale to assess public knowledge about antibiotics in China. An initial 18-item AKS was designed and validated among 1180 people recruited in June 2017. After removing redundant items, the reliability and validity of the AKS were examined. Subsequently, a nationwide survey was conducted, and 12,772 people were recruited using multistage sampling and surveyed using the developed AKS. A logistic regression model was used to identify the factors associated with poor knowledge about antibiotics. The final AKS included two screening items and fifteen knowledge evaluation items. Cronbach's alpha, test-retest reliability, and split-half reliability were 0.91, 0.88, and 0.89, respectively. These knowledge evaluation items were loaded in four distinct factors that explained 70.72% of cumulative variance among respondents. Using the developed AKS to assess public knowledge about antibiotics among 12,772 participants, the mean score on the AKS was 7.25 and 67% of participants had poor antibiotic knowledge, which was associated with male gender, rural residence, lower educational level, poor economic status, living in western China, and lacking education on antibiotics. The AKS demonstrated satisfactory reliability and validity in identifying the population with poor antibiotic knowledge. Importantly, the majority of participants had inadequate knowledge about antibiotics. Thus, it is necessary to conduct interventions focusing on improving public knowledge about antibiotics. [ABSTRACT FROM AUTHOR]

Introduction: Knowledge and attitudes towards proper antibiotic usage among students in medical and other health allied fields play a vital role in limiting the pandemic of antibiotic resistance. This study aimed to assess knowledge and attitudes toward antibiotic usage among pre-professional students at King Saud bin Abdulaziz University for Health Sciences on Jeddah Campus, Saudi Arabia. Methods: A self-administered cross-sectional survey of 347 first year students was conducted at the College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences using a validated questionnaire. Results: Nearly 63% of the students had a moderate level of knowledge. Two third of the students (69.7%) correctly knew that antibiotics are indicated for the treatment of bacterial infections. However, about 36% of the students incorrectly thought that antibiotics are also used to treat viral infections, while 28.5% were not sure. Only 38.8% of the students were aware of antibiotic resistance phenomena in relation to the overuse of antibiotics. Furthermore, only 27.3% correctly knew that penicillin is an antibiotic, and 74.4% were not sure if Paracetamol is an antibiotic. With regard to attitudes, 25.7% believed that taking antibiotics when having cold symptoms could help them to recover faster, while 39.6% expected antibiotics to be prescribed for common cold symptoms. Conclusion: The students have misconception regarding antibiotic use indications. Therefore, awareness campaigns are needed to promote student's use of antibiotics in young generations particularly among the pre-professional health sciences students. [ABSTRACT FROM AUTHOR]

Background: The increase of antimicrobial resistance, mainly due to increased antibiotic use, is worrying. Preliminary evidence suggests that antibiotic use differs across ethnic groups in the Netherlands, with higher use in people of non-Dutch origin. We aimed to determine whether appropriate knowledge and use of antibiotics differ by ethnicity and whether knowledge on antibiotics is associated with antibiotic use. Methods: We performed a cross-sectional study analyzing baseline data (2011–2015) from a population-based cohort (HELIUS study), which were linked to data from a health insurance register. We included 21,617 HELIUS participants of South-Asian Surinamese, African-Surinamese, Turkish, Moroccan, Ghanaian, and Dutch origin. Fifteen thousand seven participants had available prescription data from the Achmea Health Data-base (AHD) in the year prior to their HELIUS study visit. Participants were asked five questions on antibiotic treatment during influenza-like illness, pneumonia, fever, sore throat and bronchitis, from which higher versus lower antibiotic knowledge level was determined. Number of antibiotic prescriptions in the year prior to the HELIUS study visit was used to determine antibiotic use. Results: The percentage of individuals with a higher level of antibiotic knowledge was lower among all ethnic minority groups (range 57 to 70%) compared to Dutch (80%). After correcting for baseline characteristics, including medical conditions, first-generation African Surinamese and Turkish migrants received a significantly lower number of antibiotic prescriptions compared to individuals of Dutch origin. Only second-generation Ghanaian participants received more prescriptions compared to Dutch participants (aIRR 2.09, 95%CI 1.06 to 4.12). Higher level of antibiotic knowledge was not significantly associated with the number of prescriptions (IRR 0.92, 95%CI 0.85 to 1.00). Conclusions: Levels of antibiotic knowledge varied between ethnic groups, but a lower level of antibiotic knowledge did not correspond with a higher number of antibiotic prescriptions. [ABSTRACT FROM AUTHOR]

Background: Antibiotic resistance is a global health threat. Public knowledge is considered a prerequisite for appropriate use of antibiotics and limited spread of antibiotic resistance. Our aim was to examine the level of knowledge of antibiotics and antibiotic resistance among Norwegian pharmacy customers, and to assess to which degree beliefs, attitudes and sociodemographic factors are associated with this knowledge.Methods: A questionnaire based, cross-sectional study was conducted among pharmacy customers in three Norwegian cities. The questionnaire covered 1) knowledge of antibiotics (13 statements) and antibiotic resistance (10 statements), 2) the general beliefs about medicines questionnaire (BMQ general) (three subdomains, four statements each), 3) attitudes toward antibiotic use (four statements), and 4) sociodemographic factors, life style and health. High knowledge level was defined as > 66% of maximum score. Factors associated with knowledge of antibiotics and antibiotic resistance were investigated through univariate and multiple linear regression. Hierarchical model regression was used to estimate a population average knowledge score weighted for age, gender and level of education.Results: Among 877 participants, 57% had high knowledge of antibiotics in general and 71% had high knowledge of antibiotic resistance. More than 90% knew that bacteria can become resistant against antibiotics and that unnecessary use of antibiotics can make them less effective. Simultaneously, more than 30% erroneously stated that antibiotics are effective against viruses, colds or influenza. Factors positively associated with antibiotic knowledge were health professional background, high education level, and a positive view on the value of medications in general. Male gender, a less restrictive attitude toward antibiotic use, and young age were negatively associated with antibiotic knowledge. The mean overall antibiotic knowledge score was relatively high (15.6 out of maximum 23 with estimated weighted population score at 14.8).Conclusions: Despite a high level of knowledge of antibiotics and antibiotic resistance among Norwegian pharmacy customers, there are obvious knowledge gaps. We suggest that action is taken to increase the knowledge level, and particularly target people in vocational, male dominated occupations outside the health service, and primary/secondary school curricula. [ABSTRACT FROM AUTHOR]