EVALUATING COMMUNITY KNOWLEDGE AND ATTITUDES TOWARDS ANTIBIOTIC USE AND RESISTANCE: A CROSS-SECTIONAL ANALYSIS -A GROWING PUBLIC HEALTH ISSUE
Main Article Content
Keywords
knowledge, antibiotic resistance, misconception, convenience sampling, attitude.
Abstract
Background
In Pakistan, there is a lack of regulations governing prescription of drug sales. As a result, pharmacies can sell most medications, including antibiotics without a prescription. This lack of regulation places a significant burden on the public to educate themselves about antibiotic use. Objective: This study investigated public knowledge, attitudes regarding antibiotic use and resistance in Karachi. Methodology: The study was conducted in Dow university hospital from 15 May - 15 July 2024, using a questionnaire and convenience sampling. Participants included 250 individuals aged 21-60 from public institutions in Karachi. Respondents provided demographic data, knowledge and attitudes toward antibiotic use and resistance. Results: The study revealed alarming trends in antibiotic use among respondents. A staggering 91% had used antibiotics at least once and 55% mistakenly believed that antibiotics can speed up recovery from common colds. Furthermore, 55% reported receiving antibiotics without consulting a doctor and 62% admitted to purchasing antibiotics without a prescription. The study also exposed a significant knowledge gap, as respondents demonstrated confusion between bacteria and viruses. While 52% correctly recognized the effectiveness of antibiotics against bacteria, a concerning 55% believed antibiotics can combat viruses. Despite these misconceptions, trust in doctors remained high, with 80% of respondents expressing confidence in medical professionals. Analysis revealed that increased knowledge correlated with lower likelihood of purchasing antibiotics without medical consultation. Conclusion: This study highlighted significant misconceptions and knowledge gaps regarding antibiotic use and resistance. Despite high trust in medical personnel, a substantial proportion of respondents used antibiotics without prescription or consultation. These findings emphasize the need for targeted educational campaigns and policy interventions to address antibiotic resistance
References
2. McGowan JE, Jr. Antimicrobial resistance in hospital organisms and its relation to antibiotic use. Rev Infect Dis 1983;5:1033–48.
3. Canton R, Loza E, Morosini MI, Baquero F. Antimicrobial resistance amongst isolates of Streptococcus pyogenes and Staphylococcus aureus in the PROTEKT antimicrobial surveillance programme during 1999-2000. J Antimicrob Chemother 2002;50 Suppl S1:9–24. 30.
4. Harbarth S, Albrich W, Brun-Buisson C. Outpatient antibiotic use and prevalence of antibiotic-resistant pneumococci in France and Germany: a sociocultural perspective. Emerg Infect Dis 2002;8:1460–7.
5. Harbarth S, Harris AD, Carmeli Y, Samore MH. Parallel analysis of individual and aggregated data on antibiotic exposure and resistance in gram-negative bacilli. Clin Infect Dis. 2001;33:1462–8.
6. Seppälä H, Klaukka T, Vuopio-Varkila J, Muotiala A, Helenius H, Lager K, The effect of changes in the consumption of macrolide antibiotics on erythromycin resistance in group A streptococci in Finland. N Engl J Med. 1997;337:4416
7. Harbarth S, Albrich W, Goldmann DA, Huebner J. Control of multiply resistant cocci: do international comparisons help? Lancet Infect Dis. 2001;1:251–61.
8. Pihlajamaki M, Kotilainen P, Kaurila T, Klaukka T, Palva E, Huovinen P. Macrolide-resistant Streptococcus pneumoniae and use of antimicrobial agents. Clin Infect Dis. 2001;33:483–8.
9. Bronzwaer SL, Cars O, Buchholz U, Molstad S, Goettsch W, Veldhuijzen IK, A European study on the relationship between antimicrobial use and antimicrobial resistance. Emerg Infect Dis. 2002;8:278–82.
10. Andre´ M, Vernby Å, Berg J, Lundborg CS. A survey of public knowledge and awareness related to antibiotic use and resistance in Sweden. J Antimicrob Chemother. 2010;65(6):1292–6
11. Sun KS, Seongmi M, Jung KE. Public knowledge and attitudes regarding antibiotic use in South Korea. J Korean Acad Nurs. 2011;41(6):742–9.
12. Oh Ling A, A/Hassali M, Al-Haddad MS, Sulaiman SAS, Shafie AA, Awaisu A. Public knowledge and attitudes towards antibiotic usage: a cross-sectional study among the general public in the state of Penang, Malaysia. J Infect Dev Ctries. 2011;5(5):338–47.
13. Wilson AA, Crane LA, Barrett PH Jr, Gonzales R. Public beliefs and use of antibiotics for acute respiratory illness. J Gen Intern Med. 1999;14(11):658–62.
14. Curry M, Sung L, Arroll B, Goodyear-Smith F, Kerse N, Norris P. Public views and use of antibiotics for the common cold before and after an education campaign in New Zealand. N Z Med J. 2006;119:U1957.
15. Cals JW, Boumans D, Lardinois RJ, Gonzales R, Hopstaken RM, Butler CC, Dinant GJ. Public beliefs on antibiotics and respiratory tract infections: an internet-based questionnaire study. Br J Gen Pract. 2007;57:9427.
16. Viberg N, Kalala W, Mujinja P, Tomson G, Lundborg CS. Practical knowledge and perceptions of antibiotics and antibiotic resistance among drugsellers in Tanzanian private drugstores. BMC Infect Dis. 2010;16(10):270.
17. WHO/CDS/CSR/DRS. WHO global strategy for containment of antimicrobial resistance 2001.
18. Costelloe C, Metcalfe C, Lovering A, Mant AD. Hay effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ. 2010;18(340):c2096.
19. Muller A, Coenen S, Goossens H, Monnet DL, ESAC Project Group. European surveillance of antimicrobial consumption (ESAC): outpatient antibiotic use in Europe 1998–2005. Euro Surveill. 2007;12(10):E071011.1.
20. Botica MV, Botica I, Stamenić V, Andrasević AT, Kern J, Spehar SS. Antibiotic prescription rate for upper respiratory tract infections and risks for unnecessary prescription in Croatia. Coll Antropol. 2013;37(2):449–54.
21. Wong DM, Blumberg DA, Lowe LG. Guidelines for the use of antibiotics in acute upper respiratory tract infections. Am Fam Physician. 2006;74(6):956–66.
22. Versporten A, Bolokhovets G, Ghazaryan L, Abilova V, Pyshnik G, Spasojevic T, Korinteli I, Raka L, Kambaralieva B, Cizmovic L, Carp A, Radonjic V, Maqsudova N, Celik HD, Payerl-Pal M, Pedersen HB, Sautenkova N, Goossens H, WHO/Europe-ESAC Project Group. Antibiotic use in Eastern Europe: a cross-national database study in coordination with the WHO Regional Office for Europe. Lancet Infect Dis. 2014;14(5):381–7.
23. Finch RG, Metlay JP, Davey PG, Baker LJ, International Forum On Antibiotic Resistance Colloquium. Educational interventions to improve antibiotic use in the community: report from the International Forum on Antibiotic Resistance (IFAR) colloquium, 2002. Lancet Infect Dis. 2004;4:44–53.
24. Ranji SR, Steinman MA, Shojania KG, Gonzales R. Interventions to reduce unnecessary antibiotic prescribing: a systematic review and quantitative analysis. Med Care. 2008;46:847–62.
25. Vanden Eng J, Marcus R, Hadler JL, Imhoff B, Vugia DJ, Cieslak PR, Zell E, Deneen V, McCombs KG, Zansky SM, Hawkins MA, Besser RE. Consumer attitudes and use of antibiotics. Emerg Infect Dis. 2003;9:1128–35.
26. Viberg N, Tomson G, Mujinja P, Lundborg CS. The role of the pharmacist-voices from nine African countries. Pharm World Sci. 2007;29(1):25–33.
27. Sedighi B, Ghaderi-Sohi S, Emami S. Evaluation of self-medication prevalence, diagnosis and prescription in migraine in Kerman, Iran. Saudi Med J. 2006;27(3):377–80.
28. McKinstry B, Ashcroft RE, Car J, Freeman GK, Sheikh A. Interventions for improving patients’ trust in doctors and groups of doctors. Cochrane Database Syst Rev. 2006;19(3):CD004134.
29. Rice lB. The Maxwell Finland Lecture: for the duration—rational antibiotic administration in an era of antimicrobial resistance and Clostridium difficile. Clin Infect Dis. 2008; 46:491–6.
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Sonia Khan
Associate Professor, Department of Pharmacology, Al-Tibri Medical College, Karachi, Pakistan
Abdul Latif Mahesar
Professor, Department of Pharmacology, Al-Tibri Medical College, Karachi, Pakistan
Asad Jiskani
Professor, Department of Community Medicine, Al-Tibri Medical College, Karachi, Pakistan
Shahid Kamran
Associate Professor, Department of Forensic Medicine, Al-Tibri Medical College, Karachi, Pakistan
Ghulam Farooq
District Health Officer (DHO), Sujawal, Pakistan
Ayaz Ahmed
Town Surveillance Coordinator, District Malir Karachi, Pakistan
Bilal Jatoi
Medical Officer, Government of Sindh Health Department, Dadu, Pakistan
Beenish Jamali
Female Medical Officer, Naka kharari, Health department, District Hub, Pakistan
Jaweria Soomro
Female Medical Officer, Experimental dispensary Junjhar colony, PPHI Sindh, Pakistan