English

BackgroundStudies assessing consumers’ knowledge of the rational use of antibiotics are essential to understand the knowledge gap before intervention strategies are instituted.ObjectivesTo assess the knowledge of rational use of antibiotics among consumers in Dar es Salaam, Tanzania.MethodsA cross-sectional study assessing knowledge of rational use of antibiotics among 960 consumers was conducted in Dar es salaam in March 2021. Participants were consecutively enrolled from outpatient pharmacies in selected public and private hospitals and marketplaces in Ilala Municipality. Data were collected using the WHO-validated questions on knowledge of consumers of antibiotic uses.ResultsOverall, 196 (20.4%) and 503 (52.4%) participants demonstrated good knowledge of rational antibiotic use and conditions that can be treated with antibiotics, respectively. However, 678 (70.6%) responded that they stopped using antibiotics after dose completion, 515 (53.6%) would request the same antibiotic if it had helped to treat a similar condition in the past and 406 (42.3%) are willing to use the same antibiotic if a friend or family member used the medication previously to treat similar signs and symptoms. Besides, the following conditions were mentioned as being treatable with antibiotics: influenza (50.7%), sore throat (61.4%) and urinary tract infection (60.5%).ConclusionsThe majority of the consumers had poor knowledge of the rational uses of antibiotics and a moderate proportion had good knowledge of the conditions that are treatable with antibiotics. Those with a high level of education and with health insurance had good knowledge of rational uses of antibiotics.

Antibiotics are considered to be among the most commonly sold drug classes in Palestine. Resistance to antibiotics has increased for reasons relating to the use and misuse of antibiotics. The aim of this study was to evaluate the knowledge, and attitudes regarding antibiotic use and awareness about resistance among adults visiting the emergency departments at hospitals in North Palestine. A self-administered cross-sectional questionnaire survey involving participants aged 18 or overwas conducted from June 2012 to February 2013. Adults who visited the emergency departments at hospitals in North Palestine were included. Demographic characteristics, knowledge and attitudes towards antibiotic use were included in the questionnaire. Poor and good knowledge were defined as a total knowledge score of 0-7 and 8-15 of 15 questions, respectively. Attitude scores of 0-3 and 4-7 of 7 questions were considered poor and good, respectively. A total of 375 questionnaires were included in the study. A response rate of 83.3% was attained. About 55.0% of the participants had a good knowledge and 56.5% had a good attitude towards rational antibiotic use. A significant positive correlation was shown between participants' knowledge scores and participants' attitude scores towards antibiotic use (R=0.344, P=0.001. Participants with a high family income were more likely to be aware of appropriate antibiotic use than participants with a low family income (P-value <0.001). Participants with a higher educational level (university) had a good attitude towards rational antibiotic use than those with a lower education level (P-value <0.001). This study has documented important knowledge and attitude gaps in antibiotic use. These findings will help health policymakers in Palestine to implement intervention programmes to rationalize antibiotic use. Continuing medical education, professional development and training workshops for healthcare professionals regarding rational use of antibiotics and health risks associated with the spread of antibiotic resistance are needed. In addition, minimizing non-prescription use of antibiotics and increasing the public awareness about the health and economic hazards of antibiotic resistance are also required.

Background: The correct implementation of Rational Drug Use and Rational Antibiotic Use principles is crucial for public health both globally and nationally. The development of effective policies and interventions requires studies evaluating societal perspectives on this issue. Therefore, this study aimed to assess the knowledge, behaviors and attitudes of university students toward the rational antibiotic use, and to contribute to awareness raising when necessary. Methods: A questionnaire comprising a demographic information form, items on medication use characteristics, and a scale assessing knowledge and attitude toward rational antibiotic use was administered to university students during the 2021-2022 academic year. Results: A total of 1046 university students participated in the study. Most students reported reading medication instructions (77.1%) and using antibiotics only upon a physician’s recommendation (80.0%). Painkillers were the most frequently used medications (47.3%), followed by antibiotics (18.1%). Knowledge scores regarding rational antibiotic use did not differ significantly by gender, class level, economic status or parental education; however, students from the Faculty of Education demonstrated significantly higher knowledge levels (p

Introduction: The burden of antibiotic resistance in the hospitals and communities is progressively worsening hence the critical need to put into practice all the key components of rational use of antibiotics in our daily patient interactions. This paper aims to highlight the problem of antibiotic resistance, the importance of rational use of antibiotics and to show an on the spot sketch of the antibiotic use pattern among in-patients in the children wards in a tertiary hospital.&#x0D; Methodology: A brief review of the existing literature on antibiotic resistance and the rational use of antibiotics was done. A one-day cross-sectional point prevalence study was conducted in the children wards in UPTH and all children receiving antibiotics on that day, identified. The prevalence of antibiotic use was determined by dividing the number of inpatients on antibiotics at the time of the survey by the total number of patients on admission. Data were presented in percentages using pie and bar charts.&#x0D; Results: There were a total of 40 children on admission in the paediatric wards with a Male: Female ratio of 1.2:1. 34 (85.0%) of the children on admission were receiving at least one antibiotic. The most common route of administration of the antibiotics was the intravenous route (94.1%). The five most commonly prescribed antibiotics in the children medical wards and the emergency ward were Ceftriaxone, Gentamycin, Cefuroxime, Metronidazole and Crystalline penicillin, while the five most common antibiotics prescribed in the special care baby unit were Gentamycin, Ceftazidime, Ceftriaxone, Metronidazole and Ofloxacin. Only 10 (29.4%) out of children receiving antibiotics had a microbiology culture result available, and 4 were receiving antibiotics in line with the culture sensitivity pattern. Two (5.9%) children had a multidrug-resistant infection.&#x0D; Conclusion: This study showed a high prevalence of antibiotic use among inpatients and low utilization of microbiology culture results in the choice of antibiotics in a tertiary hospital in South-south Nigeria. Antibiotic prescribing patterns among healthcare workers should be improved upon by training and retraining of personnel as well as strict adherence to antibiotic prescription guidelines.

Irrational use of drugs, especially antibiotic is a big problem on the public health in Vietnam as well as at Ba Vi District Hospital. The use of treatment guideline may reduce irrational prescribing behavior. In Vietnam, the treatment guideline for many common diseases were issued. However, some studies revealed that most doctors at the public hospitals did not use these treatment guideline in their prescribing. It is assumed that implementation of treatment guideline and supervision of this implementation will increase adherence to available guideline. This study is to improve rational use of antibiotic focus on hospital out patients by an intervention that include implementation of treatment guideline and supervision this implementation through face-to-face education. This study focuses on children under five with ARI as model for other conditions may be addressed in the future. The main objective of proposed study is to improve rational prescribing of antibiotics by the prescribers of Bavi District Hospital. This is an intervention pre-post study design with both quantitative and qualitative approach. The out-patient ward and 3 inter-commune polyclinics of Bavi District Hospital will be selected. The intervention in this study is using face-to-face education in order to introduce again existing treatment guideline for ARI and supervise implementation of guideline of physicians by expert and researchers in 6 months at Ba Vi District Hospital. Two evaluations will be carried out, before and after intervention, by researchers. Researchers will conduct the baseline survey, evaluations studies and workshop and supervisions. Evaluation of intervention will be based on analysis of prescription encounters, and on KAP survey of prescribers in relation to guideline implementation. Prescription encounters have to collected in a prospective study while data on KAP survey of prescribes could be collected in a cross sectional study. For the qualitative purpose, one focus group discussion will be conducted to explore the knowledge of the prescribers and for developing motivating messages during education sessions. To develop skill in handing obstacles during data collection process, data exercise was done in the Ba Vi District Hospital. The results of this study will be evidence to the planners and policy maker to introduce other treatment guideline to the prescribers of Ba Vi District Hospital and to ensure rational prescribing, hence promote rational use of drugs, especially antibiotics.

Introduction: The emergence and spread of bacterial resistance to antibiotics is a growing problem worldwide and it presents a significant threat to public health globally. Substantial evidence has shown that health care workers play a role in the increase of antibiotic resistance. The main aim of this study was to explore the Knowledge, Attitude, and Practice of the healthcare workers on therational use of antibiotics in the Primary Health Care Facilities in Lilongwe District.Materials and method(s): This was a cross-sectional quantitative study that was carried out in three primary health care facilities in Lilongwe District. All the Clinicians and Nurses in the selected health facilities were requested to participate in the study using a purposive a simple random technique. Interviewer-administered questionnaires were utilized to collect relevant information. Data on the knowledge, attitude and practice of the primary health care workers was analyzed using SPSS and was presented in graphs and tables.Results: The study sample size was 73 participants however only 72 study participants responded to the questionnaire representing 98.6% response rate. Most of the participants (69/72) agreed that the rational use of antibiotics is giving the right antibiotic to theright patient in the right dose for the right duration;51,4% (37/72) of the participants responded that antibiotics cure viral infections. Most of the participants, 88.9% (64/72) agreed that it is important to know the resistance rate of the bacteria and 83.3% (60/72) agreed that Prescribing antibiotics is more influenced by the availability of antibiotics than the cause of infection.Conclusion: This study revealed that most of health care workers possess average knowledge about the rational use of antibiotics. However, their attitude and practice on the rational use of antibiotics were still poor.

Providing proper knowledge on the rational use of antibiotics plays a role in the success of the treatment process of infectious diseases and the prevention of antibiotic resistance. In this modern digital era, healthcare professionals can utilize video as a medium for patient education. This study was meant to determine the efficacy of a video-based educational intervention in improving the levels of knowledge on the rational use of antibiotics. The study used a quasi-experimental pretest-posttest with a control group design and involved 140 participants. Data collection utilized a questionnaire that was carried out from July to December 2021 at the Special Region of Yogyakarta, Indonesia. The intervention was conducted for four weeks with a lecture and group discussion using video as educational media. The results of this study found that educational videos significantly improved the levels of knowledge on the rational use of antibiotics, known by an increase in the mean value of the treatment group by 2.590 with a p-value of 0.001, and a difference in the mean value of posttest scores of both groups by 1.900 with a p-value of 0.001. It could be concluded that video could be utilized as an effective medium of patient education, notably the use of antibiotics.

Broiler meat is the most consumed poultry product in Nepal. To increase the productivity and met the demand there is high use of antibiotics for prophylactic and as growth promoter in poultry industry. Continuous use of Antibiotic in broiler and supplying them in market before with-drawl period had led to development of Antibiotic Residue. This study aims for detection of antibiotic residue in marketed broiler meat of Kathmandu Metropolitan City. A total of 150 meat samples were taken (75 liver +75 breast muscle), and 300 tests performed for two group of antibiotics Group A(Tetracyclines) and Group B (macrolides, aminoglycosides and sulphonamides). Purposive and randomized sampling procedure was done and commercially available test kit was used. 74 tests were found to be positive for antibiotic residue and 53 of them were above the Minimum residue level. The true prevalence was found to be 28.25%. The presence of antibiotic residue in meat found to be statistically significant(p<0.05). Antibiotic residue was found higher in liver than in muscle. This study concluded that antibiotics residue was found higher than recommended in poultry meat of Kathmandu metropolitan city, which could expose serious human health hazard. Hence to mitigate the situation one health and multisectoral approach guiding for safe and rational use of antibiotics should be implemented.

The overall volume of antibiotic consumption in the community is one of the foremost causes of antimicrobial resistance. In developing countries like India, pharmacists often dispense 'prescription-only' drugs, like antibiotics, to patients who do not have a prescription. Not much data is available regarding detailed information on behaviour of antibiotic use by community pharmacists which is of particular significance to develop a suitable and sustainable intervention programme to promote rational use of antibiotics. A qualitative study was conducted to understand the dispensing practices and behaviour of community pharmacists to develop policy interventions that would improve the use of antibiotics at the community level. Focus group discussions (FGDs) were held for five municipal wards of Delhi with retail pharmacists, public sector pharmacists and the office bearers of pharmacists' associations. Data on antibiotic use and resistance were collected earlier from these five wards. FGDs (n = 3 with 40 pharmacists) were analysed through grounded theory. Four broad themes identified were as follows: prescribing and dispensing behaviour; commercial interests; advisory role; and intervention strategies for rational use of antibiotics. FGDs with pharmacists working in the public sector revealed that, besides the factors listed above, overstock and near-expiry, and under-supply of antibiotics promoted antibiotic misuse. Suggestions for interventions from pharmacists were the following: (i) education to increase awareness of rational use and resistance to antibiotics; (ii) involving pharmacists as partners for creating awareness among communities for rational use and resistance to antibiotics; (iii) developing an easy return policy for near-expiry antibiotics in public sector facilities; and (iv) motivating and showing appreciation for community pharmacists who participate in intervention programmes. Inappropriate antibiotic dispensing and use owing to commercial interests and lack of knowledge about the rational use of antibiotics and antibiotic resistance were the main findings of this in-depth qualitative study. Community pharmacists were willing to participate in educational programme aimed at improving use of antibiotics. Such programmes should be initiated within a multidisciplinary framework including doctors, pharmacists, social scientists, government agencies and non-profit organizations.

Empowering Thai community pharmacists in combating antimicrobial resistance: Qualitative insight and sentiment analysis

BackgroundAntimicrobial resistance (AMR) is a global emergency, and the general public and School children are limited in their awareness of the rational use of antibiotics. Gamified education can effectively address this issue. This study aimed to improve knowledge, attitudes, and practices regarding rational antibiotic use through innovative games.MethodologyA gamified educational intervention was conducted with 2,195 high school students (13–16 years) in Mysuru, South India. The session included a blackboard introduction to microbes and antibiotics, an animated video on irrational antibiotic use, and games like Bucketing the Ball and Monkeying with Donkey to teach when antibiotics are unnecessary (e.g., respiratory tract infections and gastroenteritis). Pre- and post-test questionnaires were administered and analysed.ResultsResults showed significant improvements: knowledge of antibiotic effects increased from 2.5 to 82.5%; understanding of antibiotics for bacterial infections rose from 11.5 to 82.5%; awareness of when to avoid antibiotics for common infections improved from 5.1 to 96.77%; and awareness of their use for urinary, skin, and soft tissue infections increased from 19.6 to 90.38%. Practices like not buying antibiotics without a prescription and completing the course improved from 20.3 to 91.92%.ConclusionGamified education effectively enhances knowledge, awareness, and practice of rational antibiotic use. With rising AMR, such innovative interventions are crucial to educating the general public and School children, ensuring a long-lasting impact on this global issue.

(1) Background: Antibiotic resistance is an imperative public health issue globally. Major factors that are resulting in this trend are the irrational and excessive use of antibiotics. Children account for a greater population of antibiotics use, therefore, an educational intervention on the rational use of antibiotics for children and caregivers will be beneficial. (2) Methods: A randomized controlled and parallel group study of fifth grade children and their caregivers will be evaluated in four primary schools in Baoji and Weinan of the Shaanxi Province. Two primary schools will be randomly selected for the educational intervention and two schools will serve as a control group. In the intervention arm, educational interventions will be conducted among caregivers and their children. The intervention measures include interactive training sessions, booklets, and printed or electronic educational materials that will be given to the caregivers or the school-aged children. In the control arm, no interventions will be implemented. Baseline data collected from June, 2018 and the intervention will last for three months. Knowledge-Attitude-Practice (KAP) questionnaires will be used to evaluate the caregivers’ knowledge, their attitude, and their practice. Knowledge-Retention questionnaires will be used to assess the children’s knowledge about microbes, antibiotics, and hygiene. (3) Discussion: This study is a unique comprehensive intervention targeting both children and their caregivers. We hypothesize a decrease in the irrational use of antibiotics among the studied population. Hence, this result would provide evidence for policy makers and educational departments for the implementation of similar interventions on the rational use of antibiotics.

The consumption of antibiotics in human and animal health has increased significantly over the years, leading to irrational use and the spread of antibiotic resistance in bacteria. This study aims to investigate the impact of antibiotic resistance on the environment and public health through a narrative review of articles and reports published between 2014 and 2024. Searches were conducted using different databases and the search terms were "drug contamination," "water contamination," "medical waste," "drug resistance," "antibiotics," "rational use of medicines," and "environment," and different databases were used. The results show that animal excretions and inappropriate disposal of antibiotics have facilitated the spread of resistance genes through contamination of rivers and water sources, and consumption of contaminated meat and food. This has affected public health through the ineffectiveness of antibiotics and increased mortality from infections with antibiotic-resistant bacteria. Rational use of antibiotics combined with health education is essential to prevent irrational use and inappropriate disposal of antibiotics. These approaches can help reduce the impact on public health and the environment.

The sale of antibiotics without medical prescription has been observed in many countries. The practice is more pronounced in developing and low income countries where legislations and regulations are weak. In these countries, antibiotics are illegally purchased without medical prescriptions and very little effort has been made to tackle the situation. The role of pharmacists in contributing to healthcare remains debatable. In Nigeria, there are deficiencies in the quality of current professional practice. Community pharmacists are now seen as retailers and businessmen rather than health care providers. Nigerians are therefore left to accept the helpful and harmful practices such pharmacists. Self-medication with antibiotics is a universal problem and variations regarding such practices are obvious around the globe. The practice cuts across culture, gender, age, health status, social status, race and occupation. Irrational use of antibiotics increases the risk of bacterial resistance and adverse drug reactions. It has been found to produce various adverse effects in humans. It is the objective of this paper to discuss the irrational use and non-prescription sale of antibiotics in Nigeria. It will discuss the evidence, the concept of self-medication, resistance and interactions, legislation, probable solutions, changes in practice and the concept of sustainability which would help guarantee the appropriate sale and rational use of antibiotics in Nigeria.

BackgroundAntimicrobial resistance (AMR) is a growing public health threat. Primary care physicians are important inducers of the overuse of antimicrobials and inappropriate prescribing. Augmented reality (AR) might provide a potential educational tool in health care. The aim of this study was to identify the need for education and expectations for AR-based education in the context of improving the rational use of antibiotics by primary care physicians in China.MethodsThe study used a qualitative approach based on face-to-face interviews with eleven physicians from three community health service centers and stations in China. We used a hybrid thematic analysis approach to analyze the interview data. A conceptual design framework, mobile augmented reality education (MARE), guided the work.ResultsThe physicians’ personal prescription paradigms included problems regarding the way they diagnosed and chose treatments and prescriptions. Although the physicians mentioned that they should not treat patients with antibiotics without proof of a bacterial infection, in practice, they often did not wait for necessary test results before they prescribed antibiotics. It was also revealed that they often experienced difficulties when trying to convince patients to follow non-antibiotic treatments. Physicians’ prescription of antibiotics was based on three different paths: if they thought there was a bacterial infection, if they thought preventing additional possible infections for the patient to be necessary; and if the patients requested antibiotics. The physicians expressed various learning needs for the rational use of antibiotics, and their expectations of an AR-based educational intervention included suggestions for contents, learning assets, learning environments and learning activities.ConclusionsThe results showed that the physicians were not only unfamiliar with national guidelines on the use of antibiotics and local AMR patterns but also had personal paradigm issues related to the physicians’ decision making. Moreover, the physicians provided meaningful insights into and expectations for possible AR-based education on AMR. In this article, we demonstrate how to apply the MARE framework to analyze the needs of educational interventions for rational use of antibiotics.