Abstract
Objective: Antibiotic abuse has contributed to the development of antimicrobial resistance (AMR) and has become a global concern. With a poorly regulated health system and a general lack of data, Bangladesh remains under high risk of AMR spread. To minimize the existing gap in the literature, this study was conducted to assess the knowledge, attitude, and behavior regarding antibiotic use and misuse among university students. Methods: A cross-sectional study design was used to survey 1400 students using a self-administered questionnaire from the University of Dhaka, Bangladesh. Descriptive and inferential analyses were performed with statistical significance defined as p < 0.05. Results: More than half of the respondents had poor knowledge and neutral attitude towards antibiotics. The students from bioscience were found to have better knowledge and attitude than arts and business. Respondents with good knowledge were more likely to show a positive attitude, p<0.05. Most of the respondents did not know that antibiotics are ineffective against most coughs and cold; and above 60% practiced self-medication. About one-third did not know that antibiotics mainly target bacteria, and surprisingly, more than four-fifth perceived that humans & animals could become resistant to antibiotics. Also, half of the participants did not fulfill their prescribed antibiotic course. Conclusion: There is a substantial amount of knowledge and attitude gap about and non-compliance to the proper use of antibiotics among the university students. The research findings, therefore, reflect the need for policy-level interventions to increase awareness and develop effective countermeasures to prevent the misuse of antibiotics.
Highlights
Antimicrobials once coined as the ‘magic bullet’, are rendered futile to fight bacterial infections as antimicrobial resistance (AMR) has emerged as a global threat to public health
While the majority (78%) said that antibiotics could cause side effects, but more than 50% of the respondents said that they could terminate the antibiotic therapy without fulfilling the course in case of feeling better
Similar to a recently published study, our work demonstrated that the students of bioscience showed comparatively better knowledge and positive attitude while the faculty of arts had the highest percentage of poor knowledge and negative attitude followed by the faculty of business [28]
Summary
Antimicrobials once coined as the ‘magic bullet’, are rendered futile to fight bacterial infections as antimicrobial resistance (AMR) has emerged as a global threat to public health. Unless effective measures are taken, a substantial amount of death could occur globally due to antibiotic resistance [2]. The developing countries are at greater risk primarily due to irrational consumption of antibiotics, non-human antibiotic use, limited knowledge regarding AMR, malnutrition, inapt surveillance, and poor healthcare standards [3]. Inadequacy in developing newer drugs implies that the existing options should be pursued for the rational use of antibiotics to maximize the therapeutic benefits. The use and misuse of antibiotics largely differ across countries influenced by social and cultural perception [4]. In a global study conducted in 11 countries, 22% of the adult respondents admitted to non-compliance to antibiotic therapy [5]. The role of the physicians is in question at times as they are requested and pressurized to prescribe antibiotics both by the aggressive drug marketing policy and by the patients as a means for quick relief in trivial reasons
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