Abstract
Antibiotic resistance is one of the biggest threats to global public health. Misuse of antibiotics has never been investigated on a nationwide scale among the general public in Malaysia. This study aimed to identify sociodemographic and knowledge factors associated with inappropriate use of antibiotics in the Malaysian context to inform the development of interventions to mitigate inappropriate antibiotic use. We conducted computer-assisted telephone interviews (CATI) between June 2019 and December 2019. The telephone numbers were randomly generated from the electronic residential telephone directory of all 13 states and 3 Federal Territories in Malaysia. The survey consisted of questions on demographics, knowledge about antibiotics and antibiotic resistance (53 items), and practices of antibiotic use (16 questions). A total of 864 complete responses were received. Pronounced erroneous beliefs that antibiotics are effective against infections caused by viruses and that antibiotics can speed up recovery from coughs and colds were evident. The proportions that were aware of the terms 'drug resistance', 'antimicrobial resistance', and 'superbugs' were low. The mean and standard deviation (SD) for the antibiotic knowledge score was 23.7 (SD ±9.25; range 0 to 50) out of a possible score of 52. Regarding antibiotic practices, a considerable proportion reported non-adherence to recommended doses. The mean and SD for the antibiotic practices score was 37.9 (SD ± 6.5; range 17 to 47) out of a possible score of 48. Participants who earned an average monthly household income of MYR1001-3000 (OR 1.61, 95% CI 1.04-2.50) were more likely to report higher antibiotic practice scores than those with <MYR1000. Participants with tertiary education attainment reported higher antibiotic practice scores (OR 1.99; 95%CI 1.02-3.91) than those with primary school and below. High antibiotic knowledge scores (OR 3.94; 95% CI 2.71-5.73) were associated with higher antibiotic practice scores. Inappropriate antibiotic use is influenced by demographics and antibiotic knowledge. This study calls for education interventions focused on the lower socio-economic status population to increase awareness and to promote appropriate antibiotic use.
Highlights
Antimicrobial resistance is a public health concern around the world that significantly impacts patient health and poses a serious threat to the future health and welfare of both humans and animals [1]
This study aimed to identify sociodemographic and knowledge factors associated with inappropriate use of antibiotics in the Malaysian context to inform the development of interventions to mitigate inappropriate antibiotic use
According to the Centres for Disease Control and Prevention (CDC), an estimated of 2.8million people are infected with antibiotic-resistance bacteria or fungi, and more than 35,000 people die as a result [5]
Summary
Antimicrobial resistance is a public health concern around the world that significantly impacts patient health and poses a serious threat to the future health and welfare of both humans and animals [1]. It is well-recognised that inappropriate antibiotic use is an important and modifiable driver of antibiotic resistance [2, 3]. Public awareness of antibiotic resistance is crucial to mitigating this insidious problem It is well-established that poor knowledge regarding antibiotic usage gives rise to inappropriate consumption of antibiotics, causing the emergence of resistant microorganisms [7]. Various forms of inappropriate use of antibiotics, such as incomplete of the entire course of antibiotic treatment, skipping doses, using leftover antibiotics from previous treatment, misuse of antibiotics to cure viral infections, and self-medication or purchase of antibiotics without prescription have been commonly reported [8]
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