Knowledge, attitudes and perceptions of antibiotic use and resistance among patients in South Africa: A cross-sectional study.

Elise Farley,Tom Boyles,Dena Van den Bergh,Annemie Stewart,Renier Coetzee

doi:10.4102/sajid.v34i1.118

Abstract

BackgroundAntibiotic resistance (ABR) is a global health crisis. We conducted a cross-sectional survey to describe South African patients’ (n = 782) ABR knowledge, attitudes and perceptions (KAP), differences in KAP between public (n = 379, 48%) and private (n = 403, 52%) practice respondents and associations between attitudes, perceptions and knowledge scores.MethodsKnowledge scores (15 questions) were placed into low (0% – 53%) and high (> 54%) categories (below and above overall mean). Comparisons were conducted using chi-squared and t-tests.ResultsOf all respondents, 72% believed it was the human body that becomes resistant to antibiotics, 66% stated that antibiotics are good for treating viruses and 25% of patients believed that people should be given antibiotics on demand. Mean knowledge scores were lower in public sector respondents (public 45%, s.d. 15%; private 60%, s.d. 30%; p ≤ 0.001). Public practice patients with high knowledge scores were more likely to report both negative KAP (antibiotic prescriptions justify doctors’ visits, scientists will discover new antibiotics) and protective KAP (finishing a course of antibiotics, antibiotics do not treat all illnesses). Private practice patients with high knowledge scores were marginally less likely to report negative KAP (wanting antibiotics after long illnesses or when very sick) and more likely to report protective KAP (antibiotics have side effects and are a strong treatment).ConclusionOur study shows differences in KAP by practice type and that greater knowledge increases the likelihood of protective attitudes, perceptions and behaviours.

Highlights

Antibiotic resistance (ABR) is an acute global public health threat.[1]
Of all respondents, 72% believed it was the human body that becomes resistant to antibiotics, 66% stated that antibiotics are good for treating viruses and 25% of patients believed that people should be given antibiotics on demand
Mean knowledge scores were lower in public sector respondents

Summary

Introduction

Antibiotic resistance (ABR) is an acute global public health threat.[1]. It is estimated that 700 000 people die from ABR infections in a year.[2]. Antibiotic stewardship is critical in the efforts to slow down ABR, and patients play a fundamental role in stewardship.[12] One of the core elements of antibiotic stewardship programmes in health care is education of prescribers, dispensers and patients.[13] For the latter group, their misuse of antibiotics is in part because of a lack of understanding of the true causes of ABR. We conducted a crosssectional survey to describe South African patients’ (n = 782) ABR knowledge, attitudes and perceptions (KAP), differences in KAP between public (n = 379, 48%) and private (n = 403, 52%). Practice respondents and associations between attitudes, perceptions and knowledge scores

Methods

Results

Discussion

Conclusion