Patient Attitudes and Beliefs and Provider Practices Regarding Antibiotic Use for Acute Respiratory Tract Infections in Minya, Egypt.

Amr Kandeel,Kathleen Dooling,Lauri Hicks,Waleed El-Shoubary,Ramy Galal,Mohamed Fattah,Anna Lohiniva,Omnia Ragab,Maha Talaat

doi:10.3390/antibiotics3040632

Abstract

The inappropriate use of antibiotics in the community is one of the major causes of antimicrobial resistance. This study aimed to explore the physician prescribing pattern of antibiotics for acute respiratory infections (ARIs) and to explore the knowledge, attitudes, and practices of patients regarding antibiotic use for ARIs. The study was conducted in Upper Egypt and used quantitative and qualitative research techniques. Eligible patients exiting outpatient clinics with ARIs were invited to participate in the study. A qualitative study was conducted through 20 focus group discussions. Out of 350 encounters for patients with various ARIs, 292 (83%) had been prescribed at least one antibiotic. Factors significantly associated with antibiotic prescribing for adults included patient preference that an antibiotic be prescribed. For children younger than 18, presentation with fever, cough, loss of appetite, and sore throat, along with the caregiver’s antibiotic preference, were associated with an antibiotic prescription. Several misconceptions regarding antibiotic use among community members were stated, such as the strong belief of the curing and prophylactic power of antibiotics for the common cold. Interventions to promote proper antibiotic use for ARIs need to be piloted, targeting both physicians and the public. Educational programs for physicians and campaigns to raise public awareness regarding proper antibiotic use for ARIs need to be developed.

Highlights

The inappropriate use of antibiotics is a worldwide public health problem contributing to the emergence of antimicrobial-resistant pathogens [1]
Minya was chosen by the Ministry of Health and Population to conduct baseline studies exploring the extent of antibiotic use in Egypt and evaluate the impact of a pilot intervention to reduce unnecessary prescription and consumption of antibiotics
The practice of persons treating themselves with antibiotics for acute respiratory infections (ARIs) was very common and was mentioned by almost all participants of the focus groups

Summary

Introduction

The inappropriate use of antibiotics is a worldwide public health problem contributing to the emergence of antimicrobial-resistant pathogens [1]. The resulting antimicrobial resistance is a major threat to public health, in low and middle income countries, where the leading causes of illness and death are infectious [2]. Access to antibiotics is generally unregulated in these countries, and some studies have shown that their misuse is widespread [3,4,5], especially unnecessary antibiotic treatment for respiratory illnesses [6,7,8].

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