A cross-sectional study on public belief, knowledge and practice towards antibiotic use in the state of Perak, Malaysia

Abstract

Introduction: Inappropriate use of antibiotics has led to antimicrobial resistance, a major public health challenge worldwide. This study aimed to explore beliefs, knowledge, and practice on antibiotic use among general public.
 Methodology: Cross-sectional study was conducted at 13 hospitals and 44 primary health clinics in Perak from May to July 2017. Adults above 18 years, literate, and had experience in antibiotics consumption were selected through sequential sampling method. Data was collected using a self-administered questionnaire which included the three study domains i.e. belief, knowledge and practice. The questionnaire was pilot on 30 subjects.
 Results: Out of 2850 distributed questionnaires, 2773 returned and 2632 were included for analysis. Mean age of the respondents was 39.7 ± 14.5 years old. Most respondents were female (58.6%), Malay (74.7%) and underwent upper secondary school (45.6%). Mean score were generated for each domain with belief: 5.87 ± 3.00 (total score: 12), knowledge: 15.82 ± 3.85 (total score: 24), practice: 6.91 ± 2.07 (total score: 12). In the belief domain, 63.2% of respondents believed that antibiotics would help them to recover faster. In the knowledge domain, 52.7% of respondents inappropriately thought that antibiotics could work on viral infections. In the practice domain, 70% of respondents expected doctors to prescribe antibiotics if suffered from symptoms.
 Conclusion: Majority of the respondents expect doctors to prescribe antibiotics for their illness, and most believes that antibiotics can speed up recovery of illness. Lack of awareness on antibiotic resistance was found to be a significant factor associated with inappropriate antibiotic use.

Knowledge and Expectations on Antibiotic Use among Older Adults in Malaysia: A Cross-Sectional Survey

“…In their study, McNulty et al also concluded that there was no simple relationship between knowledge, attitude and practice on the prudent use of antibiotics [25]. However, in this study, respondents with better knowledge regarding the need to adhere to antibiotic regimen were more likely to have completed their antibiotic course, which is in line with another Malaysian study [41]. In addition, significant associations were obtained between respondents' knowledge on antibiotic effect and their expectations of antibiotic treatment for the common cold or cough.…”

“…In terms of knowledge regarding antibiotic use, respondents in this study were found to be confused with the role and identification of antibiotics, a finding that is in line with other Malaysian studies [28,35,37,[39][40][41]56]. Although 70.4% of respondents in this study answered correctly that antibiotics are medicines that can kill bacteria, only a small proportion of respondents (18.9%) were able to correctly identify antibiotics as being ineffective against viral infections.…”

“…However, the percentage of respondents using antibiotics within the past month (13.9%) was lower compared to previous studies conducted among the general public in Malaysia and among the elderly in a multi-country survey by WHO [35,[37][38][39][40]. Nevertheless, the main reasons cited for taking antibiotics in this study, which were respiratory tract infections (35.4%) and fever (19.4%), were similar to previous surveys in Malaysia [35,40,41] and in other countries [42,43]. Similar to a previous study among the general public in Penang [35], the majority of respondents (96.9%) were prescribed the antibiotic after consultation with the physician.…”

“…Only a small proportion (1.5%) of the respondents received antibiotics without physician consultation. This self-medication rate was comparatively much lower than those reported in other studies conducted among adults, which were 5.3% to 20.4% in Malaysia [35,[39][40][41]44], and 22.4% to 76.6% in other countries [42,43,[45][46][47][48][49], in which respondents obtained antibiotics from the pharmacy without prescriptions, followed by antibiotics shared by family or friends, and purchased from clinics without consultation. A systematic review reported that age is not a strong determinant in self-medication with antibiotics [50]; therefore, the lower rate of self-medication in this study might not be due to subject selection for elderly population.…”

University Students’ Antibiotic Use and Knowledge of Antimicrobial Resistance: What Are the Common Myths?

“…This could lead to the rise of antibiotic misprescribing and/or overprescribing, further impacting the development of resistance. Thus, it is important to address one’s knowledge and beliefs of the proper antibiotic usage, hence stopping the misconceptions and expectations of using antibiotics to treat minor illnesses [ 16 , 17 ].…”