Antibiotics and paediatric acute respiratory infections in rural Vietnam: health‐care providers’ knowledge, practical competence and reported practice

Abstract

Summaryobjective To assess knowledge, practical competence and reported practices among health-care providers about antibiotics to treat acute respiratory infections in children under five in rural Vietnam.method Health-care providers prescribing or dispensing western drugs for children self-completed a structured questionnaire. Recommendations concerning antibiotic use from WHO and national guidelines were used to assess the appropriateness of reported treatment of acute respiratory infections.results Ninety-six per cent of 409 eligible health care providers participated. Only 27% demonstrated correct knowledge regarding the consequences of resistance. Seventy-nine per cent would use antibiotics for common colds with fever, and 21% in cases with no fever. Nineteen per cent had overall knowledge compliant with recommended guidelines. Stated antibiotic use in written scenarios for common colds (81%) was not significantly different from that for non-referral cases of pneumonia (87%). The proportion of antibiotic use in the common cold scenario was significantly lower among health-care providers who had the correct overall knowledge. According to reported symptoms from the most recent encounter with a sick child, the diseases seen were 62% mild acute respiratory infections, 19% severe, and 19% non-respiratory infections. Among those, antibiotics, most commonly beta-lactams, were used in 90%, 87% and 78% of cases, respectively.conclusions Antibiotics are often prescribed or dispensed to treat common colds. Interventions to change prescribing and dispensing practices should be developed and implemented in collaboration with local and national paediatricians. Continuous training of health-care providers, particularly drug sellers, is important.keywords antimicrobial practice, health-care provider, Vietnam

Knowledge, attitude and practice of antibiotics: a questionnaire study among 2500 Chinese students

“…Thus, the public knowledge, attitude and practice towards antibiotic use in China warrant greater attention. Besides surveys on the general public, a number of studies have also focused on different cohorts of populations including nurses of day-care centers, parents with infants, internal medicine specialists, dentists and workers in pharmacies [13-17] and others targeting medical students and interns [18-20]. …”

Antibiotic prescribing and dispensing for acute respiratory infections in children: effectiveness of a multi-faceted intervention for health-care providers in Vietnam

“…Similarly, for the STI arm, an alternative version of the questionnaire was constructed with the STI section first, followed by the ARI part. The ARI section of the questionnaire was created contextually through previous studies in the same environment [18] and also using World Health Organization (WHO) IMCI guidelines [16,23]. It included two parts: (i) knowledge about etiology and antibiotic use for ARI symptoms among children under five; (ii) clinical scenarios examining practical competence related to the management of children under five with ARIs.…”

“…Antibiotics are frequently dispensed or prescribed in drug stores, commune health stations or private clinics, often without an appropriate indication [18–20]. It has been reported that most HCPs prescribe or dispense antibiotics for common colds and only 19% had knowledge compliant with the recommended guidelines.…”

“…It has been reported that most HCPs prescribe or dispense antibiotics for common colds and only 19% had knowledge compliant with the recommended guidelines. A serious lack of knowledge among HCPs regarding the pathogeneses of ARIs and the ability to recognize the signs for pneumonia has been noted [18–20]. …”

“…Antibiotic prescribing and dispensing has been high due to lack of knowledge, due to pressure to meet patients’ antibiotic expectations and due to misconceptions that antibiotics should be used to prevent secondary bacterial infections and complications of disease [13,18]. In Vietnam, multi-faceted interventions have previously been conducted in private pharmacies and have improved antibiotic dispensing patterns for childhood ARIs [21].…”