Knowledge, Attitude and Practice Regarding Antibacterial and Their Resistance in Medellín-Colombia: A Cross-Sectional Study

Abstract

Objective: To describe the knowledge, attitudes, and practices (KAPs) profile on bacterial resistance and antibiotic in the general population of Medellín. Material and methods: A cross-sectional study was conducted from September to December 2022, with 902 participants selected through stratified sampling with proportional allocation of different sectors of the city. The KAP scale was developed through a literature review, elimination of duplicate items, validity assessment, and reliability evaluation using Cronbach’s alpha. Each item was presented with absolute and relative frequencies on a Likert scale, with a total score ranging from 0 to 100, where a higher score indicates better knowledge, attitudes, and practices. Comparisons were made using Mann-Whitney U, Kruskal-Wallis H, and linear regression. Results: The knowledge score median was 73.3 (IQR 63.3–93.3), with 36.9% reporting that antibiotics can be stopped once symptoms improve and 26.1% considering them as analgesics or antipyretics. The attitudes score was 83.3 (IQR 73.3–93.3), with 95.3% expressing concern about the impact on their health or that of their family and over 90% agreeing that more information is needed on antibiotic resistance. The practice score was the lowest at 63.9 (IQR 50–75), with 48% having been prescribed antibiotics at the pharmacy and 42.6% taking them to treat flu symptoms. Economic status (β 2.645), education in health-related areas (β 6.224), gender (β 2.892), and education level (β 3.257) determined knowledge. Knowledge (β 0.387), gender (β 2.807), and education level (β 0.686) influenced attitudes, but practices were only determined by Knowledge (β 0.084) attitudes (β 0.552) and age group (β 2.858). Conclusions: Knowledge about antibiotics and bacterial resistance does not significantly influence the practices of the population. Therefore, interventions aimed at improving knowledge need to be reconsidered as they may not contribute to the appropriate use of antibiotics and prevention of resistance to these drugs.

Antibiotic Self-Medication Patterns and Associated Factors in the Context of COVID-19, Medellín, Colombia: A Survey Based Cross Sectional Study

“…A study in Medellín in this regard show that up to one in four people believe that antibiotics have analgesic or antipyretic properties. 13 In response to this issue, the World Health Organization (WHO) has proposed initiatives such as World Antibiotic Awareness Week. 31 However, these initiatives alone are insufficient, and it is necessary to design interventions that involve the participation of different sectors that go beyond the unidisciplinary approach of the health sector and extend to the socio-structural determinants of SM.…”

“…In the sample, we maintained the proportion of individuals contributed by each zone to the total population as follows: North-western (% of the population 19.8 -% of the sample 20.3 (95% CI 17.6-23.2)), North-eastern (% of the population 22.7 -% of the sample 19.3 (95% CI 16.6-22.2)), Central-western (% of the population 13.9 -% of the sample 14.4 (95% CI 12.1-17.0)), Central-eastern (% of the population 16.0 -% of the sample 17.1 (95% CI 14.6-19.9)), Southwestern (% of the population 10.8 -% of the sample 10.9 (95% CI 8.9-13.3)), South-eastern (% of the population 4.3 -% of the sample 5.0 (95% CI 3.6-6.7)), Rural districts (% of the population 12.5 -% of the sample 13.0 (95% CI 10.8-15.5)). The sample size was calculated following the approach used by Sampedro et al 13 Participants who demanded financial compensation for their participation, those who did not sign the informed consent form, and those who could not respond to the entire survey were excluded. Additionally, a control variable was considered to exclude participants who reported taking antibiotics but used other types of drugs such as analgesics, antihypertensives, anti-inflammatories, among others.…”

“…10,25 However, a research in Medellín found that having good knowledge does not always translate into appropriate practices. 13 This highlights the need to redesign intervention strategies with a greater emphasis on actual practices, as knowledge alone does not guarantee appropriate behavior regarding SM.…”

Knowledge, Attitudes, and Practices Regarding Antibiotic Sales in Pharmacies in Medellín, Colombia 2023

“…However, studies have largely focused on hospital settings and the molecular mechanisms by which infectious agents develop resistance, overlooking community aspects of antibiotic misuse and abuse, particularly within the pharmaceutical sector. Specifically, in the city of Medellín, the second-largest city in Colombia, our research group has examined the knowledge, attitudes, and practices regarding antibiotics and their resistance among medical students [ 15 ] and the general population [ 16 ]. In both cases, inadequate knowledge, attitudes, and practices were identified.…”