Knowledge on Multi-Drug Resistant Pathogens, Antibiotic Use and Self-Reported Adherence to Antibiotic Intake: A Population-Based Cross Sectional Survey From Pakistan

Abstract

Objective: Surveying public awareness of antibiotic use and antibiotics can identify factors relevant to the design of effective educational campaigns. The aim of this study was to evaluate the knowledge, attitudes, and practices related to antibiotic use and multidrug-resistant pathogens in the general population in Pakistan.Research Design and Methods: Cross-sectional survey was conducted, using a 60 itemed structured questionnaire and recruited individuals by convenient sampling from the general population in the four provinces of the country. Descriptive statistics were used to evaluate the responses and the chi squared statistic was used to assess differences between groups.Results: The response rate was 87.6% (6,684 out of 7,631 individuals). Half of the respondents had received at least one prescription of antibiotics in the 6 months preceding the survey. Knowledge about antibiotic use, (39.8%) individuals scored above the mean (≥3) showed good knowledge about antibiotic use. Urban residents and male showed significant higher knowledge (p < 0.001) about antibiotic use. Approximately 50% of the respondents correctly answered the question about antibiotic resistance. Of the 3,611 received antibiotics, 855 (23.7%) were indicated for cough, 497 (13.8%) for a sore throat, 335 (9.3%) for ear ache, 665 (18.4%) for a burning sensation during urination, 667 (18.4%) for wounds or soft tissue inflammation. MDR pathogen was perceived as an important topic by (4,010) 60.1% of respondents.Conclusion: Participants were aware of the problem of multidrug-resistant pathogens and understood the responsibility of each individual to avoid the spread of these infectious agents.

Pangenomic analyses of tuberculosis strains to identify resistomes using computational approaches

“…Evolutionarily, TB strains have not strewn too far from each other .15, 16 Still, they vary within their respective antibiotic resistance capacities based on the environments that the strains survived in. Possible factors might also include the approximate timeframe they developed in, where, prevalence and severity of resistant or extremely resistant TB cases in their particular regions varied.…”

“…17 With second-line antibiotics found in the most recent strains of TB, the task now is how to come up with better, more updated treatment regimens to treat TB. Secondline drugs are originally used to facilitate treatment for patients for whom first-line drugs are not feasible, 16 but now several of these drugs are ineffective. This may suggest that the current available antibiotics are being overused and inappropriately dispensed.…”

“…This may suggest that the current available antibiotics are being overused and inappropriately dispensed. 16 It is also important to consider how the treatment regimen works for TB patients altogether when considering the costs of maintaining and supervising them as a part of responsible stewardship, which is an integral part of their treatment. This may be unaffordable for many, especially in Third World countries.…”

“…17 With Pakistan in particular, where the current study took place, it comes as no surprise that it ranks highly in the TB leaderboard of annual infections. 16 Though antibiotics tend to be government-mandated and made to be more affordable to the people, any further care is often not as accommodated. Government-supported hospitals may strains.…”

Dispensing of antibiotics for tuberculosis patients using standardized patient approach at community pharmacies: results from a cross-sectional study in Pakistan

“…The dispensing of broad-spectrum antibiotics to TB patients is a major contributing factor to the development of MDR-TB ( 13 ). While the drug regulatory authority of Pakistan has mandated the presence of a qualified pharmacist at community pharmacies for antibiotic dispensing in TB cases, the common practice of dispensing antibiotics without prescription still persists in Pakistan ( 14 , 15 ).…”