The Associations between Poor Antibiotic and Antimicrobial Resistance Knowledge and Inappropriate Antibiotic Use in the General Population Are Modified by Age

Abstract

Objectives: Understanding factors influencing inappropriate antibiotic use can guide the design of interventions to improve antibiotic practices and reduce antimicrobial resistance (AMR). Methods: A nationally representative cross-sectional survey (N = 2004) was conducted between November 2020 and January 2021. Knowledge of antibiotic use and AMR using the World Health Organization’s Multi-Country AMR Survey questionnaire, and antibiotic practices were examined. Multivariable logistic regression was performed to identify factors associated with inappropriate antibiotic use and examine effect measure modifications. Results: After adjusting for potential confounding, poor knowledge of antibiotic use was associated with a 3× increased odds of inappropriate antibiotic use in adults aged ≥50 years (aOR 3.11, 95% CI [2.24–4.32]), 5x increased odds in those aged 35–49 years (aOR 4.88, 95% CI [3.32–7.16]), and 7× increased odds in those aged 21–34 years (aOR 6.58, 95% CI [4.19–10.33]). While there was no statistically significant association in adults aged ≥50 years, poor knowledge of AMR increased the odds of inappropriate antibiotic use by 4 times in adults aged 35–49 years (aOR 3.73, 95% CI [1.53–9.11]) and 5 times in those aged 21–34 years (aOR 4.90, 95% CI [1.84–13.02]). Conclusions: Targeted educational interventions for specific age groups are needed in conjunction with empowering the public with knowledge of antibiotic use and AMR.

Knowledge, Attitudes and Practices Related to Medication, Antibiotics, and Vaccination among Public Service Population: National Survey Conducted in France

“…Respondents over 40 years old or retired, proactive, confident in practitioner about antibiotics, and having a high level of knowledge about antibiotics, practiced less antibiotic misuse. These results are in agreement with those of Guo et al (2022) who observed that adults over 50 years old with poor knowledge of antibiotic use had a 3× increased odds of inappropriate antibiotic use in adults aged ≥ 50 years [ 55 ].…”

“…According to Eurobarometer data, 39% of French took antibiotics at least once in 2016 [ 54 ]. Public knowledge, attitudes, and beliefs about antibiotics were strong determinants of antibiotic misuse [ 55 ]. The main part of the French general population (84%) knew that the unnecessary use of antibiotics makes them become ineffective.…”

Health Information Orientation Profiles and Their Association with Knowledge of Antibiotic Use in a Population with Good Internet Access: A Cross-Sectional Study

“…A more nuanced approach utilising a combination of strategies that target different sub-populations is evidently necessary to address knowledge and practice gaps, and improve antibiotic stewardship in the community. This is further supported by a previous study reporting the modifying effects of age on the association between poor knowledge of antibiotic use and AMR, respectively, and poor antibiotic practices, highlighting the need to tailor educational interventions by age [ 14 ].…”

“…This suggests that for the purposes of disseminating health information, Internet-based platforms are less effective for older adults with LL-HIO due to the much lower Internet utilisation rates and barriers to utilise Internet-based information. Instead, there is a need for physical, social and healthcare touchpoints, with whom they have close and sustained relationships, to actively reach out to and educate this sub-population, using traditional non-Internet-based modalities such as posters or pamphlets and annual campaigns on appropriate antibiotic use to improve antibiotic practices [ 14 ]. Similar findings on the relationship between HIO, health information efficacy, and community participation in good preventive health behaviours have been previously reported, highlighting the importance of working with non-traditional communication platforms to reach out to specific segments of the community [ 36 ].…”

“…Furthermore, adults aged 21–34 years were also found to be more likely to have poor knowledge of antibiotic use. Such poor knowledge in these younger adults was previously shown to be associated with increased odds of having poor antibiotic practices by a factor of 6.6 [ 14 ]. While young adults were more likely to utilise Internet searches, government websites and hospital or clinic websites to seek health information, were confident in using the Internet to answer questions about health, and able to differentiate between high and low quality online health information ( p < 0.05), their low-levels of HIO would hinder them from actively seeking out health information.…”