Antimicrobial resistance (AMR) is one of the greatest threats to global health this century. The primary cause of AMR is antibiotic misuse, especially routine use of antibiotics for self-limiting illnesses. This study aimed to explore behaviours related to antibiotic use in university students across China. An electronic questionnaire was distributed at a major university in each of the six regions. A cluster random sampling method was adopted. The χ test and logistic regression were used to assess the relationship between knowledge and behaviour. A total of 11,192 students completed the questionnaire. In the past month, 3337 students (29.8%) reported a self-limiting illness, of whom 913 (27.3%) saw a doctor, 600 (65.7%) of whom were prescribed antibiotics [190 (31.7%) by infusion]; 136 students (22.7%) asked for and received antibiotics. Of the 1711 students (51.3%) who treated themselves, 507 (29.6%) self-medicated with antibiotics. In the past year, 23.0% of students had used antibiotics as prophylaxis, 63.1% kept a personal stock of antibiotics and 56.0% had bought antibiotics at a drugstore (two-thirds without a prescription). Students with lower knowledge scores about antibiotics were significantly more likely to see a doctor, be prescribed with antibiotics, self-medicate with antibiotics, and use antibiotics prophylactically. This massive misuse of antibiotics for self-limiting illnesses by well-educated young adults is a serious concern. A national campaign is urgently required to address rational prescribing of antibiotics by doctors, enforce existing restrictions on over-the-counter sale of antibiotics, and educate the general public about antibiotics and the management of self-limiting illnesses.
Background: Antimicrobial resistance (AMR) is a great threat to public health. The primary cause of AMR is human antibiotic misuse. Little is known about regional differences of antibiotic misuse behaviours in China.
Objectives: To explore the antibiotic misuse behaviours among university students in western and eastern China and find out the regional differences.
Methods: Participants were recruited from universities in less developed Guizhou Province and developed Zhejiang Province using a cluster random sampling method. A self-administered questionnaire was designed to collect data, and the χ2 test and logistic regression were adopted to assess the associations between region and antibiotic misuse behaviours.
Results: A total of 2073 university students from Guizhou and 1922 from Zhejiang completed questionnaires. Students in Guizhou had lower household income, parents’ education, and urban residence proportion than those in Zhejiang. Compared with those in Zhejiang, students in Guizhou had higher antibiotic use prescribed by doctors (79.8% vs 56.2%) and self-medication with antibiotics (33.0% vs 16.1%). Students in Guizhou were more likely to buy over-the-counter antibiotics without prescriptions (73.9% vs 63.4%), ask for antibiotics from doctors (21.4% vs 15.6%), and use antibiotics prophylactically (29.9% vs 15.7%). Adjusted models showed that the less developed region was significantly associated with higher antibiotic misuse behaviours.
Conclusions: Misuse of antibiotics by well-educated young adults was very high in two regions but most serious in the less developed one. Campaigns are urgently needed to promote appropriate antibiotic use especially in less developed regions.
Background Antimicrobial resistance (AMR) is one of the greatest threats to public health in China. The primary cause of AMR is antibiotic misuse, especially used for self-limiting illnesses. Little is known about regional differences of antibiotic-misuse behaviors in China. We aimed to explore such behaviors among university students in western and eastern China. Methods The participants were recruited from universities in Guizhou, a less developed province in western China, and from Zhejiang, a more developed province in eastern China, using a cluster random sampling method. A validated, self-administered questionnaire was designed to collect data, and the χ² test and logistic regression were adopted to assess the associations between region and antibiotic misuse.
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