Changes in public knowledge and perceptions about antibiotic use and resistance in Jordan: a cross-sectional eight-year comparative study

Abstract

Background Resistance to antibiotics is a growing problem, worldwide and particularly in developing countries like Jordan. Raising public awareness on appropriate antibiotic use is crucial to combat this problem. The current study describes the change in public Knowledge and attitudes towards the use of antibiotics over a period of 8 years. Methods Two cross-sectional studies were performed 8 years apart on Jordanians of different age groups, and social settings, residing in Amman, Jordan. Convenience non-probability sampling techniques were used. In 2010, a questionnaire was distributed in paper form, whereas in 2018 snowball sampling was used to disseminate an identical electronic questionnaire. Chi-square test and post hoc analysis were done using the z-test to compare column proportions, adjustment for multiple testing using the Bonferroni method. Multiple logistic regression was used to adjust for case mix for each survey. Comparisons were made across the two studies and within each study. Results A total of 711 participants in 2010 and 436 participants in 2018 were surveyed. Over the 8-year period, there was a significant improvement in the beliefs regarding the use of antibiotics such as disagreeing to keeping left over antibiotics for later use from 57 to 70% (p < 0.05) and disagreeing to buying antibiotics without physicians’ consent increased from 80 to 89% (P value < 0.001). There was no significant change in the beliefs that support self-medication such as: using antibiotics from a friend (72 to 77%) buying antibiotics without a prescription (42 to 45%), and getting information about medication use from leaflet without referring to a health care professional (60 to 63%). There were some areas of confusion regarding antibiotic range of effectiveness, and origin of resistance. Agreement about antibiotic resistance being a problem in Jordan increased significantly from 44 to 60% (p < 0.001). In addition, there was a significant increase in the percentage of participants who said that they don’t request antibiotics from physicians (56 to 75% (P ≤ 0.001) and who said they would trust physicians’ decisions about the necessity of antibiotics (70 to 83% P < 0.05). Conclusion Findings indicate the need for better suited, and more inclusive, public educational campaigns.

Factors Impacting Knoweldge, Practice and Attitude About Antibacterial and Its Resistance by Cross Sectional Study in Iraq

“…The association between the score of knowledge, attitude and Practice with patients' variables : The core finding about knowledge that there are ten patient characteristics had significant effect on the total knowledge score about antibiotics: Gender, residential area, availability of healthcare worker in the family, being admitted to hospital recently, using a medical devise inside the body, used antibiotics recently, using immunosuppressant medication(s), and received flu or COVID-19 vaccine(s), income and education level of participants .For instance, Female patients and those who lived in urban areas (cities) were significantly more knowledgeable about antibiotics compared to male and those lived in rural areas. The gender finding was in line with previous studies from Syria , Malaysia and Gana (18)(19)(20).The possible explanation for female having more awareness than men is they were commonly more open to alter in perceptions about antibiotic usage than men besides the development in telecommunications over the past little years and increase the social media platforms that published videos about the proper use of antibiotics and antibiotic resistance regularly (21) .Another explanation for female being more knowledgeable than male is that in most developing countries , females hold the accountability of taking care of their children and the other family members (22). In contrast to our study, survey in Bangladesh found that males were more knowledgeable than females (23).…”

Perspectives of Syrian refugees on antibiotic use and prescribing in Dutch primary care: a qualitative study

“…Antibiotics have been frequently mistakenly prescribed to cure communicable diseases such as flu and common cold which are viral infections, wherein antibiotics are ineffective (Dyar et al , 2016; Llor and Bjerrum, 2014). More than the half of the Iraqi migrants in Jordan take antibiotics without a prescription (Abdelmalek et al , 2021). Moreover, they believe – as some Syrian refugees in this study – that taking antibiotics is effective for viral infection, showing that within a patient perspective, not always a distinction is made between a bacterial and viral infection.…”

Public Knowledge and Belief Regarding Antibiotic Use and Antimicrobial Resistance in Qatar

“…Many international studies focused on public knowledge of antibiotic use and antimicrobial resistance, which indicates that a wide range of knowledge gaps exist on the effectiveness of antibiotics for viral infections [5][6][15][16][28][29] . According to the present study, a high percentage of respondents do not understand the difference between viral and bacterial infections as well as the indications for antibiotic treatment.…”

“…However, this will not exclude the possibility of self-medication with the left-over antibiotics from previous therapy, which is supported by a Eurobarometer survey in Poland 32 . According to studies conducted in the Middle East, antibiotics are often shared among family and friends or administered based on recommendations from relatives 5,16 . A promising finding of the present study was that the majority of participants (60%) stated that they were not keeping the remaining antibiotics for future use.…”

“…The community-based educational programs revealed that antibiotic-related knowledge and behaviors including the use, importance of compliance with dose, consequences of self-medication, and antibiotic resistance, had dramatically improved. However, the beliefs remained unchanged [16][17] .…”