Knowledge, attitudes and behaviour of Egyptians towards antibiotic use in the community: can we do better?

Abstract

Background Infectious diseases are among the leading causes of death worldwide. This is concerning because of the increasing capacity of the pathogens to develop antibiotic resistance. Antibiotic overuse and misuse remain the main drivers of resistance development. In the USA and Europe, annual campaigns raise awareness of antibiotic misuse hazards and promote their judicial use. Similar efforts are lacking in Egypt. This study assessed the knowledge of the public in Alexandria, Egypt of antibiotic misuse risks and their habits towards antibiotic use, in addition to conducting a campaign to increase awareness of the safe use of antibiotics. Methods A questionnaire assessing knowledge, attitudes and behaviour towards antibiotics was used to collect responses from study participants at various sports clubs in Alexandria in 2019. An awareness campaign to correct misconceptions and a post awareness survey followed. Results Most of the participants were well-educated (85%), in their middle age (51%) and took antibiotics last year (80%). 22% would take an antibiotic for common cold. This dropped to 7% following the awareness. There was a 1.6 time increase in participants who would start an antibiotic on a healthcare professional’s advice following the campaign. A 1.3 time increase in participants who would finish an antibiotic regimen was also observed. The campaign made all participants recognize that unwise antibiotic use is harmful to them or others; and 1.5 more participants would spread the word about antibiotic resistance. Despite learning of the risks of antibiotic use, there was no change in how often participants thought they should take antibiotics. Conclusions Although awareness of antibiotic resistance is rising, some wrong perceptions hold fast. This highlights the need for patient and healthcare-tailored awareness sessions as part of a structured and national public health program directed to the Egyptian population.

Susceptibility of multi-drug resistant isolates of Pseudomonas aeruginosa to ceftazidime/aviabactam and ceftolozane/tazobactam in Benha University Hospital in Egypt and detection of carbapenemase genes

“…This is in contrast to the situation in Europe and the USA, where most antimicrobial resistance in P. aeruginosa is attributable to AmpC and overexpression of efflux pumps [4,5]. Yet the rates of resistance in our institution are higher than previous reports, reflecting the selection of MDR isolates for the study, the severity of underlying diseases of the ICU patients, and the overuse and misuse of antimicrobials in the hospital and community that led to a high prevalence of MDR bacteria among the population in Egypt [21]. This is coupled with inadequate compliance with infection control and antimicrobial stewardship in hospitals [6].…”

Antibiotic Knowledge, Antibiotic Resistance Knowledge, and Antibiotic Use: A Cross-Sectional Study among Community Members of Bangkok in Thailand

“…In regard to antibiotic use, more than three-quarters (78.3%) of the respondents reported having taken an antibiotic in their lifetime prior to our study. The result showed that the overall antibiotic usage was higher than the global antibiotic consumption (65%); however, the result is in line with LMICs such as Ukraine (80.0%), Egypt (80.0%), Kazakhstan (80.0%), Bosnia (79.0%), and Sudan (73.0%) [ 34 , 35 , 36 ]. This indicates that although Thailand has developed a national strategic plan to combat antibiotic resistance, this plan may not communicate effectively with regard to the use of antibiotics, specific risks of antibiotic overuse, and existing knowledge about antibiotic use behavior.…”

Prevalence of knowledge, attitudes, and practices regarding antimicrobial resistance in Africa: a systematic review and meta-analysis

“…This systematic review and meta-analysis included 39 (Thriemer et al, 2013;Abera et al, 2014;Pereko et al, 2015;Simba et al, 2016;Asante et al, 2017;Farley, 2017;Genga et al, 2017;Tafa et al, 2017;El Sherbiny et al, 2018;Seid and Hussein, 2018;Mate et al, 2019;Sunusi et al, 2019;Fetensa et al, 2020;Gemeda et al, 2020;Kabba et al, 2020;Mengesha et al, 2020;Nisabwe et al, 2020;Sindato et al, 2020;Wesangula et al, 2020;Zulu et al, 2020;Aworh et al, 2021;Babatola et al, 2021;Chukwu et al, 2021;Gebeyehu et al, 2021;Geta and Kibret, 2021;Mostafa et al, 2021;Ogoina et al, 2021;Russom et al, 2021;Adegbite et al, 2022;Belachew et al, 2022;Dejene et al, 2022;Kanyike et al, 2022;Mudenda et al, 2022;Paye and McClain, 2022;Tembo et al, 2022;Abubakar and Sárváry, 2023;Davwar et al, 2023;Maarouf et al, 2023;Otieku et al, 2023) published studies involving 18,769 study subjects. The review included primary studies with a remarkably varied sample size, ranging from just 47 (Adegbite et al, 2022) to 2,477…”

“…Of the included studies, 33 were cross-sectional (Thriemer et al, 2013;Abera et al, 2014;Pereko et al, 2015;Simba et al, 2016;Asante et al, 2017;Farley, 2017;Genga et al, 2017;Tafa et al, 2017;El Sherbiny et al, 2018;Seid and Hussein, 2018;Mate et al, 2019;Fetensa et al, 2020;Gemeda et al, 2020;Mengesha et al, 2020;Nisabwe et al, 2020;Sindato et al, 2020;Zulu et al, 2020;Aworh et al, 2021;Babatola et al, 2021;Chukwu et al, 2021;Gebeyehu et al, 2021;Geta and Kibret, 2021;Mostafa et al, 2021; FIGURE 1 PRISMA flow diagram explaining selection of primary studies in Africa. 10.3389/fmicb.2024.1345145 Frontiers in Microbiology 05 frontiersin.org Ogoina et al, 2021;Russom et al, 2021;Adegbite et al, 2022;Dejene et al, 2022;Kanyike et al, 2022;Mudenda et al, 2022;Paye and McClain, 2022;Abubakar and Sárváry, 2023;Davwar et al, 2023;Maarouf et al, 2023), while six studies followed a cohort study design (Sunusi et al, 2019;Kabba et al, 2020;Wesangula et al, 2020;Belachew et al, 2022;Tembo et al, 2022;O...…”