Non-prescriptionxx antibiotic use for people aged 15 years or older for cough in China: a community-based survey

Abstract

Background Non-prescription antibiotic use at community is a main driver of antimicrobial resistance. Cough is a common condition and prevalent in all townships, including China. This study aims to investigate the non-prescription antibiotic use for cough in China and explore to which extent antibiotic use knowledge was correctly instructed in communities. Methods A probability-proportionate-to-size sampling method was adopted to survey from all 14 townships in Yiwu city, China. All participants were investigated by face-to-face interview on Portable Android Devices. The continuous variables were presented by mean and standard deviation or medium and inter-quartile range (IQR). The categorical variables were presented using percentage or constituent ratio. Chi-square test for univariate analysis and logistic regression for multivariate analysis were conducted to assess the odds ratios and 95% confidence intervals, respectively. Results A total of 3034 respondents across all the 14 townships and the 50 natural villages/streets completed all key items of the questionnaire. Of 2400 (79.10%) respondents stated that they experienced cough in the past 12 months with the medium age of 36.5 (IQR: 26–49) and 12.21% (293/2400) respondents had the non-prescription antibiotic use behavior. Among those 293 respondents, the proportion of non-prescription antibiotic use for cough peaked at around 16% among people aged 30–39 years old. The major sources of antibiotics were pharmacy (77.70%) and/or family storage (43.92%). Conclusions Non-prescription antibiotics use for cough is prevalent in the community, especially among people in their thirties. Strengthened drug purchase regulation and well-trained professional pharmacists would be promising alternatives to ameliorate AMR. Moreover, penetrating antibiotics knowledge to common citizens and is an urgent task to alleviate antimicrobial resistance. Therefore, proactive policies and regulations should be made to improve current situations.

The vicious cycle of the public's irrational use of antibiotics for upper respiratory tract infections: A mixed methods systematic review

“…Of the 53 studies containing a quantitative component, 18 studies ( 22 , 42 , 52 – 54 , 63 – 67 , 75 , 78 , 96 – 101 ) analyzed the care-seeking behavior of URTI patients ( Table 2 ), 24 studies ( 22 , 43 , 44 , 52 , 55 , 56 , 58 , 64 , 68 , 75 , 91 , 93 , 96 – 99 , 102 – 108 , 114 ) reported public expectations/demand for antibiotics for URTIs ( Table 3 ), 19 studies ( 58 , 67 , 69 – 72 , 75 , 78 , 96 – 98 , 100 , 101 , 106 , 108 – 111 , 114 ) documented antibiotic self-medication (including leftover antibiotics and those purchased without a prescription) for URTIs ( Table 4 ), eight studies ( 57 – 59 , 67 , 75 , 98 , 106 , 114 ) described the non-adherence of the public to antibiotic treatments ( Table 5 ), and 10 studies ( 45 , 46 , 67 , 79 , 80 , 106 , 112 – 114 , 118 ) surveyed the public's overall irrational use of antibiotics ( Supplementary File S5 ). Another six studies ...…”

“…In terms of the overall prevalence of antibiotic self-medication, 11 studies show that the rate ranges from 6.2 to 42.3% ( Table 4 ). Mongolia has the highest rate (42.3%) ( 71 ) followed by those from Trinidad and Tobago ( 58 ) (33.1%), the US ( 70 , 114 ) (6.2–23.6%), China ( 96 , 97 , 101 , 111 ) (12.2–20.5%), the Republic of Macedonia ( 78 ) (17.8%), Saudi Arabia ( 110 ) (15.7%), and Lebanon ( 106 ) (6.5%).…”

“…It is likely that their effects are context-dependent. In most settings, high levels of individual capacity (education, medical background, knowledge of antibiotic use and AR) have been found to be associated with the appropriate use of antibiotics ( 58 , 68 , 70 , 71 , 79 , 91 , 93 , 103 , 104 , 106 , 107 , 111 , 113 , 114 ). However, the public understanding of the value of antibiotics can be vague and sometimes wrong ( 76 , 77 , 91 , 93 , 95 , 117 ), which can result in the irrational use of antibiotics ( 45 , 80 , 97 , 111 ).…”

Knowledge, attitude, and practice of healthcare providers on chronic refractory cough: A cross-sectional study

“…A study also suggested that managing patients with chronic cough is unduly time-consuming and expensive [ 33 ], suggesting improvements in practice and maybe attitudes. Previous studies reported data regarding the misdiagnosis and mistreatment status of cough in China, especially the overuse of antibiotics and overdiagnosis of chronic bronchitis [ [34] , [35] , [36] , [37] ], suggesting poor practice. Still, the present study is the first regarding the comprehensive KAP toward CRC in China.…”