The Predictors Influencing the Rational Use of Antibiotics Among Public Sector: A Community-Based Survey in Thailand

Abstract

Background The spread and emergence of antimicrobial resistance is the significant public health concerns over past decades. The major leading cause comes from irrational use of antibiotics. Aim To explore the characteristics of rational use of antibiotics and identify its predictive factors among public sector living in Nakhon Nayok Province, Thailand. Methods This project was conducted by using the data-source from Rational Use of Antibiotics (RUA) Survey Project at Nakhon Nayok Province. A cross-sectional community-based study method and face to face interviews were conducted. Two hundred fifty-four participants were selected by using Quota sampling method. Descriptive statistics were used to describe the sociodemographic and antibiotics use characteristics. Chi-square test were utilized to determine the association between explanatory variables and major outcome while multiple logistic regression was analysed to identify the predictors of antibiotics use behavior. Results The mean age of the participants was 42 years, those with aged between 35 and 56 had more rational use of antibiotics behavior than those with 13–34 years while older adults (57–78 years) were significantly associated with irrational use of antibiotics [AOR = 0.38; 95% CI (0.17–0.85)] than those with less than 34 years of age. Less than half (45.7%) and about one third of them (31.1%) showed adequate knowledge and appropriate attitude towards antibiotics use. An adequate knowledge [AOR = 3.37; 95% CI (1.92–5.90)], appropriate attitude [AOR = 2.90; 95% CI (1.54–5.43)], not using antibiotics within last 3 months [AOR = 1.89; 95% CI (1.04–3.43)], and not visiting drugstore when having three main diseases [AOR = 2.04; 95% CI (1.06–3.92)] were the significant predictors of rational antibiotics use (p-value <0.05). Conclusion Strategies development in terms of knowledge and attitude enhancement about antibiotics use particularly at the different ages together with RDU pharmacy encouragement and policy restriction of community drugstores antibiotics sales are the most effective method to promote rational antibiotics use behavior in the public sector.

Antimicrobial Resistance: A Growing Serious Threat for Global Public Health

“…There are many clinical implications of AMR, and following are some of the major concerns [ 70 ]: Successful treatment of microbial infections including bacterial, fungal, and viral infections is hindered by antimicrobial resistance. Emergence and dissemination of new resistant mechanisms threaten the scope of treatment for many common illnesses such as urinary tract infections, upper respiratory tract infections, typhoid, and flu, resulting in treatment failure, permanent disability, or even death.…”

“…“Rational use of medicine” has been defined by the WHO as using correct medications including antibiotics appropriate for clinical needs of patients, in exact doses of individual needs, for an adequate period of time, and at the lowest cost [ 70 ]. The optimal results of treating infections can only be achieved when the selection of pathogens, drug toxicity, and development of resistance are minimized through the rational use of antibiotics.…”

Evolving Epidemiology and Antibiotic Resistance in Enteric Fever: A Comprehensive Review

“…The rational use of antibiotics is a cornerstone in healthcare, striving to achieve optimal treatment outcomes while mitigating toxicity and curbing the development of antimicrobial resistance. Fundamental principles contributing to this endeavor include avoiding unnecessary antibiotic prescriptions, ensuring accurate dosing, adhering to appropriate treatment durations, and maintaining suitable dosage intervals [ 41 , 42 ]. Antibiotics should be administered solely for documented infections, and it is imperative to complete the entire prescribed course of treatment to forestall the emergence of resistance [ 42 ].…”

“…Fundamental principles contributing to this endeavor include avoiding unnecessary antibiotic prescriptions, ensuring accurate dosing, adhering to appropriate treatment durations, and maintaining suitable dosage intervals [ 41 , 42 ]. Antibiotics should be administered solely for documented infections, and it is imperative to complete the entire prescribed course of treatment to forestall the emergence of resistance [ 42 ]. Globally, efforts to promote rational antibiotic use have gained traction, with initiatives like the European Awareness Day for Rational Use of Antibiotics, observed on November 18, aimed at raising awareness among the public and healthcare practitioners to curtail antimicrobial overuse through informed prescribing practices [ 42 ].…”

“…Antibiotics should be administered solely for documented infections, and it is imperative to complete the entire prescribed course of treatment to forestall the emergence of resistance [ 42 ]. Globally, efforts to promote rational antibiotic use have gained traction, with initiatives like the European Awareness Day for Rational Use of Antibiotics, observed on November 18, aimed at raising awareness among the public and healthcare practitioners to curtail antimicrobial overuse through informed prescribing practices [ 42 ]. The research underscores the ramifications of irrational antibiotic use, including the escalation of antimicrobial resistance, treatment failures, and heightened mortality rates, particularly evident in critical care settings [ 41 ].…”