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Published in: BMC Infectious Diseases 1/2022

Open Access 01-12-2022 | Antibiotic | Research

Prevalence of inappropriate use behaviors of antibiotics and related factors among chinese antibiotic users: an online cross-sectional survey

Authors: Xiaoxv Yin, Yanhong Gong, Na Sun, Dandan Li, Jianxiong Wu, Jing Wang, Lei Qiu, Hui Li

Published in: BMC Infectious Diseases | Issue 1/2022

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Abstract

Background

Inappropriate use of antibiotics could have a profound negative impact on individual and community. This study aimed to assess the prevalence of inappropriate use behaviors of antibiotics in Chinese antibiotic users and explored their related factors.

Methods

A cross-sectional survey was conducted from July 1, 2018 to September 30, 2018. A structured questionnaire was widely distributed on the online survey platform (Questionnaire Star, https://​www.​wjx.​cn) and was used to collect data from respondents in China on demographic and sociological characteristics, antibiotic use and related knowledge. Main outcomes included self-medication with antibiotics (SMA), self-storage with antibiotics (SSA), and non-adherence to antibiotic treatment (NAAT). Logistic regression was used to identify the related factors of above inappropriate use behaviors of antibiotics.

Results

Of the 15,526 participants, 37.1% reported SMA in the past 6 months, 67.9% reported SSA in the past 6 months, and 48.3%, 15.2%, 25.5% and 78.0% of respondents said that they had missed antibiotics, increased antibiotic dosage, decreased antibiotic dosage, and discontinued antibiotics once symptoms disappear, respectively. Overall, 53.3% reported NAAT during this period. After adjusting for other variables, multivariate logistic regression analyses showed that those aged 30–44 years old, with higher levels of education, poorer status of self-perceived health, or lower levels of antibiotic knowledge were more likely to have these inappropriate use behaviors of SMA, SSA, and NAAT (P < 0.05).

Conclusions

The prevalence of SMA, SSA, and NAAT is high in China. Developing a nationwide action plan for the rational use of antibiotics among publics, including national media publicity, online and offline health education, and medication guidance from general practitioners, is urgently needed.
Literature
1.
go back to reference Högberg LD, Muller A, Zorzet A, Monnet DL, Cars O. Antibiotic use worldwide. Lancet Infect Dis. 2014;14(12):1179–80.CrossRef Högberg LD, Muller A, Zorzet A, Monnet DL, Cars O. Antibiotic use worldwide. Lancet Infect Dis. 2014;14(12):1179–80.CrossRef
2.
go back to reference Tangcharoensathien V, Chanvatik S, Sommanustweechai A. Complex determinants of inappropriate use of antibiotics. Bull World Health Organ. 2018;96(2):141–4.CrossRef Tangcharoensathien V, Chanvatik S, Sommanustweechai A. Complex determinants of inappropriate use of antibiotics. Bull World Health Organ. 2018;96(2):141–4.CrossRef
3.
go back to reference WHO. The world health report 2007: a safer future: global public health security in the 21st century. World Health Organization; 2007. WHO. The world health report 2007: a safer future: global public health security in the 21st century. World Health Organization; 2007.
4.
go back to reference Grigoryan L, Haaijer-Ruskamp FM, Burgerhof JG, Mechtler R, Deschepper R, Tambic-Andrasevic A, et al. Self-medication with antimicrobial drugs in Europe. Emerg Infect Dis. 2006;12(3):452–9.CrossRef Grigoryan L, Haaijer-Ruskamp FM, Burgerhof JG, Mechtler R, Deschepper R, Tambic-Andrasevic A, et al. Self-medication with antimicrobial drugs in Europe. Emerg Infect Dis. 2006;12(3):452–9.CrossRef
5.
go back to reference Kardas P, Pechere JC, Hughes DA, Cornaglia G. A global survey of antibiotic leftovers in the outpatient setting. Int J Antimicrob Agents. 2007;30(6):530–6.CrossRef Kardas P, Pechere JC, Hughes DA, Cornaglia G. A global survey of antibiotic leftovers in the outpatient setting. Int J Antimicrob Agents. 2007;30(6):530–6.CrossRef
6.
go back to reference Almohammed RA, Bird EL. Public knowledge and behaviours relating to antibiotic use in Gulf Cooperation Council countries: a systematic review. J Infect Public Health. 2019;12(2):159–66.CrossRef Almohammed RA, Bird EL. Public knowledge and behaviours relating to antibiotic use in Gulf Cooperation Council countries: a systematic review. J Infect Public Health. 2019;12(2):159–66.CrossRef
7.
go back to reference Fatokun O. Exploring antibiotic use and practices in a Malaysian community. Int J Clin Pharm. 2014;36(3):564–9.CrossRef Fatokun O. Exploring antibiotic use and practices in a Malaysian community. Int J Clin Pharm. 2014;36(3):564–9.CrossRef
8.
go back to reference Huh K, Chung DR, Kim SH, Cho SY, Ha YE, Kang CI, et al. Factors affecting the public awareness and behavior on antibiotic use. Eur J Clin Microbiol Infect Dis. 2018;37(8):1547–52.CrossRef Huh K, Chung DR, Kim SH, Cho SY, Ha YE, Kang CI, et al. Factors affecting the public awareness and behavior on antibiotic use. Eur J Clin Microbiol Infect Dis. 2018;37(8):1547–52.CrossRef
9.
go back to reference Ocan M, Bbosa GS, Waako P, Ogwal-Okeng J, Obua C. Factors predicting home storage of medicines in Northern Uganda. BMC Public Health. 2014;14:650.CrossRef Ocan M, Bbosa GS, Waako P, Ogwal-Okeng J, Obua C. Factors predicting home storage of medicines in Northern Uganda. BMC Public Health. 2014;14:650.CrossRef
10.
go back to reference Machado-Alba JE, Echeverri-Cataño LF, Londoño-Builes MJ, Moreno-Gutiérrez PA, Ochoa-Orozco S, ARuiz-Villa JO. Social, cultural and economic factors associated with self-medication. Biomedica. 2014;34(4):580–8.PubMed Machado-Alba JE, Echeverri-Cataño LF, Londoño-Builes MJ, Moreno-Gutiérrez PA, Ochoa-Orozco S, ARuiz-Villa JO. Social, cultural and economic factors associated with self-medication. Biomedica. 2014;34(4):580–8.PubMed
11.
go back to reference Xiao Y. Antimicrobial stewardship in China: systems, actions and future strategies. Clin Infect Dis. 2018;67(suppl_2):S135–41.CrossRef Xiao Y. Antimicrobial stewardship in China: systems, actions and future strategies. Clin Infect Dis. 2018;67(suppl_2):S135–41.CrossRef
12.
go back to reference Xiao Y, Zhang J, Zheng B, Zhao L, Li S, Li L. Changes in Chinese policies to promote the rational use of antibiotics. PLoS Med. 2013;10(11): e1001556.CrossRef Xiao Y, Zhang J, Zheng B, Zhao L, Li S, Li L. Changes in Chinese policies to promote the rational use of antibiotics. PLoS Med. 2013;10(11): e1001556.CrossRef
14.
go back to reference Kuang L, Liu Y, Wei W, Song X, Li X, Liu Q, et al. Non-prescription sale of antibiotics and service quality in community pharmacies in Guangzhou, China: A simulated client method. PLoS ONE. 2020;15(12): e243555.CrossRef Kuang L, Liu Y, Wei W, Song X, Li X, Liu Q, et al. Non-prescription sale of antibiotics and service quality in community pharmacies in Guangzhou, China: A simulated client method. PLoS ONE. 2020;15(12): e243555.CrossRef
15.
go back to reference Gong Y, Jiang N, Chen Z, Wang J, Zhang J, Feng J, et al. Over-the-counter antibiotic sales in community and online pharmacies. China Bull World Health Organ. 2020;98(7):449–57.CrossRef Gong Y, Jiang N, Chen Z, Wang J, Zhang J, Feng J, et al. Over-the-counter antibiotic sales in community and online pharmacies. China Bull World Health Organ. 2020;98(7):449–57.CrossRef
16.
go back to reference Lv B, Zhou Z, Xu G, Yang D, Wu L, Shen Q, et al. Knowledge, attitudes and practices concerning self-medication with antibiotics among university students in western China. Trop Med Int Health. 2014;19(7):769–79.CrossRef Lv B, Zhou Z, Xu G, Yang D, Wu L, Shen Q, et al. Knowledge, attitudes and practices concerning self-medication with antibiotics among university students in western China. Trop Med Int Health. 2014;19(7):769–79.CrossRef
17.
go back to reference Ye D, Chang J, Yang C, Yan K, Ji W, Aziz MM, et al. How does the general public view antibiotic use in China? Result from a cross-sectional survey. Int J Clin Pharm. 2017;39(4):927–34.CrossRef Ye D, Chang J, Yang C, Yan K, Ji W, Aziz MM, et al. How does the general public view antibiotic use in China? Result from a cross-sectional survey. Int J Clin Pharm. 2017;39(4):927–34.CrossRef
18.
go back to reference Yu M, Zhao G, Stålsby LC, Zhu Y, Zhao Q, Xu B. Knowledge, attitudes, and practices of parents in rural China on the use of antibiotics in children: a cross-sectional study. BMC Infect Dis. 2014;14:112.CrossRef Yu M, Zhao G, Stålsby LC, Zhu Y, Zhao Q, Xu B. Knowledge, attitudes, and practices of parents in rural China on the use of antibiotics in children: a cross-sectional study. BMC Infect Dis. 2014;14:112.CrossRef
19.
go back to reference Li Y, Song Y, Shao R, Jiang J, Huang D, Lu Y, et al. Determinants of self-medication with antibiotics among residents in Nantong(Chinese). Chin Health Serv Manag. 2016;33(01):39–41. Li Y, Song Y, Shao R, Jiang J, Huang D, Lu Y, et al. Determinants of self-medication with antibiotics among residents in Nantong(Chinese). Chin Health Serv Manag. 2016;33(01):39–41.
20.
go back to reference China National Health Commission. China Health Statistics Yearbook (2018). Beijing: Chinese Peking Union Medical College Press; 2018. China National Health Commission. China Health Statistics Yearbook (2018). Beijing: Chinese Peking Union Medical College Press; 2018.
21.
go back to reference Sanson-Fisher R, Bowman J, Armstrong S. Factors affecting nonadherence with antibiotics. Diagn Microbiol Infect Dis. 1992;15(4 Suppl):103S-109S.CrossRef Sanson-Fisher R, Bowman J, Armstrong S. Factors affecting nonadherence with antibiotics. Diagn Microbiol Infect Dis. 1992;15(4 Suppl):103S-109S.CrossRef
22.
go back to reference Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG Clinical guideline: treatment of Helicobacter pylori infection. Am J Gastroenterol. 2017;112(2):212–39.CrossRef Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG Clinical guideline: treatment of Helicobacter pylori infection. Am J Gastroenterol. 2017;112(2):212–39.CrossRef
23.
go back to reference Llewelyn MJ, Fitzpatrick JM, Darwin E, Tonkin-Crine S, Gorton C, Paul J, et al. The antibiotic course has had its day. BMJ. 2017;358:j3418.CrossRef Llewelyn MJ, Fitzpatrick JM, Darwin E, Tonkin-Crine S, Gorton C, Paul J, et al. The antibiotic course has had its day. BMJ. 2017;358:j3418.CrossRef
24.
go back to reference Ateshim Y, Bereket B, Major F, Emun Y, Woldai B, Pasha I, et al. Prevalence of self-medication with antibiotics and associated factors in the community of Asmara, Eritrea: a descriptive cross sectional survey. BMC Public Health. 2019;19(1):726.CrossRef Ateshim Y, Bereket B, Major F, Emun Y, Woldai B, Pasha I, et al. Prevalence of self-medication with antibiotics and associated factors in the community of Asmara, Eritrea: a descriptive cross sectional survey. BMC Public Health. 2019;19(1):726.CrossRef
25.
go back to reference Tomas A, Paut KM, Tomić Z, Horvat O, Djurović Koprivica D, Bukumirić D, et al. Self-medication with antibiotics in Serbian households: a case for action? Int J Clin Pharm. 2017;39(3):507–13.CrossRef Tomas A, Paut KM, Tomić Z, Horvat O, Djurović Koprivica D, Bukumirić D, et al. Self-medication with antibiotics in Serbian households: a case for action? Int J Clin Pharm. 2017;39(3):507–13.CrossRef
26.
go back to reference McNulty CA, Boyle P, Nichols T, Clappison P, Davey P. Don’t wear me out–the public’s knowledge of and attitudes to antibiotic use. J Antimicrob Chemother. 2007;59(4):727–38.CrossRef McNulty CA, Boyle P, Nichols T, Clappison P, Davey P. Don’t wear me out–the public’s knowledge of and attitudes to antibiotic use. J Antimicrob Chemother. 2007;59(4):727–38.CrossRef
27.
go back to reference Al-Azzam SI, Al-Husein BA, Alzoubi F, Masadeh MM, Al-Horani MA. Self-medication with antibiotics in Jordanian population. Int J Occup Med Environ Health. 2007;20(4):373–80.CrossRef Al-Azzam SI, Al-Husein BA, Alzoubi F, Masadeh MM, Al-Horani MA. Self-medication with antibiotics in Jordanian population. Int J Occup Med Environ Health. 2007;20(4):373–80.CrossRef
28.
go back to reference El-Zowalaty ME, Belkina T, Bahashwan SA, El-Zowalaty AE, Tebbens JD, Abdel-Salam HA, et al. Knowledge, awareness, and attitudes toward antibiotic use and antimicrobial resistance among Saudi population. Int J Clin Pharm. 2016;38(5):1261–8.CrossRef El-Zowalaty ME, Belkina T, Bahashwan SA, El-Zowalaty AE, Tebbens JD, Abdel-Salam HA, et al. Knowledge, awareness, and attitudes toward antibiotic use and antimicrobial resistance among Saudi population. Int J Clin Pharm. 2016;38(5):1261–8.CrossRef
30.
go back to reference Vaughn VM, Flanders SA, Snyder A, Conlon A, Rogers MA, Malani AN, et al. Excess antibiotic treatment duration and adverse events in patients hospitalized with pneumonia: a multihospital cohort study. Ann Intern Med. 2019;171(3):153–63.CrossRef Vaughn VM, Flanders SA, Snyder A, Conlon A, Rogers MA, Malani AN, et al. Excess antibiotic treatment duration and adverse events in patients hospitalized with pneumonia: a multihospital cohort study. Ann Intern Med. 2019;171(3):153–63.CrossRef
31.
go back to reference Bogale AA, Amhare AF, Chang J, Bogale HA, Betaw ST, Gebrehiwot NT, et al. Knowledge, attitude, and practice of self-medication with antibiotics among community residents in Addis Ababa, Ethiopia. Expert Rev Anti Infect Ther. 2019;17(6):459–66.CrossRef Bogale AA, Amhare AF, Chang J, Bogale HA, Betaw ST, Gebrehiwot NT, et al. Knowledge, attitude, and practice of self-medication with antibiotics among community residents in Addis Ababa, Ethiopia. Expert Rev Anti Infect Ther. 2019;17(6):459–66.CrossRef
32.
go back to reference Grosso G, Marventano S, Ferranti R, Mistretta A. Pattern of antibiotic use in the community: non-adherence and self-prescription rates in an Italian urban population. Mol Med Rep. 2012;5(5):1305–10.PubMed Grosso G, Marventano S, Ferranti R, Mistretta A. Pattern of antibiotic use in the community: non-adherence and self-prescription rates in an Italian urban population. Mol Med Rep. 2012;5(5):1305–10.PubMed
33.
go back to reference Mitsi G, Jelastopulu E, Basiaris H, Skoutelis A, Gogos C. Patterns of antibiotic use among adults and parents in the community: a questionnaire-based survey in a Greek urban population. Int J Antimicrob Agents. 2005;25(5):439–43.CrossRef Mitsi G, Jelastopulu E, Basiaris H, Skoutelis A, Gogos C. Patterns of antibiotic use among adults and parents in the community: a questionnaire-based survey in a Greek urban population. Int J Antimicrob Agents. 2005;25(5):439–43.CrossRef
34.
go back to reference Carvalho MF, Pascom AR, Souza-Júnior PR, Damacena GN, Szwarcwald CL. Utilization of medicines by the Brazilian population, 2003. Cad Saude Publica. 2005;21(Suppl):100–8.CrossRef Carvalho MF, Pascom AR, Souza-Júnior PR, Damacena GN, Szwarcwald CL. Utilization of medicines by the Brazilian population, 2003. Cad Saude Publica. 2005;21(Suppl):100–8.CrossRef
35.
go back to reference Napolitano F, Izzo MT, Di Giuseppe G, Angelillo IF. Public knowledge, attitudes, and experience regarding the use of antibiotics in Italy. PLoS ONE. 2013;8(12): e84177.CrossRef Napolitano F, Izzo MT, Di Giuseppe G, Angelillo IF. Public knowledge, attitudes, and experience regarding the use of antibiotics in Italy. PLoS ONE. 2013;8(12): e84177.CrossRef
36.
go back to reference Lee C, Norris P, Duck IM, Sibley CG. Demographic and psychological factors associated with feelings of antibiotic entitlement in New Zealand. Antibiotics (Basel). 2018;7(3):82.CrossRef Lee C, Norris P, Duck IM, Sibley CG. Demographic and psychological factors associated with feelings of antibiotic entitlement in New Zealand. Antibiotics (Basel). 2018;7(3):82.CrossRef
37.
go back to reference Wu J, Yang F, Yang H, Zhang G, Mu K, Feng J, et al. Prevalence of antibiotic self-medication behavior and related factors among children aged 0 to 5 years. Expert Rev Anti Infect Ther. 2021;19(9):1157–64.CrossRef Wu J, Yang F, Yang H, Zhang G, Mu K, Feng J, et al. Prevalence of antibiotic self-medication behavior and related factors among children aged 0 to 5 years. Expert Rev Anti Infect Ther. 2021;19(9):1157–64.CrossRef
38.
go back to reference Racey M, Machmueller D, Field D, Kulak V, Newton GS. Perceptions and use of sources of health knowledge by young adolescents. Int J Adolesc Med Health. 2016;30(1). Racey M, Machmueller D, Field D, Kulak V, Newton GS. Perceptions and use of sources of health knowledge by young adolescents. Int J Adolesc Med Health. 2016;30(1).
Metadata
Title
Prevalence of inappropriate use behaviors of antibiotics and related factors among chinese antibiotic users: an online cross-sectional survey
Authors
Xiaoxv Yin
Yanhong Gong
Na Sun
Dandan Li
Jianxiong Wu
Jing Wang
Lei Qiu
Hui Li
Publication date
01-12-2022
Publisher
BioMed Central
Keyword
Antibiotic
Published in
BMC Infectious Diseases / Issue 1/2022
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-022-07671-1

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