Public knowledge,attitudes and behaviour regarding antibiotics

Objective: To assess public knowledge, attitudes and behaviour regarding antibiotics to provide information for a local health education policy.

Design: Postal survey to 605 patients registered with two general medical practices in Grampian, NorthEast Scotland (351 respondents, 59.3%) in February/ March 2000. Questionnaire topics covered attitudes, knowledge and behaviour towards antibiotic use.

Results: 326 (93%) bad experience of antibiotic use and 319 (81%) were happy to take antibiotics when necessary. 158 (45%) were concerned about antibiotic resistance. Few would expect antibiotics to treat a slight cold or heavy cold, but around half would expect antibiotics for very sore throats and influenza. 262 (75%) indicated they would ask a pharmacist for advice about the treatment of RTI. Most respondents experienced at least one episode of RTI during the review period. 280 (80%) provided details of their most recent episode; most self-treated, 57 consulted a doctor of whom 43 (75%) were prescribed antibiotics.

Conclusions: Antibiotic resistance is a matter of concern for the public. Mixed opinions about the use of antibiotics for common respiratory tract infection were heard. Encouragingly the majority of people suffering an RTI during the review period treated themselves with paracetamol-based products for symptom relief. Those who consulted a doctor were in the minority but were likely to be prescribed antibiotics. Future local health education initiatives should target antibiotic use for sore throats as well as colds and flu.     

Factors influencing antibiotic prescribing in China: an exploratory analysis

OBJECTIVES: China has very high rates of antibiotic resistance and a health care system that provides strong incentives for over-prescribing. This paper describes the findings of a qualitative study in a province of southern China that seeks to assess knowledge, attitudes, and practices in relation to the use of antibiotics. METHODS: Semi-structured interviews with patients and health workers at provincial, county, township, and village level. Interviews used four probes (common cold, cough, mild diarrhoea and tiredness) where antibiotics were not indicated, supplemented by questions on knowledge, attitudes, and practices. These data were supplemented by two focus groups, with medical students and pharmacists, and discussions with participants at a national conference on antibiotic use. RESULTS: Coughs and diarrhoea are almost universally treated with antibiotics, while the cold is normally treated with antivirals instead or as well. Many physicians are aware that the cold is usually self-limiting but believe that they can speed recovery and that they are responding to patient expectations. Most physicians and many patients are aware of the phenomenon of antibiotic resistance, although it is often seen as a property acquired by the patient and not the micro-organism. Physicians face financial incentives to prescribe, with profit splitting with pharmaceutical suppliers. Sales profits form a major part of a hospital's income. National guidance on use of antibiotics is fragmentary and incomplete. CONCLUSION: The misuse of antibiotics poses considerable risks. Effective action will require a multi-faceted strategy including education, based on an understanding of existing beliefs, the replacement of perverse incentives with those promoting best practice, and investment in improved surveillance. Much of this will require action at national level.     

Antibiotic use and upper respiratory infections: a survey of knowledge, attitudes, and experience in Wisconsin and Minnesota

BACKGROUND: Public attitudes and expectations contribute to inappropriate antibiotic prescribing and antibiotic resistance. This study assessed knowledge, attitudes, and experiences regarding antibiotic use for respiratory infection or illness. METHODS: Random-digit-dialing telephone surveys of adults and parents of children <5 years old were conducted in Wisconsin and Minnesota during 1999. RESULTS: The survey was completed by 405 adults and 275 parents of children <5 years old. The median age was 32 years for parents and 50 years for adults. Seven percent of parents and 17% of adults believed that antibiotics are never or almost never necessary for bronchitis. More than 70% in each group believed that antibiotics are needed for green or yellow nasal drainage, and nearly half of respondents believed that they knew whether an antibiotic was needed before seeing a physician. Exposure to multiple information sources on antibiotic resistance in the past 6 months was independently associated with a knowledge score greater than or equal to the median for nine questions. CONCLUSIONS: The general public has misconceptions regarding indications for antibiotic use, and this may contribute to inappropriate prescribing. Providing multiple and varied antibiotic-related informational messages may increase knowledge of appropriate antibiotic prescribing and decrease patient demand for antibiotics.     

基于医生和患者角度的抗生素不合理使用行为

目的：分析农村居民感冒时抗生素使用态度和行为以及医务人员对待感冒患者的抗生素用药态度和处方行为,探讨针对医患双方的抗生素合理使用干预措施。方法：采用农村居民问卷、医务人员问卷和处方资料中涉及感冒抗生素用药的相关数据进行综合分析,共计居民问卷810份,医生问卷188份,感冒处方1 590份。结果：78.40%的农村居民表示在感冒时会选择使用抗生素类药品,村卫生室的感冒处方中抗生素使用率占70.91%;1.05%的医生表示面对一般感冒患者时会使用抗生素,但处方分析结果显示农村地区54.65%的感冒处方中含有抗生素药品。结论： 农村居民的抗生素用药态度与实际用药行为一致,而医务人员的抗生素用药态度与实际行为不一致,促进农村地区抗生素合理使用首先需要转变农村居民对抗生素的用药态度;而对医务人员来说,需要根据其态度与行为不一致的原因有针对性地采取相关措施来改变其不合理的抗生素处方行为。     

Sexual behavior, knowledge, and attitudes about AIDS among college freshmen.

We surveyed 158 college freshmen on an urban campus to determine their sexual practices and their knowledge and attitudes about acquired immunodeficiency syndrome (AIDS). Many students (47%) were heterosexually active; 1% were homosexual, 1% were bisexual, and 51% had not been sexually active. Among the 77 sexually active students, many engaged in activities that can facilitate transmission of human immunodeficiency virus (HIV): 58% did not always use condoms with a new partner; 31% had had two or more sex partners in the last year; 8% engaged in anonymous sex; and 14% of sexually active women had anal intercourse. Although most sexually active students said they would use condoms more or reduce the number of their sexual partners if they believed these changes would reduce "my risk for getting AIDS," few students had adopted these safer sexual practices. Safer sexual practices were associated with heightened personal concerns about AIDS but not with knowledge, which was at a high level. These findings underscore the need for preventive programs that overcome the gap between knowledge and safer sexual behaviors in this and similar groups of adolescents and suggest that programs that heighten personal concerns may be most effective. Community-based physicians who care for adolescents should develop such preventive programs and integrate them into their practices.     

Sore throat management practices of Canadian family physicians

OBJECTIVES AND METHODS: A survey was conducted of Canadian family physicians about their usual sore throat management practices. Physician knowledge, attitudes, beliefs and the effect of selected patient factors on variation in practices was assessed. RESULTS: The majority of physicians did not follow North American expert recommendations to usually take a throat culture and wait for culture results before prescribing an antibiotic. Similarly to the practices of family physicians in many countries, they favoured a clinical policy of selective use of throat cultures and decisions about the need for antibiotics based on clinical judgement. CONCLUSIONS: Physician practice site, demographics, knowledge, attitudes, beliefs and patient factors did not explain differences in approach. The implications for antibiotic utilization in the management of upper respiratory tract infections are discussed.      

高中生参观性病/艾滋病图片展前后KAP调查分析

目的：了解闵行区高中生艾滋病知、信、行现状以及探索艾滋病宣传策略。方法：对闵行区两个班的高中学生参观性病艾滋病图片展览前后问卷调查。结果：高中学生艾滋病知识水平不高,参观前平均知晓率５９．４％,参观后６５．９％;６１．１％的学生希望获得性病／艾滋病知识,女生为６２．１％;４６．３％的学生认为,为预防艾滋病人们能控制自己的性行;３６．８％认为与一个新性伴发生性关系时应使用避孕套;４４．２％认为人一生     

Unnecessary antibiotic use for mild acute respiratory infections during 28-day follow-up of 823 children under five in rural Vietnam

Few prospective studies regarding antibiotic use for mild acute respiratory infections (ARI) have been conducted in community settings. This paper aimed to assess knowledge of children's caregivers and actual antibiotic use for children under five and to identify factors associated with antibiotic treatment for mild ARIs. Caregivers in 828 households in Bavi, Vietnam, were interviewed using a structured questionnaire assessing both knowledge and practice. Subsequently, 823 children were followed for 28 days to collect information regarding symptoms and drug use. For management of ARIs, only 13% of caregivers demonstrated correct overall knowledge in accordance with standard guidelines. The symptoms of the most recent illness were consistent with mild ARI in 79% of cases, and antibiotics were used in 71% of these. During the 28-day period, 62% of children had been given antibiotics and 63% of antibiotic courses were used for mild ARIs. One-half of the mild ARI episodes and 63% of the children with mild ARIs were treated with antibiotics. Most of the unnecessary antibiotic treatment was recommended by healthcare providers (82%). Most of the children had been administered antibiotics for common colds, although most caregivers believed that antibiotics were not required. Antibiotics were unnecessarily recommended at health facilities in the area.     

Attitudes of rural and urban elderly concerning supplement use

To examine supplement purchase practices and attitudes toward supplements of rural and urban elderly, two questionnaires were designed. One questionnaire included demographic questions, an attitude scale, and questions concerning supplements purchases and sources of information about nutrition. The second questionnaire contained an advertisement about calcium supplements followed by questions regarding means to "improve calcium" and health concerns. The rural elderly had a significantly lower mean education level and a significantly higher number of misconceptions. The average expenditures on supplements were $52.00 per month for the total group and sources of information were media, physicians, family and friends. In response to the advertisement, nearly one-third of the respondents reported that they would be unlikely to take calcium supplements to improve calcium even though 86.7% stated they would take calcium supplements to prevent health problems and 51.7% believed there could be dangers in taking calcium supplements. The most commonly reported means to improve calcium were to increase milk and to eat cheese (86.7% each). Contradictions in the responses may indicate that these elderly are susceptible to advertising implying supplements are needed to prevent health problems.     

Attitudes of Rural and Urban Elderly Concerning Supplement Use

To examine supplement purchase practices and attitudes toward supplements of rural and urban elderly. two questionnaires were designed. One questionnaire included demographic questions, an attitude scale, and questions concerning supplement purchases and sources of information about nutrition, The second questionnaire contained an advertisement about calcium supplements followed by questions regarding means to "improve calcium" and health concerns. The rural elderly had a significantly lower mean education level and a significantly higher number of misconceptions. The average expenditures on supplements were $52.00 per month for the total group and sources of information were media, physicians, family and friends. In response to the advertisement, nearly one-third of the respondents reported that they would be unlikely to take calcium supplements to improve calcium even though 86.7% stated they would take calcium supplements to prevent health problems and 51.7% believed there could be dangers in taking calcium supplements. The most commonly reported means to improve calcium were to increase milk and to eat cheese (86.7% each). Contradictions in the responses may indicate that these elderly are susceptible to advertising implying supplements are needed to prevent health problems.     

山东省农村居民抗生素认知与使用行为

目的：分析农村居民的抗生素认知及使用行为,探讨农村居民抗生素不合理使用的原因,提出有针对性的干预措施。方法： 采用分层随机抽样方法抽取山东省3县18村1 014名农村居民进行问卷调查,分析其抗生素认知和行为现状,比较不同人群间的差异。结果： 34.7%的农村居民不知道抗生素,而使用过抗生素的居民占 80.3%;在知道或用过抗生素居民中,63.8%不知道购买抗生素需凭医生处方的规定;居民获得抗生素的主要场所是村卫生室,而选用抗生素时考虑的因素主要是医生建议。此外,各年龄段居民中以7岁以下儿童抗生素滥用现象最严重。结论：农村地区存在抗生素不合理使用现象,居民对抗生素相关知识认识不足,乡村医生和年轻的父母是今后农村抗生素合理使用促进工作的重点干预人群。     

Asthma education for school staff in Riyadh city: effectiveness of pamphlets as an educational tool

Teachers and support staff are often called upon to manage asthma at school but may have little knowledge and understanding of the condition. The objectives of this study were to develop educational package (pamphlets) about asthma, and assess its effectiveness as an educational tool for schools' staff through evaluation of its impact on the staff's asthma-related knowledge, attitudes and management practices on their pupils. A pre-post experimental research design was used in Riyadh city with distribution of self-administered questionnaires and asthma package to 4 randomly selected girls schools compounds. Participants were school staff (n = 297) of primary, intermediate and secondary schools. Results showed that only 5.7% of the staff had received previous training in asthma education. Lack of knowledge and misconceptions about asthma medication were evident among a considerable proportion of the staff specifically for use of antibiotics, steroids, side effect of ventolin, and addicting effect of inhalers. At pretest, only 35% and 40.1% of the staff had good level of knowledge and management practices. At posttest, the corresponding percentages increased significantly to be 83.9% and 68.6% respectively. The mean total score of staff's asthma related-attitudes became more favorable towards asthma education after intervention, it increased significantly from 53.5 to be 55.0. Total posttest knowledge score was the only predictor of both staff attitudes and management practices constituting 9.1% and 10.2% of their variance. The great majority cited lack of training (92%), unavailability school policy (86.8%), and shortage of educational resources (88.3%) as barriers against asthma education and management in their schools. Conclusions: Most of school staff had poor to fair level of asthma knowledge and management practices. Such simple educational intervention using pamphlets and demonstration of inhaler use and peaked flow meter was significantly successful in enhancing staff's asthma-related knowledge, attitudes and management practices among their pupils. It is very important that training is directed to all staff as pre-service and in-service programs.