Grigoryan Larissa, Burgerhof Johannes G M, Degener John E, Deschepper Reginald, Lundborg Cecilia Stålsby, Monnet Dominique L, Scicluna Elizabeth A, Birkin Joan, Haaijer-Ruskamp Flora M
Department of Clinical Pharmacology, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, AV Groningen, The Netherlands.
Pharmacoepidemiol Drug Saf. 2007 Nov;16(11):1234-43. doi: 10.1002/pds.1479.
Although the relevance of cultural factors for antibiotic use has been recognized, few studies exist in Europe. We compared public attitudes, beliefs and knowledge concerning antibiotic use and self-medication between 11 European countries.
In total, 1101 respondents were interviewed on their attitudes towards appropriateness of self-medication with antibiotics and situational use of antibiotics, beliefs about antibiotics for minor ailments, knowledge about the effectiveness of antibiotics on viruses and bacteria and awareness about antibiotic resistance. To deal with the possible confounding effect of both use of self-medication and education we performed stratified analyses, i.e. separate analyses for users and non-users of self-medication, and for respondents with high and low education. The differences between countries were considered relevant when regression coefficients were significant in all stratum-specific analyses.
Respondents from the UK, Malta, Italy, Czech Republic, Croatia, Israel and Lithuania had significantly less appropriate attitudes, beliefs or knowledge for at least one of the dimensions compared with Swedish respondents. The Dutch, Austrian and Belgian respondents did not differ from Swedish for any dimension.
The most pronounced differences were for awareness about resistance, followed by attitudes towards situational use of antibiotics. Awareness about antibiotic resistance was the lowest in countries with higher prevalence of resistance.
尽管文化因素与抗生素使用的相关性已得到认可,但在欧洲此类研究较少。我们比较了11个欧洲国家公众对抗生素使用和自我药疗的态度、信念及知识。
总共对1101名受访者进行了访谈,内容涉及他们对抗生素自我药疗的适当性及抗生素的情境性使用的态度、对小病使用抗生素的信念、对抗生素对病毒和细菌有效性的了解以及对抗生素耐药性的认识。为处理自我药疗使用情况和教育程度可能产生的混杂效应,我们进行了分层分析,即分别对自我药疗使用者和非使用者,以及高学历和低学历受访者进行分析。当回归系数在所有分层特定分析中均显著时,各国之间的差异被视为具有相关性。
与瑞典受访者相比,来自英国、马耳他、意大利、捷克共和国、克罗地亚、以色列和立陶宛的受访者在至少一个维度上的态度、信念或知识明显不那么恰当。荷兰、奥地利和比利时受访者在任何维度上与瑞典受访者均无差异。
最显著的差异在于对抗生素耐药性的认识,其次是对抗生素情境性使用的态度。在耐药性患病率较高的国家,对抗生素耐药性的认识最低。