Aponte-González Johanna, González-Acuña Angélica, Lopez José, Brown Paul, Eslava-Schmalbach Javier
Pharmacy Department, School of Sciences, Universidad Nacional de Colombia. Bogotá (Colombia).
Director Public Health and Health Sciences Research Institute, University of California. Merced, CA (United States).
Pharm Pract (Granada). 2019 Jan-Mar;17(1):1394. doi: 10.18549/PharmPract.2019.1.1394. Epub 2019 Mar 10.
The use of antibiotics without prescription is common in Colombia as well as in other developing countries. The objective of this study is to explore the attitudes and motivations associated with the use of antibiotics without prescription.
Focus group sessions were held with residents of Bogotá. Different socioeconomic groups were approached to identify possible differences of opinion. A semi-structured interview guide was used to guide the discussion, with thematic analysis used to identify central themes.
In total, 21 people, aged between 25 and 50 years participated in four focus groups. The results suggest that the use of antibiotics without prescription is common practice. The main reasons included barriers to access to prescribed medications due to limited health insurance. Even those with adequate access to health insurance report being willing to use a treatment without a prescription if they have confidence in its effectiveness. The relationship with the physician is important, but pharmacy storekeepers are also highly trusted. While some participants understood that antibiotics can cure infections but cause serious adverse events, several misconceptions about antibiotics therapy were identified. These included a lack of knowledge of resistance transmissibility among communities.
The results have implications for interventions aimed at reducing inappropriate use of antibiotics, highlighting i) how lack of access to timely care creates an incentive to self-prescribe, ii) the key role that pharmacy storekeepers play in the Colombian healthcare system and the need to include them in interventions, and iii) the misconceptions about inappropriate use of medications that need to be addressed by educational programs. These findings provide insights to other countries where antibiotics misuse is also a problem.
在哥伦比亚以及其他发展中国家，无处方使用抗生素的现象很普遍。本研究的目的是探讨与无处方使用抗生素相关的态度和动机。
与波哥大的居民举行了焦点小组会议。接触了不同社会经济群体以确定可能存在的意见差异。使用半结构化访谈指南指导讨论，并采用主题分析来确定核心主题。
共有21名年龄在25至50岁之间的人参加了四个焦点小组。结果表明，无处方使用抗生素是常见做法。主要原因包括医疗保险有限导致获取处方药存在障碍。即使那些有足够医疗保险的人也表示，如果他们对某种治疗的有效性有信心，也愿意在没有处方的情况下使用该治疗。与医生的关系很重要，但药店店主也备受信任。虽然一些参与者明白抗生素可以治愈感染但会导致严重不良事件，但也发现了一些关于抗生素治疗的误解。这些误解包括对社区中耐药性传播缺乏了解。
这些结果对旨在减少抗生素不当使用的干预措施具有启示意义，突出了以下几点：一是无法及时获得医疗服务如何促使人们自我开药；二是药店店主在哥伦比亚医疗保健系统中所起的关键作用以及将他们纳入干预措施的必要性；三是教育项目需要解决的关于药物不当使用的误解。这些发现为其他抗生素滥用也是问题的国家提供了见解。
