Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain.
PLoS One. 2020 Jul 22;15(7):e0232464. doi: 10.1371/journal.pone.0232464. eCollection 2020.
Antibiotic resistance is a major public health concern. It has been associated with factors such as uncontrolled consumption, lack of knowledge, beliefs, and sociodemographic characteristics. Lebanon is characterized by high levels of antibiotic misuse, as almost half of the population self-medicates with antibiotics and over 30% of the antibiotics are dispensed without prescription. To-date, no studies determined adequately the association between knowledge, beliefs and antibiotic misuse in Lebanon.
To assess the association between level of knowledge and beliefs about antibiotics, and antibiotic misuse in Lebanon.
We conducted a cross-sectional study among 1,421 parents of schoolchildren using an anonymous self-administered Knowledge, Attitude and Practices questionnaire. The participants´ level of agreement with each item of knowledge and beliefs was measured using a Likert-type (0-10) scale. Misuse practices in the last month were detected through a series of questions aimed at determining the level of compliance with physicians´ instructions in terms of dosage and duration. Data were analyzed using logistic regression.
277 participants (16%) acknowledged using antibiotics in the previous month, 41% of whom showed at least one misuse behavior. Misconceptions and beliefs about antibiotics substantially increased the odds of their misuse. For instance, participants who believed that antibiotics were effective in treating viruses, cold, or sore throat infections were twice as likely to misuse antibiotics [Adjusted Interquartile Odds Ratio (aIqOR): 2.08 (95%CI: 1.32, 3.19), aIqOR: 1.81 (95%CI: 1.41, 2.29), aIqOR: 2.19 (95%CI: 1.61, 2.93), respectively]. Parents who usually keep antibiotics at home antibiotics for future use were more likely to misuse antibiotics [aIqOR: 2.44 (95%CI: 1.68, 3.46)].
Our findings indicate that the low level of knowledge and the existence of erroneous beliefs about antibiotics are associated with increased odds of antibiotic misuse. Key elements including rationale prescription and control of dispensing should be addressed when designing educational campaigns against antibiotic misuse.
抗生素耐药性是一个主要的公共卫生问题。它与诸如不受控制的消费、缺乏知识、信念和社会人口特征等因素有关。黎巴嫩的抗生素滥用程度很高，几乎一半的人口自行用抗生素治疗，超过 30%的抗生素未经处方配药。迄今为止，尚无研究充分确定黎巴嫩的知识、信念与抗生素滥用之间的关系。
评估黎巴嫩抗生素知识和信念水平与抗生素滥用之间的关系。
我们对 1421 名小学生的家长进行了一项横断面研究，使用匿名自我管理的知识、态度和实践问卷。参与者对每一项知识和信念的同意程度使用李克特量表（0-10）进行衡量。通过一系列问题来检测上个月的滥用行为，旨在确定在剂量和持续时间方面遵守医生指示的程度。使用逻辑回归分析数据。
277 名参与者（16%）承认在过去一个月中使用了抗生素，其中 41%的人表现出至少一种滥用行为。对抗生素的误解和信念大大增加了他们滥用的可能性。例如，认为抗生素对治疗病毒、感冒或喉咙感染有效的参与者，抗生素滥用的可能性是其他人的两倍[调整四分位间距比值（aIqOR）：2.08（95%CI：1.32，3.19），aIqOR：1.81（95%CI：1.41，2.29），aIqOR：2.19（95%CI：1.61，2.93）]。通常将抗生素存放在家中以备将来使用的父母更有可能滥用抗生素[a IqOR：2.44（95%CI：1.68，3.46）]。
我们的研究结果表明，抗生素知识水平低和存在错误的抗生素信念与抗生素滥用的可能性增加有关。在设计针对抗生素滥用的教育活动时，应考虑包括合理处方和控制配药在内的关键因素。
