Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Infection Control Unit at Medical Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia.
PLoS One. 2021 Oct 20;16(10):e0258698. doi: 10.1371/journal.pone.0258698. eCollection 2021.
Antibiotic resistance is one of the biggest threats to global public health. Misuse of antibiotics has never been investigated on a nationwide scale among the general public in Malaysia. This study aimed to identify sociodemographic and knowledge factors associated with inappropriate use of antibiotics in the Malaysian context to inform the development of interventions to mitigate inappropriate antibiotic use. We conducted computer-assisted telephone interviews (CATI) between June 2019 and December 2019. The telephone numbers were randomly generated from the electronic residential telephone directory of all 13 states and 3 Federal Territories in Malaysia. The survey consisted of questions on demographics, knowledge about antibiotics and antibiotic resistance (53 items), and practices of antibiotic use (16 questions). A total of 864 complete responses were received. Pronounced erroneous beliefs that antibiotics are effective against infections caused by viruses and that antibiotics can speed up recovery from coughs and colds were evident. The proportions that were aware of the terms 'drug resistance', 'antimicrobial resistance', and 'superbugs' were low. The mean and standard deviation (SD) for the antibiotic knowledge score was 23.7 (SD ±9.25; range 0 to 50) out of a possible score of 52. Regarding antibiotic practices, a considerable proportion reported non-adherence to recommended doses. The mean and SD for the antibiotic practices score was 37.9 (SD ± 6.5; range 17 to 47) out of a possible score of 48. Participants who earned an average monthly household income of MYR1001-3000 (OR 1.61, 95% CI 1.04-2.50) were more likely to report higher antibiotic practice scores than those with <MYR1000. Participants with tertiary education attainment reported higher antibiotic practice scores (OR 1.99; 95%CI 1.02-3.91) than those with primary school and below. High antibiotic knowledge scores (OR 3.94; 95% CI 2.71-5.73) were associated with higher antibiotic practice scores. Inappropriate antibiotic use is influenced by demographics and antibiotic knowledge. This study calls for education interventions focused on the lower socio-economic status population to increase awareness and to promote appropriate antibiotic use.
抗生素耐药性是全球公共卫生面临的最大威胁之一。在马来西亚，从未对公众在全国范围内对抗生素的滥用情况进行过调查。本研究旨在确定与马来西亚背景下抗生素不合理使用相关的社会人口学和知识因素，为制定减轻抗生素不合理使用的干预措施提供信息。我们于 2019 年 6 月至 12 月期间进行了计算机辅助电话访谈 (CATI)。电话号码是从马来西亚 13 个州和 3 个联邦领土的电子居民电话簿中随机生成的。调查包括人口统计学、抗生素和抗生素耐药性知识（53 项）以及抗生素使用实践（16 个问题）。共收到 864 份完整回复。人们明显存在错误的信念，认为抗生素对病毒引起的感染有效，抗生素可以加速咳嗽和感冒的康复。知道“耐药性”、“抗菌耐药性”和“超级细菌”这些术语的比例很低。抗生素知识得分的平均值和标准差（SD）为 23.7（SD ±9.25；范围 0 至 50），满分为 52 分。关于抗生素使用实践，相当一部分人报告不遵守推荐剂量。抗生素使用实践得分的平均值和标准差为 37.9（SD ±6.5；范围 17 至 47），满分为 48 分。月收入为 1001-3000 令吉（马来西亚林吉特）的参与者（OR 1.61，95%CI 1.04-2.50）比收入低于 1000 令吉的参与者更有可能报告较高的抗生素使用实践得分。具有高等教育学历的参与者（OR 1.99；95%CI 1.02-3.91）比小学及以下学历的参与者报告更高的抗生素使用实践得分。较高的抗生素知识得分（OR 3.94；95%CI 2.71-5.73）与较高的抗生素使用实践得分相关。抗生素的不合理使用受到人口统计学和抗生素知识的影响。本研究呼吁针对社会经济地位较低的人群开展教育干预措施，以提高认识并促进抗生素的合理使用。
