Inchara Manjunath, Reddy Mahendra M, Ramya Nagesh
Undergraduate Student, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India.
Indian Council of Medical Research - Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India.
J Educ Health Promot. 2022 Jun 30;11:181. doi: 10.4103/jehp.jehp_896_21. eCollection 2022.
Contribution to antibiotic resistance can happen at two interfaces - doctor prescribing antibiotics inadvertently or patient's usage of antibiotics inadvertently. This study was conducted among diabetic inpatients in a rural tertiary health center in Kolar, South India, to assess the various practices related to antibiotic use and to explore the possible reasons for these practices with regard to antibiotic use.
An exploratory sequential mixed-methods study was conducted with an initial cross-sectional quantitative study followed by qualitative in-depth interviews during August-September 2019. A pretested semi-structured questionnaire was used to capture the sociodemographic, disease-, and treatment-related characteristics and practices related to antibiotic use. An open-ended interview guide was used to conduct in-depth interviews. The practices to antibiotic use were reported using frequency (percentage). Manual descriptive content analyses were done by two investigators separately to identify codes under the broad topic "reasons for adopted practices with regard to antibiotic use."
Of the 152 diabetic inpatients interviewed, 20 (13.2%) felt that antibiotics are safe drugs and can be used commonly. Among these inpatients, seven (4.6%) knew that antibiotics can kill bacteria and four (2.6%) perceived 'antibiotic resistance' as a big problem in India. The practice of checking the expiry date before using antibiotics was seen in 21 (13.8%) and 44 (29%) of them finished the full course of antibiotics. A total of six codes were identified under the broad theme of "reasons for adopted practices with regard to antibiotic use" among diabetic inpatients.
Less than one-third of them completed the antibiotic course given by the doctor, and almost everyone was ready for over-the-counter purchase of antibiotics offered by the pharmacist. The reasons for such practices were mostly attributed to the "partial drug purchases" and "incomplete advice by the doctor." There is an urgent need to plan and deliver an interventional package to enhance the knowledge and inculcate good antibiotic usage practices among these high-risk populations.
抗生素耐药性的产生可能发生在两个环节——医生无意中开具抗生素或患者无意中使用抗生素。本研究在印度南部科拉尔一家农村三级医疗中心的糖尿病住院患者中开展，旨在评估与抗生素使用相关的各种行为，并探究这些抗生素使用行为背后可能的原因。
2019年8月至9月进行了一项探索性序贯混合方法研究，首先进行横断面定量研究，随后进行定性深入访谈。使用经过预测试的半结构化问卷收集社会人口统计学、疾病及治疗相关特征以及与抗生素使用相关的行为。使用开放式访谈指南进行深入访谈。抗生素使用行为以频率（百分比）报告。由两名研究人员分别进行手动描述性内容分析，以确定“抗生素使用行为背后的原因”这一宽泛主题下的编码。
在接受访谈的152名糖尿病住院患者中，20名（13.2%）认为抗生素是安全药物，可以经常使用。在这些患者中，7名（4.6%）知道抗生素能杀死细菌，4名（2.6%）认为“抗生素耐药性”在印度是个大问题。21名（13.8%）患者在使用抗生素前会检查保质期，44名（29%）患者完成了抗生素的全程治疗。在糖尿病住院患者“抗生素使用行为背后的原因”这一宽泛主题下，共确定了六个编码。
不到三分之一的患者完成了医生开具的抗生素疗程，几乎每个人都愿意从药剂师处购买非处方抗生素。这些行为的原因主要归因于“部分购药”和“医生建议不完整”。迫切需要规划并实施一套干预措施，以提高这些高危人群的知识水平，并灌输良好的抗生素使用习惯。
