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CC BY-NC-ND 4.0 · Avicenna J Med 2021; 11(03): 132-138
DOI: 10.1055/s-0041-1732815
Original Article

Assessing the Syrian Population’s Knowledge, Attitudes, and Practices Regarding Antibiotic Usage

Abdallah Altorkmani
1   Faculty of Medicine, Department of Internal Medicine, Syrian Private University, Damascus, Syria
,
Mhd Amin Alzabibi
1   Faculty of Medicine, Department of Internal Medicine, Syrian Private University, Damascus, Syria
,
Mosa Shibani
1   Faculty of Medicine, Department of Internal Medicine, Syrian Private University, Damascus, Syria
,
Hlma Ismail
1   Faculty of Medicine, Department of Internal Medicine, Syrian Private University, Damascus, Syria
,
Bisher Sawaf
2   Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
,
Nizar Daher
1   Faculty of Medicine, Department of Internal Medicine, Syrian Private University, Damascus, Syria
,
Ahmad Al-Moujahed
3   Department of Ophthalmology, Byers Eye Institute, Stanford School of Medicine, Stanford, California, United States
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Abstract

Background Antibiotic resistance is a serious public health threat that results mainly secondary to antibiotics misuse. The present study aimed to determine the knowledge, attitude, and practice toward antibiotic use among the Syrian population.

Methods This cross-sectional study was conducted at the outpatient clinics of two major hospitals in Damascus, Syria. Applying a random convenience sampling, data were collected in a 1-week period by interviewing participants using a structured questionnaire, which targeted demographics, practice, knowledge, and attitude. Data were used to assess the relationship between the knowledge level and attitudes and demographics.

Results Most respondents had a moderate level of knowledge (187, 74.8%) and a moderate attitude score (148, 59.2%). In addition, most respondents (149, 59.6%) stated that they take antibiotics based on pharmacist advice only and do not complete the full antibiotic course (200, 80%). A significant association was found between the knowledge level and financial status (p-value = 0.003), education level (p-value = 0.001), and having relatives working in the health care sector (p-value = 0.021). In addition, a significant association was found between the attitude and having health insurance.

Conclusion This study provides baseline evidence about the knowledge, attitudes, and practices regarding antibiotics among the Syrian population, that will help in designing targeted interventions to solve the inappropriate use of antibiotics.

Keywords

antibiotic use - antibiotic resistance - knowledge - attitude - practices - Syria

Supplementary Material



Publikationsverlauf

Artikel online veröffentlicht:
13. August 2021

© 2021. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Franco E, ed. The Global Risks Report 2020. Cologny, Switzerland: World Economic Forum; 2020
  • 2 Vilá JJ. Update on antibacterial resistance in low-income countries: factors favoring the emergence of resistance. Open Infect Dis J 2010; 4: 38-54
    Google Scholar
  • 3 Nations ICGoARJRtts-gotU. No time to Wait: Securing the Future from Drug-Resistant Infections. Geneva, Switzerland: World Health Organization 2019
  • 4 World Health Organization. Antimicrobial Resistance: Global Report on Surveillance. Geneva, Switzerland: World Health Organization 2014
  • 5 Coast J, Smith RD, Millar MR. Superbugs: should antimicrobial resistance be included as a cost in economic evaluation?. Health Econ 1996; 5 (03) 217-226
    CrossrefPubMedGoogle Scholar
  • 6 World Health Organization %J World Health Day A. Antimicrobial Resistance: No Action Today, No Cure Tomorrow. Geneva, Switzerland: World Health Organization; 2011
  • 7 Taylor J, Hafner M, Yerushalmi E. et al. Estimating the Economic Costs of Antimicrobial Resistance: Model and Results. Santa Monica, CA: RAND Corporation 2014
  • 8 World Health Organization. Antibiotic Resistance: Multi-Country Public Awareness Survey. Geneva, Switzerland: World Health Organization; 2015
  • 9 McNulty CA, Boyle P, Nichols T, Clappison P, Davey P. The public’s attitudes to and compliance with antibiotics. J Antimicrob Chemother 2007; 60 (Suppl. 01) i63-i68
    CrossrefPubMedGoogle Scholar
  • 10 Van Duong D, Binns CW, Van Le T. Availability of antibiotics as over-the-counter drugs in pharmacies: a threat to public health in Vietnam. Trop Med Int Health 1997; 2 (12) 1133-1139
    CrossrefPubMedGoogle Scholar
  • 11 Yagupsky P. Selection of antibiotic-resistant pathogens in the community. Pediatr Infect Dis J 2006; 25 (10) 974-976
    CrossrefPubMedGoogle Scholar
  • 12 Michael CA, Dominey-Howes D, Labbate M. The antimicrobial resistance crisis: causes, consequences, and management. Front Public Health 2014; 2: 145
    CrossrefPubMedGoogle Scholar
  • 13 Pechère JC. Patients’ interviews and misuse of antibiotics. Clin Infect Dis 2001; 33 (Suppl. 03) S170-S173
    CrossrefPubMedGoogle Scholar
  • 14 Grigoryan L, Haaijer-Ruskamp FM, Burgerhof JGM. et al. Self-medication with antimicrobial drugs in Europe. Emerg Infect Dis 2006; 12 (03) 452-459
    CrossrefPubMedGoogle Scholar
  • 15 Gonzales R, Steiner JF, Sande MA. Antibiotic prescribing for adults with colds, upper respiratory tract infections, and bronchitis by ambulatory care physicians. JAMA 1997; 278 (11) 901-904
    CrossrefPubMedGoogle Scholar
  • 16 Reardon S. Antibiotic treatment for COVID-19 complications could fuel resistant bacteria. Science 2020. doi: 10.1126/science.abc2995
  • 17 Franki R. Survey: Hydroxychloroquine use fairly common in COVID-19 MDedge.com: MDedge 2020. Available from: https://www.mdedge.com/hematology-oncology/article/221494/coronavirus-updates/survey-hydroxychloroquine-use-fairly-common. Accessed December 10, 2020
  • 18 Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): the epidemic and the challenges. Int J Antimicrob Agents 2020; 55 (03) 105924
    CrossrefPubMedGoogle Scholar
  • 19 Usman M, Farooq M, Hanna K. Environmental side effects of the injudicious use of antimicrobials in the era of COVID-19. Sci Total Environ 2020; 745: 141053
    CrossrefPubMedGoogle Scholar
  • 20 Jacobs TG, Robertson J, van den Ham HA, Iwamoto K, Bak Pedersen H, Mantel-Teeuwisse AK. Assessing the impact of law enforcement to reduce over-the-counter (OTC) sales of antibiotics in low- and middle-income countries; a systematic literature review. BMC Health Serv Res 2019; 19 (01) 536
    CrossrefPubMedGoogle Scholar
  • 21 Bahnassi A. A qualitative analysis of pharmacists’ attitudes and practices regarding the sale of antibiotics without prescription in Syria. J Taibah Univ Med Sci 2015; 10 (02) 227-233
    Google Scholar
  • 22 Mansour O, Al-Kayali R. Community pharmacists’ role in controlling bacterial antibiotic resistance in Aleppo, Syria. Iran J Pharm Res 2017; 16 (04) 1612-1620
    PubMedGoogle Scholar
  • 23 Jakovljevic M, Al Ahdab S, Jurisevic M, Mouselli S. Antibiotic resistance in Syria: a local problem turns into a global threat. Front Public Health 2018; 6: 212
    CrossrefPubMedGoogle Scholar
  • 24 Nellums LB, Thompson H, Holmes A. et al. Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis. Lancet Infect Dis 2018; 18 (07) 796-811
    CrossrefPubMedGoogle Scholar
  • 25 Mouhieddine TH, Olleik Z, Itani MM. et al. Assessing the Lebanese population for their knowledge, attitudes and practices of antibiotic usage. J Infect Public Health 2015; 8 (01) 20-31
    CrossrefPubMedGoogle Scholar
  • 26 Awad AI, Aboud EAJ. Knowledge, attitude and practice towards antibiotic use among the public in Kuwait. PLoS One 2015; 10 (02) 0117910
    Google Scholar
  • 27 Chaintarli K, Ingle SM, Bhattacharya A, Ashiru-Oredope D, Oliver I, Gobin M. Impact of a United Kingdom-wide campaign to tackle antimicrobial resistance on self-reported knowledge and behaviour change. BMC Public Health 2016; 16 (01) 393
    CrossrefPubMedGoogle Scholar
  • 28 Barah F, Gonçalves V. Antibiotic use and knowledge in the community in Kalamoon, Syrian Arab Republic: a cross-sectional study. East Mediterr Health J 2010; 16 (05) 516-521
    CrossrefPubMedGoogle Scholar
  • 29 Darwish DA, Abdelmalek S, Abu Dayyih W, Hamadi S. Awareness of antibiotic use and antimicrobial resistance in the Iraqi community in Jordan. J Infect Dev Ctries 2014; 8 (05) 616-623
    CrossrefPubMedGoogle Scholar
  • 30 Ocan M, Obuku EA, Bwanga F. et al. Household antimicrobial self-medication: a systematic review and meta-analysis of the burden, risk factors and outcomes in developing countries. BMC Public Health 2015; 15 (01) 742
    CrossrefPubMedGoogle Scholar
  • 31 Grigoryan L, Haaijer-Ruskamp FM, Burgerhof JGM. et al. Self-medication with antimicrobial drugs in Europe. Emerg Infect Dis 2006; 12 (03) 452-459
    CrossrefPubMedGoogle Scholar
  • 32 Kassie AD, Bifftu BB, Mekonnen HS. Self-medication practice and associated factors among adult household members in Meket district, Northeast Ethiopia, 2017. BMC Pharmacol Toxicol 2018; 19 (01) 15
    CrossrefPubMedGoogle Scholar
  • 33 Sweileh PW. Self-Medication and Over-the-Counter Practices: A Study in Palestine.. J Al-Aqsa Unv 2004; 8
    Google Scholar
  • 34 Al-Worafi YM. Chapter 29 – Drug safety in Yemen. In: Al-Worafi Y, ed. Drug Safety in Developing Countries.. Fujairah, UAE: Academic Press 2020; 391-405
    Google Scholar
  • 35 Chukwu EE, Oladele DA, Awoderu OB. et al. A national survey of public awareness of antimicrobial resistance in Nigeria. Antimicrob Resist Infect Control 2020; 9 (01) 72
    CrossrefPubMedGoogle Scholar
  • 36 Badreldin HA, Atallah B. Global drug shortages due to COVID-19: impact on patient care and mitigation strategies. Res Social Adm Pharm 2021; 17 (01) 1946-1949
    CrossrefPubMedGoogle Scholar
  • 37 Abbara A, Rawson TM, Karah N. et al. A summary and appraisal of existing evidence of antimicrobial resistance in the Syrian conflict. Int J Infect Dis 2018; 75: 26-33
    CrossrefPubMedGoogle Scholar
  • 38 Al-Assil B, Mahfoud M, Hamzeh AR. First report on class 1 integrons and Trimethoprim-resistance genes from dfrA group in uropathogenic E. coli (UPEC) from the Aleppo area in Syria. Mob Genet Elements 2013; 3 (03) e25204
    CrossrefPubMedGoogle Scholar
  • 39 World Bank. The Toll of War: The Economic and Social Consequences of the Conflict in Syria. Washington, D.C.: World Bank 2017
  • 40 Moienzadeh A, Massoud T, Black E. Evaluation of the general public’s knowledge, views and practices relating to appropriate antibiotic use in Qatar. Int J Pharm Pract 2017; 25 (02) 133-139
    CrossrefPubMedGoogle Scholar
  • 41 Jose J, Jimmy B, Alsabahi AG. Al Sabei GA. A study assessing public knowledge, belief and behavior of antibiotic use in an Omani population. Oman Med J 2013; 28 (05) 324-330
    CrossrefPubMedGoogle Scholar
  • 42 Abu Taha A, Abu-Zaydeh AH, Ardah RA. et al. Public knowledge and attitudes regarding the use of antibiotics and resistance: findings from a cross-sectional study among Palestinian adults. Zoonoses Public Health 2016; 63 (06) 449-457
    CrossrefPubMedGoogle Scholar
  • 43 Jifar A, Ayele Y. Assessment of knowledge, attitude, and practice toward antibiotic use among Harar city and its surrounding community, Eastern Ethiopia.. Interdiscip Perspect Infect Dis 2018; 2018: 849-2740
    CrossrefPubMedGoogle Scholar
  • 44 Irawati L, Alrasheedy AA, Hassali MA, Saleem F. Low-income community knowledge, attitudes and perceptions regarding antibiotics and antibiotic resistance in Jelutong District, Penang, Malaysia: a qualitative study. BMC Public Health 2019; 19 (01) 1292
    CrossrefPubMedGoogle Scholar
  • 45 El-Hawy RM, Ashmawy MI, Kamal MM. et al. Studying the knowledge, attitude and practice of antibiotic misuse among Alexandria population. Eur J Hosp Pharm Sci Pract 2017; 24 (06) 349-354
    CrossrefPubMedGoogle Scholar
  • 46 Yusef D, Babaa AI, Bashaireh AZ. et al. Knowledge, practices & attitude toward antibiotics use and bacterial resistance in Jordan: a cross-sectional study. Infect Dis Health 2018; 23 (01) 33-40
    CrossrefPubMedGoogle Scholar
  • 47 Tourmousoglou CE, Yiannakopoulou ECh, Kalapothaki V. Bramis J, St Papadopoulos J. Adherence to guidelines for antibiotic prophylaxis in general surgery: a critical appraisal. J Antimicrob Chemother 2008; 61 (01) 214-218
    CrossrefPubMedGoogle Scholar
  • 48 Al-Momany NH, Al-Bakri AG, Makahleh ZM, Wazaify MM. Adherence to international antimicrobial prophylaxis guidelines in cardiac surgery: a Jordanian study demonstrates need for quality improvement. J Manag Care Pharm 2009; 15 (03) 262-271
    CrossrefPubMedGoogle Scholar
  • 49 Kim SS, Moon S, Kim EJ. Public knowledge and attitudes regarding antibiotic use in South Korea. J Korean Acad Nurs 2011; 41 (06) 742-749
    CrossrefPubMedGoogle Scholar
  • 50 Elsafti AM, van Berlaer G, Al Safadi M. et al. Children in the Syrian civil war: the familial, educational, and public health impact of ongoing violence. Disaster Med Public Health Prep 2016; 10 (06) 874-882
    CrossrefPubMedGoogle Scholar
  • 51 Goossens H, Guillemot D, Ferech M. et al. National campaigns to improve antibiotic use. Eur J Clin Pharmacol 2006; 62 (05) 373-379
    CrossrefPubMedGoogle Scholar
  • 52 Huttner B, Goossens H, Verheij T, Harbarth S. CHAMP consortium. Characteristics and outcomes of public campaigns aimed at improving the use of antibiotics in outpatients in high-income countries. Lancet Infect Dis 2010; 10 (01) 17-31
    CrossrefPubMedGoogle Scholar