Irrational antibiotic use : understanding the knowledge, attitudes and practices amongst the public of developing nations

Abstract

Background Antibiotic use is a major driver of antibiotic resistance. Irrational antibiotic use is prevalent in developing countries due to inaccessible healthcare system, financial burden barring procurement of full treatment course, and availability of substandard drugs. Much interventions targeting on physicians and pharmacists have been done, while little have been studied on general public. Due to lack of healthcare access, interventions to improve rational antibiotic use in general public through healthcare professionals will not reach most of the deprived and heavily-burdened populations. An understanding on KAP of general public will point out areas of concern, and may shed light on possible interventions. This review aims to provide an overview of KAP of antibiotic use amongst the public of developing nations and effect of components along the KAP continuum.

Method A systematic review was carried out. Literatures published in the recent 15 years were retrieved from systematic search using PubMed and EMBASE, and relevant evidence on KAP of antibiotic use amongst public of developing nations were assembled and synthesized. Findings 26 studies were included in this review. Misconceptions were reported in significant proportion of study population for aim of antibiotic use, antibiotic resistance as adverse effect and necessity of prescription. Inappropriate attitude towards antibiotic use for common cold and ceasing treatment upon feeling better was common among study population. Non-prescribed antibiotic usage was also common, and about one-third of non-prescribed users have done so for common cold. One-third of study population truncated their antibiotic treatment course. KAP components were on general directly correlated along the continuum. Conclusion Lack of knowledge, inappropriate attitude and usage are common amongst the specific population. Educational intervention targeting to improve knowledge may be a strong and vital complement to regulatory measures in improving rational antibiotic use.