Public Patterns and Determinants of Antibiotic Self-Medication and Antibiotic Knowledge in Southern Jordan
Abstract
:1. Introduction
2. Methodology
2.1. Study Design
2.2. Instrument
2.3. Validity and Reliability
2.4. Data Analysis
3. Results
3.1. Characteristics of the Survey Respondents
3.2. Prevalence of Using Antibiotics
3.3. The Impact of Socio-Demographic Factors on Self-Medication Practice
3.4. Knowledge of Antibiotics Use and Resistance
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Awad, A.; Thalib, L.; Matowe, L. Self-medication with antibiotics and antimalarials in the community of Khartoum State, Sudan. J. Pharm Pharm. Sci. 2005, 8, 326–331. [Google Scholar]
- Alhomoud, F.; Aljamea, Z.; Almahasnah, R.; Alkhalifah, K.; Basalelah, L.; Alhomoud, F.K. Self-medication and self-prescription with antibiotics in the Middle East—Do they really happen? A systematic review of the prevalence, possible reasons, and outcomes. Int. J. Infect. Dis. 2017, 57, 3–12. [Google Scholar] [CrossRef] [PubMed]
- Ocan, M.; Obuku, E.A.; Bwanga, F.; Akena, D.; Richard, S.; Ogwal-Okeng, J.; Obua, C. 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, 742. [Google Scholar] [CrossRef] [PubMed]
- Mumtaz, Y.; Jahangeer, S.; Mujtaba, T.; Zafar, S.; Adnan, S. Self-medication among university students of Karachi. Jlumhs 2011, 10, 102–105. [Google Scholar]
- Ali, S.M.; Fatima, M.; Ali, L. Self-medication among downtown urban population of Karachi, Pakistan. Indian J. Med. Res. Pharm. 2015, 2. [Google Scholar]
- Bennadi, D. Self-medication: A current challenge. J. Basic Clin. Pharm. 2013, 5, 19. [Google Scholar] [CrossRef] [PubMed]
- Lescure, D.; Paget, J.; Schellevis, F.; Van Dijk, L. Determinants of self-medication with antibiotics in European and Anglo-Saxon countries: A systematic review of the literature. Front. Public Health 2018, 6, 370. [Google Scholar] [CrossRef]
- Tomas, A.; Paut Kusturica, M.; Tomić, Z.; Horvat, O.; Djurović Koprivica, D.; Bukumirić, D.; Sabo, A. Self-medication with antibiotics in Serbian households: A case for action? Int. J. Clin. Pharm. 2017, 39, 507–513. [Google Scholar] [CrossRef]
- Morgan, D.J.; Okeke, I.N.; Laxminarayan, R.; Perencevich, E.N.; Weisenberg, S. Non-prescription antimicrobial use worldwide: A systematic review. Lancet Infect. Dis. 2011, 11, 692–701. [Google Scholar] [CrossRef]
- Azevedo, M.-M.; Pinheiro, C.; Yaphe, J.; Baltazar, F. Assessing the impact of a school intervention to promote students’ knowledge and practices on correct antibiotic use. Int. J. Environ. Res. Public Health 2013, 10, 2920–2931. [Google Scholar] [CrossRef]
- Kumarasamy, K.K.; Toleman, M.A.; Walsh, T.R.; Bagaria, J.; Butt, F.; Balakrishnan, R.; Chaudhary, U.; Doumith, M.; Giske, C.G.; Irfan, S. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: A molecular, biological, and epidemiological study. Lancet Infect. Dis. 2010, 10, 597–602. [Google Scholar] [CrossRef]
- Mostafaei, A.; Akbari, H.; Lundborg, C.S.; Kabiri, N.; Vahed, N.; Hajebrahimi, S.; Doshmangir, L. A systematic synthesis of expert opinion on effective policies to tackle bacterial resistance worldwide. Vet. Med. Sci. 2023, 9, 1395–1406. [Google Scholar] [CrossRef]
- Chokshi, A.; Sifri, Z.; Cennimo, D.; Horng, H. Global contributors to antibiotic resistance. J. Glob. Infect. Dis. 2019, 11, 36. [Google Scholar] [PubMed]
- Abebe, A.A.; Birhanu, A.G. Methicillin Resistant Staphylococcus aureus: Molecular Mechanisms Underlying Drug Resistance Development and Novel Strategies to Combat. Infect. Drug Resist. 2023, 16, 7641–7662. [Google Scholar] [CrossRef] [PubMed]
- Linares, J.; Ardanuy, C.; Pallares, R.; Fenoll, A. Changes in antimicrobial resistance, serotypes and genotypes in Streptococcus pneumoniae over a 30-year period. Clin. Microbiol. Infect. 2010, 16, 402–410. [Google Scholar] [CrossRef] [PubMed]
- Sallam, M.; Abbadi, J.; Natsheh, A.; Ababneh, N.A.; Mahafzah, A.; Özkaya Şahin, G. Trends in antimicrobial drug resistance of Streptococcus pneumoniae isolates at Jordan University Hospital (2000–2018). Antibiotics 2019, 8, 41. [Google Scholar] [CrossRef] [PubMed]
- Khabbaz, R.F.; Moseley, R.R.; Steiner, R.J.; Levitt, A.M.; Bell, B.P. Challenges of infectious diseases in the USA. Lancet 2014, 384, 53–63. [Google Scholar] [CrossRef] [PubMed]
- Al-Azzam, S.I.; Al-Husein, B.A.; Alzoubi, F.; Masadeh, M.M.; Al-Horani, S. Self-medication with antibiotics in Jordanian population. Int. J. Occup. Med. Environ. Health 2007, 20, 373. [Google Scholar] [CrossRef]
- Jamhour, A.; El-Kheir, A.; Salameh, P.; Abi Hanna, P.; Mansour, H. Antibiotic knowledge and self-medication practices in a developing country: A cross-sectional study. Am. J. Infect. Control. 2017, 45, 384–388. [Google Scholar] [CrossRef]
- Mallah, N.; Orsini, N.; Figueiras, A.; Takkouche, B. Income level and antibiotic misuse: A systematic review and dose–response meta-analysis. Eur. J. Health Econ. 2022, 23, 1015–1035. [Google Scholar] [CrossRef]
- Al-Bakri, A.G.; Bustanji, Y.; Yousef, A.M. Community consumption of antibacterial drugs within the Jordanian population: Sources, patterns and appropriateness. Int. J. Antimicrob. Agents 2005, 26, 389–395. [Google Scholar] [CrossRef]
- Yusef, D.; Babaa, A.I.; Bashaireh, A.Z.; Al-Bawayeh, H.H.; Al-Rijjal, K.; Nedal, M.; Kailani, S. Knowledge, practices & attitude toward antibiotics use and bacterial resistance in Jordan: A cross-sectional study. Infect. Dis. Health 2018, 23, 33–40. [Google Scholar] [PubMed]
- Almaaytah, A.; Mukattash, T.L.; Hajaj, J. Dispensing of non-prescribed antibiotics in Jordan. Patient. Prefer. Adherence 2015, 9, 1389–1395. [Google Scholar] [CrossRef] [PubMed]
- Shaamekhi, H.R.; Jafarabadi, M.A.; Alizadeh, M. Demographic determinants of self-medication in the population covered by health centers in Tabriz. Health Promot. Perspect. 2019, 9, 181. [Google Scholar] [CrossRef]
- Taber, K.S. The use of Cronbach’s alpha when developing and reporting research instruments in science education. Res. Sci. Educ. 2018, 48, 1273–1296. [Google Scholar] [CrossRef]
- Simegn, W.; Moges, G. Antibiotics Self-Medication Practice and Associated Factors Among Residents in Dessie City, Northeast Ethiopia: Community-Based Cross-Sectional Study. Patient. Prefer. Adherence 2022, 16, 2159–2170. [Google Scholar] [CrossRef] [PubMed]
- Nyambega, J.O. Antibiotic use and misuse among adults in Magwagwa Ward, Nyamira County in Kenya. Age Ageing 2017, 18, 26–35. [Google Scholar] [CrossRef]
- Ajibola, O.; Omisakin, O.A.; Eze, A.A.; Omoleke, S.A. Self-medication with antibiotics, attitude and knowledge of antibiotic resistance among community residents and undergraduate students in Northwest Nigeria. Diseases 2018, 6, 32. [Google Scholar] [CrossRef]
- Mohanna, M. Self-medication with antibiotic in children in Sana’a City, Yemen. Oman Med. J. 2010, 25, 41. [Google Scholar] [CrossRef]
- Abdel-Qader, D.H.; Albassam, A.; Ismael, N.S.; El-Shara’, A.A.; Shehri, A.; Almutairi, F.S.; Al-Harbi, D.M.; Al Zahrani, M.M.; Chen, L.C.; Al Mazrouei, N. Awareness of antibiotic use and resistance in Jordanian Community. J. Prim. Care Community Health 2020, 11, 2150132720961255. [Google Scholar] [CrossRef]
- Raz, R.; Edelstein, H.; Grigoryan, L.; Haaijer-Ruskamp, F.M. Self-medication with antibiotics by a population in northern Israel. Isr. Med. Assoc. J. 2005, 7, 722–725. [Google Scholar] [PubMed]
- Ivanovska, V.; Zdravkovska, M.; Bosevska, G.; Angelovska, B. Antibiotics for upper respiratory infections: Public knowledge, beliefs and self-medication in the Republic of Macedonia. Contributions, Sec. Biol. Med. Sci. 2013, 34, 60–70. [Google Scholar]
- Llewelyn, M.J.; Fitzpatrick, J.M.; Darwin, E.; Gorton, C.; Paul, J.; Peto, T.E.; Yardley, L.; Hopkins, S.; Walker, A.S. The antibiotic course has had its day. BMJ 2017, 358, j3418. [Google Scholar] [CrossRef]
- Kardas, P.; Devine, S.; Golembesky, A.; Roberts, C. A systematic review and meta-analysis of misuse of antibiotic therapies in the community. Int. J. Antimicrob. Agents 2005, 26, 106–113. [Google Scholar] [CrossRef]
- Jafari, F.; Khatony, A.; Rahmani, E. Prevalence of self-medication among the elderly in Kermanshah-Iran. Glob. J. Health Sci. 2015, 7, 360. [Google Scholar] [CrossRef] [PubMed]
- Martín-Pérez, M.; Barrera, V.H.; de Andrés, A.L.; Jiménez-Trujillo, I.; Jiménez-García, R.; Carrasco-Garrido, P. Predictors of medication use in the Roma population in Spain: A population-based national study. Public Health 2015, 129, 453–459. [Google Scholar] [CrossRef] [PubMed]
- Fekadu, G.; Dugassa, D.; Negera, G.Z.; Woyessa, T.B.; Turi, E.; Tolossa, T.; Fetensa, G.; Assefa, L.; Getachew, M.; Shibiru, T. Self-medication practices and associated factors among health-care professionals in selected hospitals of Western Ethiopia. Patient Prefer. Adherence 2020, 14, 353–361. [Google Scholar] [CrossRef]
- Subashini, N.; Udayanga, L. Demographic, socio-economic and other associated risk factors for self-medication behaviour among university students of Sri Lanka: A cross sectional study. BMC Public Health 2020, 20, 613. [Google Scholar] [CrossRef]
- Fathima Johnbasha, A.; Tamilchelvan, V.; Kumar, S. Prevalence of Self-medication Practices and Their Associated Factors in Puducherry, India: A Cross-sectional Study. J. Health Res. 2022, 12, 291–296. [Google Scholar] [CrossRef]
- Lv, B.; Zhou, Z.; Xu, G.; Yang, D.; Wu, L.; Shen, Q.; Jiang, M.; Wang, X.; Zhao, G.; Yang, S. Knowledge, attitudes and practices concerning self-medication with antibiotics among university students in western China. Trop. Med. Int. Health 2014, 19, 769–779. [Google Scholar] [CrossRef]
- Sapkota, A.R.; Coker, M.E.; Rosenberg Goldstein, R.E.; Atkinson, N.L.; Sweet, S.J.; Sopeju, P.O.; Ojo, M.T.; Otivhia, E.; Ayepola, O.O.; Olajuyigbe, O.O. Self-medication with antibiotics for the treatment of menstrual symptoms in southwest Nigeria: A cross-sectional study. BMC Public Health 2010, 10, 610. [Google Scholar] [CrossRef]
- Aslam, A.; Zin, C.S.; Jamshed, S.; Rahman, N.S.A.; Ahmed, S.I.; Pallós, P.; Gajdács, M. Self-Medication with Antibiotics: Prevalence, Practices and Related Factors among the Pakistani Public. Antibiotics 2022, 11, 795. [Google Scholar] [CrossRef] [PubMed]
- Nazir, S.; Azim, M. Assessment of antibiotic self-medication practice among public in the northwestern region of Pakistan. Eur. J. Hosp. Pharm. 2017, 24, 200–203. [Google Scholar] [CrossRef]
- Pavydė, E.; Veikutis, V.; Mačiulienė, A.; Mačiulis, V.; Petrikonis, K.; Stankevičius, E. Public knowledge, beliefs and behavior on antibiotic use and self-medication in Lithuania. Int. J. Environ. Res. Public Health 2015, 12, 7002–7016. [Google Scholar] [CrossRef]
- Zhen, X.; Chen, J.; Sun, X.; Sun, Q.; Guo, S.; Stålsby Lundborg, C. Socioeconomic factors contributing to antibiotic resistance in China: A panel data analysis. Antibiotics 2021, 10, 994. [Google Scholar] [CrossRef]
- Hadi, U.; Duerink, D.O.; Lestari, E.S.; Nagelkerke, N.J.; Werter, S.; Keuter, M.; Suwandojo, E.; Rahardjo, E.; van den Broek, P.; Gyssens, I.C. Survey of antibiotic use of individuals visiting public healthcare facilities in Indonesia. Int. J. Infect. Dis. 2008, 12, 622–629. [Google Scholar] [CrossRef] [PubMed]
- van Houten, C.B.; Cohen, A.; Engelhard, D.; Hays, J.P.; Karlsson, R.; Moore, E.; Fernández, D.; Kreisberg, R.; Collins, L.V.; de Waal, W. Antibiotic misuse in respiratory tract infections in children and adults—A prospective, multicentre study (TAILORED Treatment). Eur. J. Clin. Microbiol. Infect. Dis. 2019, 38, 505–514. [Google Scholar] [CrossRef] [PubMed]
- Shivhare, S.; Kunjwani, H.; Manikrao, A.; Bondre, A. Drugs hazards and rational use of drugs: A review. J. Chem. Pharm. Res. 2010, 2, 106–112. [Google Scholar]
- Harbarth, S.; Balkhy, H.H.; Goossens, H.; Jarlier, V.; Kluytmans, J.; Laxminarayan, R.; Saam, M.; Van Belkum, A.; Pittet, D.; World Healthcare-Associated Infections Resistance Forum Participants. Antimicrobial resistance: One world, one fight! Antimicrob. Resist. Infect. Control. 2015, 4, 49. [Google Scholar] [CrossRef]
Variables | All Participants | ||
---|---|---|---|
Frequency | Percent | ||
Gender | Male | 386 | 39.2 |
Female | 598 | 60.8 | |
Age | 18–27 | 569 | 57.8 |
28–37 | 217 | 22.1 | |
38–47 | 96 | 9.8 | |
48–57 | 40 | 4.1 | |
>57 | 62 | 6.3 | |
Education level | Basic education | 13 | 1.3 |
Secondary education | 310 | 31.5 | |
Technical diploma | 106 | 10.8 | |
Bachelor’s degree | 465 | 47.3 | |
MSc or PhD | 90 | 9.1 | |
Region | Urban | 340 | 34.6 |
Rural | 644 | 65.4 | |
Health insurance | YES | 822 | 83.5 |
NO | 162 | 16.5 | |
Job | Professional | 166 | 16.9 |
Governmental | 70 | 7.1 | |
Manual | 170 | 17.3 | |
Unemployed | 244 | 24.8 | |
Student | 166 | 16.9 | |
Housewife | 168 | 17.1 |
Variables | Total n (%) | Self-Medication n (%) | Rational n (%) | X2 | p-Value | |
---|---|---|---|---|---|---|
Gender | Male | 343 (45.6) | 172 (50.1) | 171 (49.9) | 5.807 | 0.016 |
Female | 409 (54.4) | 241 (58.9) | 168 (41.1) | |||
Age | 18–27 | 412 (54.8) | 212 (51.5) | 200 (48.5) | 8.79 | 0.067 |
28–37 | 165 (21.9) | 90 (54.5) | 75 (45.5) | |||
38–47 | 79 (10.5) | 52 (65.8) | 27 (34.2) | |||
48–57 | 37 (4.9) | 20 (54.1) | 17 (45.9) | |||
>57 | 59 (7.8) | 39(66.1) | 20 (33.9) | |||
Education | Basic Education | 12 (1.6) | 9 (75.0) | 3 (25.0) | 18.481 | 0.001 |
Secondary Education | 239 (31.8) | 153 (64.0) | 86 (36.0) | |||
Technical Diploma | 80 (10.6) | 42 (52.5) | 38 (47.5) | |||
Bachelor’s Degree | 361 (48.0) | 186 (51.5) | 175 (48.5) | |||
MSc Or PhD | 60 (8.0) | 23 (38.3) | 37 (61.7) | |||
Location | Urban | 254 (33.8) | 117 (46.1) | 137 (53.9) | 12.154 | <0.001 |
Rural | 498 (66.2) | 296 (59.4) | 202 (40.6) | |||
Health insurance | Yes | 638 (84.8) | 335 (52.5) | 303 (47.5) | 9.893 | 0.002 |
No | 114 (15.2) | 78 (68.4) | 36 (31.6) | |||
Occupation | Professional | 129 (17.2) | 59 (45.7) | 70 (54.3) | 16.939 | 0.005 |
Governmental | 36 (4.8) | 13 (36.1) | 23 (63.9) | |||
Manual | 115 (15.3) | 64 (55.7) | 51 (44.3) | |||
Unemployed | 188 (25.0) | 109 (58.0) | 79 (42.0) | |||
Student | 142 (18.9) | 75 (52.8) | 67 (47.2) | |||
Housewife | 142 (18.9) | 93 (65.5) | 49 (34.5) |
Variable | Wald | df | p-Value | Adj.OR | 95.0% CI (AOR) | ||
---|---|---|---|---|---|---|---|
Lower | Upper | ||||||
Gender | Male | 1 c | |||||
Female | 19.904 | 1 | <0.001 | 2.207 | 1.559 | 3.126 a | |
Age | 18–27 | 6.547 | 4 | 0.162 | 1 c | ||
28–37 | 0.119 | 1 | 0.730 | 1.132 b | 0.559 | 2.293 | |
38–47 | 0.135 | 1 | 0.714 | 0.870 b | 0.412 | 1.835 | |
48–57 | 1.823 | 1 | 0.177 | 0.558 b | 0.239 | 1.302 | |
>57 | 0.093 | 1 | 0.761 | 1.158 b | 0.451 | 2.973 | |
Education | Basic Education | 12.484 | 4 | 0.014 | 1 c | ||
Secondary Education | 5.214 | 1 | 0.022 | 0.496 b | 0.272 | 0.906 | |
Technical Diploma | 1.481 | 1 | 0.224 | 0.637 b | 0.308 | 1.317 | |
Bachelor’s Degree | 9.494 | 1 | 0.002 | 0.363 b | 0.190 | 0.691 | |
MSc Or PhD | 4.143 | 1 | 0.042 | 0.203 b | 0.044 | 0.943 | |
Location | Urban | 1 c | |||||
Rural | 8.569 | 1 | 0.003 | 1.672 | 1.185 | 2.359 a | |
Health insurance | Yes | 1 c | |||||
No | 12.645 | 1 | <0.001 | 2.603 | 1.536 | 4.411 a | |
Occupation | Professional | 12.413 | 5 | 0.030 | 1 c | ||
Governmental | 0.512 | 1 | 0.474 | 0.832 b | 0.503 | 1.376 | |
Manual | 5.136 | 1 | 0.023 | 0.556 b | 0.335 | 0.924 | |
Unemployed | 2.479 | 1 | 0.115 | 1.878 b | 0.857 | 4.114 | |
Student | 1.620 | 1 | 0.203 | 0.707 b | 0.415 | 1.206 | |
Housewife | 3.353 | 1 | 0.067 | 2.154 b | 0.948 | 4.895 |
Statements (Correct Response) | Correct Answer | Incorrect Answer | ||
---|---|---|---|---|
Frequency | Percent (%) | Frequency | Percent (%) | |
Antibiotics are effective against viral infections. (NO) | 281 | 28.6 | 703 | 71.4 |
Antibiotics increase the speed of recovery from colds. (NO) | 316 | 32.1 | 668 | 67.9 |
The utilization of antibiotics should last till disappear the symptoms regardless the time length. (NO) | 294 | 29.9 | 690 | 70.1 |
Antibiotics can distinguish between bacterial flora that normally live in the human body and pathogenic bacteria that cause diseases. (NO) | 220 | 22.4 | 764 | 77.6 |
Unprescribed antibiotics does not have health consequences. (NO) | 479 | 48.7 | 505 | 51.3 |
The human body can become resistant to antibiotic after a period of use. (YES) | 348 | 35.4 | 636 | 64.6 |
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Al-Tarawneh, A.; Ali, T.; Al-Taani, G.M. Public Patterns and Determinants of Antibiotic Self-Medication and Antibiotic Knowledge in Southern Jordan. Antibiotics 2024, 13, 98. https://doi.org/10.3390/antibiotics13010098
Al-Tarawneh A, Ali T, Al-Taani GM. Public Patterns and Determinants of Antibiotic Self-Medication and Antibiotic Knowledge in Southern Jordan. Antibiotics. 2024; 13(1):98. https://doi.org/10.3390/antibiotics13010098
Chicago/Turabian StyleAl-Tarawneh, Alaa, Tasneem Ali, and Ghaith M Al-Taani. 2024. "Public Patterns and Determinants of Antibiotic Self-Medication and Antibiotic Knowledge in Southern Jordan" Antibiotics 13, no. 1: 98. https://doi.org/10.3390/antibiotics13010098
APA StyleAl-Tarawneh, A., Ali, T., & Al-Taani, G. M. (2024). Public Patterns and Determinants of Antibiotic Self-Medication and Antibiotic Knowledge in Southern Jordan. Antibiotics, 13(1), 98. https://doi.org/10.3390/antibiotics13010098