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15 pages, 1077 KiB

Open AccessArticle

Misconceptions of Antibiotics as a Potential Explanation for Their Misuse. A Survey of the General Public in a Rural and Urban Community in Sri Lanka

by Yasodhara Deepachandi Gunasekera, Tierney Kinnison, Sanda Arunika Kottawatta, Ayona Silva-Fletcher and Ruwani Sagarika Kalupahana

Antibiotics 2022, 11(4), 454; https://doi.org/10.3390/antibiotics11040454 - 27 Mar 2022

Cited by 9 | Viewed by 2807

Abstract

Reducing the growth of antimicrobial resistance (AMR) through public understanding is a goal of the World Health Organization. It is especially important in countries where antibiotics are widely available for common ailments without prescription. This study assessed understanding of antibiotics and AMR alongside [...] Read more.

Reducing the growth of antimicrobial resistance (AMR) through public understanding is a goal of the World Health Organization. It is especially important in countries where antibiotics are widely available for common ailments without prescription. This study assessed understanding of antibiotics and AMR alongside perception of antibiotic usage among the general public in two diverse Sri Lankan communities: ordinary urban and indigenous rural. A cross-sectional questionnaire survey was conducted, gaining 182 urban and 147 rural responses. The majority of urban respondents (69.2%) believed that they had very good or good knowledge about antibiotics compared to 40.1% of rural respondents. Belief about knowledge and actual knowledge (measured via a test question) were correlated (r = 0.49, p = 0.001) for rural respondents, but not for urban respondents. Several misconceptions about antibiotics were highlighted, including that Paracetamol, a painkiller, was thought to be an antibiotic by more than 50% of both urban and rural respondents. In addition, 18.5% of urban and 35.4% of rural participants would keep and re-use what they perceived as leftover antibiotics. It is urgent that we pay attention to educating the general public regarding the identified misconceptions of these powerful drugs and their appropriate use. Full article

(This article belongs to the Special Issue Antibiotic Use in the Communities)

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18 pages, 2647 KiB

Open AccessArticle

Antibiotic Prescribing Patterns in Paediatric Primary Care in Italy: Findings from 2012–2018

by Elisa Barbieri, Costanza di Chiara, Paola Costenaro, Anna Cantarutti, Carlo Giaquinto, Yingfen Hsia and Daniele Doná

Antibiotics 2022, 11(1), 18; https://doi.org/10.3390/antibiotics11010018 - 24 Dec 2021

Cited by 10 | Viewed by 2972

Abstract

Comprehensive data are needed to monitor antibiotic prescribing and inform stewardship. We aimed to evaluate the current antibiotic prescribing patterns, including treatment switching and prolongation, in the paediatric primary care setting in Italy. This database study assessed antibiotic prescriptions retrieved from Pedianet, a [...] Read more.

Comprehensive data are needed to monitor antibiotic prescribing and inform stewardship. We aimed to evaluate the current antibiotic prescribing patterns, including treatment switching and prolongation, in the paediatric primary care setting in Italy. This database study assessed antibiotic prescriptions retrieved from Pedianet, a paediatric primary care database, from 1 January 2012 to 31 December 2018. Descriptive analyses were stratified by diagnosis class, calendar year, and children’s age. Generalized linear Poisson regression was used to assess variation in the prescriptions. In total, 505,927 antibiotic prescriptions were included. From 2012 to 2018, the number of antibiotics per child decreased significantly by 4% yearly from 0.79 in 2012 to 0.62 in 2018. Amoxicillin prescriptions decreased with increasing children’s age, while macrolides and third-generation cephalosporins had the opposite trend. Prescriptions were associated with a diagnosis of upper respiratory infection in 23% of cases, followed by pharyngitis (21%), bronchitis and bronchiolitis (12%), and acute otitis media (12%). Eight percent of treatment episodes were prolonged or switched class, mostly represented by co-amoxiclav, macrolides, and third-generation cephalosporins. Our findings report an overall decrease in antibiotic prescriptions, but pre-schoolers are still receiving more than one antibiotic yearly, and broad-spectrum antibiotics prescription rates remain the highest. Full article

(This article belongs to the Special Issue Antibiotic Use in the Communities)

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15 pages, 767 KiB

Open AccessArticle

How Socioeconomic, Health Seeking Behaviours, and Educational Factors Are Affecting the Knowledge and Use of Antibiotics in Four Different Cities in Asia

by Susan Ka Yee Chow, Xingjuan Tao, Xuejiao Zhu, Atsadaporn Niyomyart and Edward Choi

Antibiotics 2021, 10(12), 1522; https://doi.org/10.3390/antibiotics10121522 - 13 Dec 2021

Cited by 2 | Viewed by 2010

Abstract

Antibiotic resistance is occurring widely throughout the world and is affecting people of all ages. Socioeconomic factors, education, use of antibiotics, knowledge of antibiotics, and antibiotic resistance were assessed in four cities in Asia, namely Hong Kong, Shanghai, Hangzhou, and Bangkok. A survey [...] Read more.

Antibiotic resistance is occurring widely throughout the world and is affecting people of all ages. Socioeconomic factors, education, use of antibiotics, knowledge of antibiotics, and antibiotic resistance were assessed in four cities in Asia, namely Hong Kong, Shanghai, Hangzhou, and Bangkok. A survey using cluster sampling was used in 2021 to collect data on 642 subjects. Hongkongers used less antibiotics and were knowledgeable about using antibiotics to treat diseases, while Shanghainese were knowledgeable about antibiotic resistance. The multi-linear regression model reported that respondents who lived in Hong Kong (β = 0.744 (95% CI: 0.36–1.128), Shanghai (β = 1.65 (95% CI: 1.267–2.032), and Hangzhou (β = 1.393 (95% CI: 0.011–1.775) (reference group: Bangkok), who had higher scores on antibiotics knowledge (β = 0.161 (95% CI: 0.112–0.21)), higher educational attainment (β = 0.46 (95% CI: 0.296–0.625)), and who were more likely to consult a doctor on using antibiotics (β = 1.102 (95% CI: 0.606–1.598)), were more likely to give correct answers about antibiotic resistance, p < 0.001. Older respondents were less likely to answer the items correctly (β = −0.194 (95% CI: −0.333–−0.055), p < 0.01. When educating the public on the proper use of antibiotics and antibiotic resistance, multiple strategies could be considered for people from all walks of life, as well as target different age groups. Full article

(This article belongs to the Special Issue Antibiotic Use in the Communities)

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12 pages, 264 KiB

Open AccessArticle

The Effect of Sociodemographic Factors, Parity and Cervical Cancer on Antibiotic Treatment for Uncomplicated Cystitis in Women: A Nationwide Cohort Study

by Filip Jansåker, Xinjun Li, Jenny Dahl Knudsen, Veronica Milos Nymberg and Kristina Sundquist

Antibiotics 2021, 10(11), 1389; https://doi.org/10.3390/antibiotics10111389 - 12 Nov 2021

Cited by 4 | Viewed by 1579

Abstract

Background: Uncomplicated cystitis is one of the most common reasons for antibiotic treatment in otherwise healthy women. Nationwide studies on antibiotic treatment for this infection and in relation to factors beyond the infection itself have hitherto not been available. Methods: This was a [...] Read more.

Background: Uncomplicated cystitis is one of the most common reasons for antibiotic treatment in otherwise healthy women. Nationwide studies on antibiotic treatment for this infection and in relation to factors beyond the infection itself have hitherto not been available. Methods: This was a nationwide open cohort study consisting of 352,507 women aged 15–50 years with uncomplicated cystitis (2006–2018). The outcome was a redeemed antibiotic prescription within five days from the cystitis diagnosis. Logistic regression models were used to examine the relationship between the outcome and the predictor variables. Results: This study identified 192,065 redeemed treatments (54.5%). Several sociodemographic variables were associated with antibiotic treatment. For example, women with the lowest income had an odds ratio (OR) of 1.26 (95% CI 1.23–1.28) compared to those with the highest income. History of cervical cancer and high parity were also associated with lower treatment rates. Conclusion: This study presents novel factors beyond the infection which seem to affect the antibiotic treatment for uncomplicated cystitis in women. Future studies to investigate possible mechanisms are warranted in order to properly use our findings. This may help healthcare workers and planners to provide a more equal treatment plan for this common infection, which may reduce misuse of antibiotics, decrease costs and improve efforts against antibiotic resistance. Full article

(This article belongs to the Special Issue Antibiotic Use in the Communities)

11 pages, 250 KiB

Open AccessArticle

Community Use of Antibiotics in Turkey: The Role of Knowledge, Beliefs, Attitudes, and Health Anxiety

by Ümmügülsüm Gaygısız, Timo Lajunen and Esma Gaygısız

Antibiotics 2021, 10(10), 1171; https://doi.org/10.3390/antibiotics10101171 - 27 Sep 2021

Cited by 8 | Viewed by 2119

Abstract

Turkey has been among the leading countries in antibiotic consumption. As a result of the 4-year National Action Plan for Rational Drug Use, antibiotic prescriptions had declined from 34.9% in 2011 to 24.6% in 2018. However, self-medication with antibiotics without prescription is common, [...] Read more.

Turkey has been among the leading countries in antibiotic consumption. As a result of the 4-year National Action Plan for Rational Drug Use, antibiotic prescriptions had declined from 34.9% in 2011 to 24.6% in 2018. However, self-medication with antibiotics without prescription is common, which is not reflected in official statistics. The present study aims at investigating antibiotic use in the community and the factors related to it. A web-based survey was conducted among 945 Turkish-speaking respondents (61.3% female). The questionnaire included questions about antibiotic use for different illnesses, ways to obtain and handle leftover antibiotics, knowledge, beliefs of the antibiotic effectiveness, attitudes, health anxiety, and background factors. According to the results, 34.2% of the sample had self-medicated themselves with antibiotics without a valid prescription. The most common way to self-medicate was to use leftover antibiotics. While 80.4% knew that antibiotics are used to treat bacterial infections, 51.4% thought that antibiotics are effective for viral diseases. The most important predictor of antibiotic use frequency was the belief in their efficiency for various illnesses and symptoms, followed by negative attitudes to antibiotics, health anxiety, knowledge level, positive attitudes, and health status. The results underline the importance of targeting misbeliefs about antibiotics in future campaigns. Full article

(This article belongs to the Special Issue Antibiotic Use in the Communities)

14 pages, 1036 KiB

Open AccessArticle

Antibiotics Use and Its Knowledge in the Community: A Mobile Phone Survey during the COVID-19 Pandemic in Bangladesh

by Zubair Akhtar, Syeda Mah-E-Muneer, Md. Mahbubur Rashid, Md. Shakil Ahmed, Md. Ariful Islam, Sukanta Chowdhury, Zobaid Khan, Md. Zakiul Hassan, Khaleda Islam, Shahana Parveen, Nitish Debnath, Mahmudur Rahman and Fahmida Chowdhury

Antibiotics 2021, 10(9), 1052; https://doi.org/10.3390/antibiotics10091052 - 29 Aug 2021

Cited by 12 | Viewed by 6453

Abstract

The general population has been excessively using antibiotics during the COVID-19 pandemic. Therefore, the use of antibiotics for any reported illnesses in the preceding four weeks and knowledge of antibiotics among the general population in the community were assessed for possible interventions. A [...] Read more.

The general population has been excessively using antibiotics during the COVID-19 pandemic. Therefore, the use of antibiotics for any reported illnesses in the preceding four weeks and knowledge of antibiotics among the general population in the community were assessed for possible interventions. A mobile phone survey among a general population across eight administrative divisions of Bangladesh was conducted during January–March 2021. Reported illness episodes irrespective of COVID-19 in the preceding four weeks of the interview, use of antibiotics for the illnesses, and knowledge on antibiotics among the general population were recorded. Descriptive analyses were performed. We randomly interviewed 1854 participants, with a mean age of 28.5 years (range: 18–75 years); 60.6% were male. Among all participants, 86.3% (95% CI: 84.7–87.8) heard names of antibiotics, but only 12.1% reported unspecified harmful effects, and 3.5% reported antimicrobial resistance when antibiotics were taken without a physician’s prescription. Among 257 (13.9%) participants, who consumed medicines for their recent illness episode, 32.7% (95% CI: 27.2–38.6) reported using antibiotics. Of those who could recall the names of antibiotics prescribed (n = 36), the most frequently used was azithromycin (22.2%) followed by cefixime (11.1%) and ciprofloxacin (5.6%). Our findings show an increased antibiotic use for illnesses reported in the preceding four weeks and an elevated knowledge at the community level during the COVID-19 pandemic compared with the pre-pandemic period. Full article

(This article belongs to the Special Issue Antibiotic Use in the Communities)

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15 pages, 2723 KiB

Open AccessArticle

Dispensing Antibiotics without Prescription at Community Pharmacies and Accredited Drug Dispensing Outlets in Tanzania: A Cross-Sectional Study

by Pendo M. Ndaki, Martha F. Mushi, Joseph R. Mwanga, Eveline T. Konje, Nyanda E. Ntinginya, Blandina T. Mmbaga, Katherine Keenan, Wilber Sabiiti, Mike Kesby, Fernando Benitez-Paez, Alison Sandeman, Matthew T. G. Holden, Stephen E. Mshana and HATUA Consortium

Antibiotics 2021, 10(8), 1025; https://doi.org/10.3390/antibiotics10081025 - 23 Aug 2021

Cited by 30 | Viewed by 5123

Abstract

Worldwide, antimicrobial resistance is increasing rapidly and is associated with misuse of antimicrobials. The HATUA study (a broader 3-country study) investigated the antibiotic dispensing practices of pharmaceutical providers to clients, particularly the propensity to dispense without prescription. A cross-sectional study using a ‘mystery [...] Read more.

Worldwide, antimicrobial resistance is increasing rapidly and is associated with misuse of antimicrobials. The HATUA study (a broader 3-country study) investigated the antibiotic dispensing practices of pharmaceutical providers to clients, particularly the propensity to dispense without prescription. A cross-sectional study using a ‘mystery client’ method was conducted in 1148 community pharmacies and accredited drugs dispensing outlets (ADDO) in Mwanza (n = 612), Mbeya (n = 304) and Kilimanjaro (n = 232) in Tanzania. Mystery clients asked directly for amoxicillin, had no prescription to present, did not discuss symptoms unless asked [when asked reported UTI-like symptoms] and attempted to buy a half course. Dispensing of amoxicillin without prescription was common [88.2, 95%CI 86.3–89.9%], across all three regions. Furthermore, the majority of outlets sold a half course of amoxicillin without prescription: Mwanza (98%), Mbeya (99%) and Kilimanjaro (98%). Generally, most providers in all three regions dispensed amoxicillin on demand, without asking the client any questions, with significant variations among regions [p-value = 0.003]. In Mbeya and Kilimanjaro, providers in ADDOs were more likely to do this than those in pharmacies but no difference was observed in Mwanza. While the Tanzanian government has laws, regulations and guidelines that prohibit antibiotic dispensing without prescription, our study suggests non-compliance by drug providers. Enforcement, surveillance, and the provision of continuing education on dispensing practices is recommended, particularly for ADDO providers. Full article

(This article belongs to the Special Issue Antibiotic Use in the Communities)

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9 pages, 576 KiB

Open AccessArticle

Prevalence of and Risk Factors for Nonprescription Antibiotic Use among Individuals Presenting to One Hospital in Saudi Arabia after the 2018 Executive Regulations of Health Practice Law: A Cross-Sectional Study

by Ali Mohsen Al-Hazmi, Ahmed Arafa, Haytham Sheerah, Khalid Saeed Alshehri, Khalid Alwalid Alekrish, Khalid Abdulla Aleisa, Abdullah Ali Jammah and Nawaf Abdullah Alamri

Antibiotics 2021, 10(8), 923; https://doi.org/10.3390/antibiotics10080923 - 29 Jul 2021

Cited by 3 | Viewed by 1857

Abstract

Antibiotic resistance is a worldwide public health emergency. Nonprescription antibiotic use is a chief cause of antibiotic resistance. The Saudi Government, as a consequence, imposed in 2018 executive regulations to prevent the distribution of antibiotics without a prescription. Herein, we aimed to investigate [...] Read more.

Antibiotic resistance is a worldwide public health emergency. Nonprescription antibiotic use is a chief cause of antibiotic resistance. The Saudi Government, as a consequence, imposed in 2018 executive regulations to prevent the distribution of antibiotics without a prescription. Herein, we aimed to investigate the prevalence of and risk factors for nonprescription antibiotic use among individuals presenting to one hospital in Saudi Arabia after enacting these regulations. This cross-sectional study was conducted on people, aged ≥18 years, who presented to the primary healthcare clinics of King Khalid University Hospital in Riyadh during the period between 1/1/2019 and 28/2/2019. Participants were asked to fill out a self-administrated questionnaire assessing their nonprescription antibiotic use during the past year in addition to sociodemographic information. Then, logistic regression analyses were performed to calculate the odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for age, sex, education, and nationality of any nonprescription antibiotic use compared with no use within the past year. Out of 463 participants, 62.9% were females, 67.4% were <40 years, and 93.7% were Saudi citizens. Overall, 30.5% of participants reported nonprescription antibiotic use during the past year (19.7% one to two times and 10.8% more than two times). Male and non-Saudi participants were more likely to report any nonprescription antibiotic use, with HRs (95% CIs) of 1.99 (1.30, 3.04) and 3.81 (1.73, 8.35), respectively. The main reasons behind nonprescription antibiotic use were having previous experience with a health condition (69.2%), inaccessibility of healthcare (26.6%), and recommendation from a relative or a friend (16.1%). A major limitation of this study was that it included individuals attending one hospital. Individuals who seek medical consultation could be dissimilar to those who do not see doctors regarding nonprescription antibiotic use. Full article

(This article belongs to the Special Issue Antibiotic Use in the Communities)

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9 pages, 1260 KiB

Open AccessArticle

Antimicrobial Usage in Commercial and Domestic Poultry Farming in Two Communities in the Ashanti Region of Ghana

by Ellis Kobina Paintsil, Linda Aurelia Ofori, Charity Wiafe Akenten, Dennis Fosu, Seth Ofori, Maike Lamshöft, Jürgen May, Kwasi Obiri Danso, Ralf Krumkamp and Denise Dekker

Antibiotics 2021, 10(7), 800; https://doi.org/10.3390/antibiotics10070800 - 30 Jun 2021

Cited by 19 | Viewed by 3442

Abstract

Poultry farming is a common practice in Ghana. Antibiotics are used, particularly in commercial poultry farming, as growth promoters and to prevent and cure infections. However, there is little information on antimicrobial usage in domestic poultry farming in Ghana. This study aimed to [...] Read more.

Poultry farming is a common practice in Ghana. Antibiotics are used, particularly in commercial poultry farming, as growth promoters and to prevent and cure infections. However, there is little information on antimicrobial usage in domestic poultry farming in Ghana. This study aimed to describe antimicrobial usage in commercial and domestic poultry farming. A cross-sectional survey was conducted within the Ashanti region of Ghana including 33 commercial farms and 130 households with domestic poultry farming. The median poultry population on commercial farms was 1500 (IQR: 300–3000) compared with 18 (IQR: 10–25) on domestic farms. The majority (97%, n = 32) of commercial farms used antimicrobials, compared with 43% (n = 56) of the domestic farms. Commercial farmers were 6.1 (CI: 3.2–11.8) times more likely to read and follow instructions on antimicrobials in comparison with domestic poultry keepers. About 11% of domestic and 34% of commercial farmers had received education on antimicrobial usage. None of the commercial farmers used herbal remedies; however, 40% (n/N = 52/130) of domestic farmers administered herbs. The misuse of antimicrobials in domestic poultry production calls for stricter regulations and training to limit the emergence and spread of antimicrobial-resistant bacteria among poultry. Full article

(This article belongs to the Special Issue Antibiotic Use in the Communities)

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11 pages, 501 KiB

Open AccessArticle

Dispensing of Non-Prescribed Antibiotics from Community Pharmacies of Pakistan: A Cross-Sectional Survey of Pharmacy Staff’s Opinion

by Muhammad Majid Aziz, Fatima Haider, Muhammad Fawad Rasool, Furqan Khurshid Hashmi, Sadia Bahsir, Pengchao Li, Mingyue Zhao, Thamir M. Alshammary and Yu Fang

Antibiotics 2021, 10(5), 482; https://doi.org/10.3390/antibiotics10050482 - 22 Apr 2021

Cited by 11 | Viewed by 3076

Abstract

Community pharmacies are the main channel of antibiotics distribution. We aimed to analyze the dispensing of non-prescribed antibiotics and knowledge of pharmacy staff. We conducted a cross-sectional study in Punjab, Pakistan between December 2017 and March 2018. A self-administered, structured, pretested, and validated [...] Read more.

Community pharmacies are the main channel of antibiotics distribution. We aimed to analyze the dispensing of non-prescribed antibiotics and knowledge of pharmacy staff. We conducted a cross-sectional study in Punjab, Pakistan between December 2017 and March 2018. A self-administered, structured, pretested, and validated bilingual questionnaire was used, and we used chi-square tests in the statistical analysis. A total of 573 (91.7%) pharmacy retailers responded to the survey; 44.0% were aged 31–40 years and all were men. Approximately 81.5% of participants declared that dispensing non-prescribed antibiotics is a common practice in community pharmacies, and 51.1% considered themselves to be authorized to dispense these drugs; 69.3% believed this a contributing factor to antimicrobial resistance. Most (79.1%) respondents believed that this practice promotes irrational antibiotics use, and half (52.2%) considered antimicrobial resistance to be a public health issue. Only 34.5% of respondents reported recommending that patients consult with a doctor prior to using antibiotics, and 61.8% perceived that their dispensing practices reduce patients’ economic burden. Approximately 44.9% of pharmacy retailers stated that they have proper knowledge about antibiotics use. Nitroimidazole was the main class of antibiotic dispensed without a prescription. Dispensing of injectable and broad-spectrum antibiotics can be potential threat for infection cure. Poor knowledge of staff is associated with dispensing of non-prescribed antibiotics. This inappropriate practice must be addressed immediately. Full article

(This article belongs to the Special Issue Antibiotic Use in the Communities)

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18 pages, 6640 KiB

Open AccessArticle

Impact of a Social Marketing Intervention on General Practitioners’ Antibiotic Prescribing Practices for Acute Respiratory Tract Complaints in Malta

by Anna Machowska, Gaetano Marrone, Peter Saliba-Gustafsson, Michael A. Borg, Erika A. Saliba-Gustafsson and Cecilia Stålsby Lundborg

Antibiotics 2021, 10(4), 371; https://doi.org/10.3390/antibiotics10040371 - 31 Mar 2021

Cited by 2 | Viewed by 2182

Abstract

Introduction: Antibiotics are commonly prescribed in primary care for acute respiratory tract complaints (aRTCs), often inappropriately. Social marketing interventions could improve prescribing in such settings. We evaluate the impact of a social marketing intervention on general practitioners’ (GPs’) antibiotic prescribing for aRTCs [...] Read more.

Introduction: Antibiotics are commonly prescribed in primary care for acute respiratory tract complaints (aRTCs), often inappropriately. Social marketing interventions could improve prescribing in such settings. We evaluate the impact of a social marketing intervention on general practitioners’ (GPs’) antibiotic prescribing for aRTCs in Malta. Methods: Changes in GPs’ antibiotic prescribing were monitored over two surveillance periods between 2015 and 2018. Primary outcome: change in antibiotic prescription for aRTCs. Secondary outcomes: change in antibiotic prescription: (i) for immediate use, (ii) for delayed antibiotic prescription, (iii) by diagnosis, and (iv) by antibiotic class. Data were analysed using clustered analysis and interrupted time series analysis (ITSA). Results: Of 33 participating GPs, 18 successfully completed the study. Although clustered analyses showed a significant 3% decrease in overall antibiotic prescription (p = 0.024), ITSA showed no significant change overall (p = 0.264). Antibiotic prescription decreased significantly for the common cold (p < 0.001), otitis media (p = 0.044), and sinusitis (p = 0.004), but increased for pharyngitis (p = 0.015). Conclusions: The intervention resulted in modest improvements in GPs’ antibiotic prescribing. A more top-down approach will likely be required for future initiatives to be successful in this setting, focusing on diagnostic and prescribing support like rapid diagnostic testing, prescribing guidelines, and standardised delayed antibiotic prescriptions. Full article

(This article belongs to the Special Issue Antibiotic Use in the Communities)

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18 pages, 2368 KiB

Open AccessArticle

Antibiotic Use in Periodontal Therapy among French Dentists and Factors Which Influence Prescribing Practices

by Kevimy Agossa, Kadiatou Sy, Théo Mainville, Marjolaine Gosset, Sylvie Jeanne, Brigitte Grosgogeat, Florence Siepmann, Florence Loingeville and Marie Dubar

Antibiotics 2021, 10(3), 303; https://doi.org/10.3390/antibiotics10030303 - 15 Mar 2021

Cited by 12 | Viewed by 3891

Abstract

The aim of the present survey is to investigate the use of antibiotics during periodontal therapy among French dentists with a focus on exploring potential differences between various groups of practitioners. A self-administered questionnaire was distributed to different groups of practitioners including members [...] Read more.

The aim of the present survey is to investigate the use of antibiotics during periodontal therapy among French dentists with a focus on exploring potential differences between various groups of practitioners. A self-administered questionnaire was distributed to different groups of practitioners including members of (i) the French Society of Periodontology and Implantology; (ii) the College of University Teachers in Periodontology and, (iii) private practitioners participating in the French general dental practice-based research network. 272 questionnaires were included in the analysis. Prescription patterns were globally in line with the current recommendations. Systemic antibiotics are most frequently used as a first-line therapy in necrotizing periodontitis (92%) and aggressive periodontitis (53.3% to 66.1%). However, malpractice still exists, including in the management of periodontal abscesses. Antibiotics are prescribed (i) less frequently for periodontal abscesses and (ii) more frequently for generalized aggressive periodontitis by members of the periodontal society and University college (p < 0.05). Amoxicillin (59.9%) and the amoxicillin + metronidazole (59.6%) combination were the most frequently prescribed molecules. Providing a high number of periodontal treatments per week, being more recently graduated, having a post-graduate certificate in periodontology and holding or having held an academic position/hospital practice were all factors associated with a better knowledge of and/or more adequate antibiotic use. Full article

(This article belongs to the Special Issue Antibiotic Use in the Communities)

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11 pages, 270 KiB

Open AccessArticle

Preventive Antibiotic Prescribing Habits among Professionals Dedicated to Oral Implantology: An Observational Study

by Angel Orión Salgado-Peralvo, Naresh Kewalramani, Juan Francisco Peña-Cardelles, María Victoria Mateos-Moreno, Loreto Monsalve-Guil, Álvaro Jiménez-Guerra, Iván Ortiz-García and Eugenio Velasco-Ortega

Antibiotics 2021, 10(3), 301; https://doi.org/10.3390/antibiotics10030301 - 14 Mar 2021

Cited by 8 | Viewed by 2522

Abstract

The prescription of preventive antibiotics (PA) in oral implantology is a controversial issue. The study aimed to determine the prescribing habits of PA in professionals dedicated to oral implantology in various treatments in healthy and at-risk patients. This is a cross-sectional observational study [...] Read more.

The prescription of preventive antibiotics (PA) in oral implantology is a controversial issue. The study aimed to determine the prescribing habits of PA in professionals dedicated to oral implantology in various treatments in healthy and at-risk patients. This is a cross-sectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. An electronic survey consisting of 4 blocks of questions was sent to members of the Spanish Society of Implants. The data were analyzed using descriptive analysis. A total of 303 participants (20.8%) responded to the questionnaire. One percent never prescribed PA, 55.4% prescribed them always, and 43.6% prescribed them sometimes. Ninety-six percent administered them preoperatively, while 92.4% administered them postoperatively. The most commonly used antibiotic is amoxicillin followed by amoxicillin with clavulanic acid (875/125 mg). Clindamycin is the most commonly administered antibiotic in patients with allergies. Professionals dedicated to oral implantology frequently prescribe PA in both healthy and at-risk patients, especially perioperatively. Immediate implant placement, sinus lifts, bone regeneration, and multiple implant placement are the treatments in which PA are most commonly prescribed, as well as in patients with heart valve prostheses or a history of bacterial endocarditis and immunodeficiency. Full article

(This article belongs to the Special Issue Antibiotic Use in the Communities)

11 pages, 252 KiB

Open AccessArticle

Antibiotic Prescribing Practices in Endodontic Infections: A Survey of Dentists in Serbia

by Milan Drobac, Katarina Otasevic, Bojana Ramic, Milica Cvjeticanin, Igor Stojanac and Ljubomir Petrovic

Antibiotics 2021, 10(1), 67; https://doi.org/10.3390/antibiotics10010067 - 12 Jan 2021

Cited by 5 | Viewed by 2641

Abstract

The study goal was to provide an overview of antibiotic prescribing practices of Serbian dentists when treating endodontic infections and to disseminate the current ESE (European Society of Endodontology) recommendations to the study participants. A link to an online questionnaire was sent to [...] Read more.

The study goal was to provide an overview of antibiotic prescribing practices of Serbian dentists when treating endodontic infections and to disseminate the current ESE (European Society of Endodontology) recommendations to the study participants. A link to an online questionnaire was sent to 628 Serbian dentists whose email addresses were publicly available on the Internet, 158 of whom responded to the survey, resulting in a 25.16% response rate. The significance of possible associations was assessed via the Chi-squared test and Cramer’s V measure of association, with p < 0.05 considered as statistically significant. According to the study findings, 55.7% of respondents prescribed a 5-day antibiotic course. Moreover, Amoxicillin 500 mg was the first-choice antibiotic for 55.1% of the respondents, followed by Clindamycin 600 mg (18.4%). For patients allergic to penicillin, 61.4% of respondents prescribed Clindamycin. Statistically significant differences emerged only in relation to acute apical abscess with systemic involvement, whereby dentists aged 46–55 were least likely to prescribe antibiotics in these clinical situations (p = 0.04). Analyses further revealed that recommendations for safe antibiotic prescribing practices were not always followed, as in certain cases, patients were given antibiotics even when this was not indicated. These findings highlight the need for additional education on responsible antibiotic use to prevent bacterial resistance. Full article

(This article belongs to the Special Issue Antibiotic Use in the Communities)

14 pages, 665 KiB

Open AccessArticle

Is Early Oral Antimicrobial Switch Useful for Less Critically Ill Adults with Community-Onset Bacteraemia in Emergency Departments?

by Ching-Chi Lee, Po-Lin Chen, Chih-Chia Hsieh, Chao-Yung Yang, Chih-Hao Lin and Wen-Chien Ko

Antibiotics 2020, 9(11), 807; https://doi.org/10.3390/antibiotics9110807 - 13 Nov 2020

Cited by 1 | Viewed by 1503

Abstract

To compare prognoses and adverse events between bacteraemic patients in the emergency department (ED) who received an early antimicrobial IV-to-PO switch and those treated with late or no IV-to-PO switch, an 8-year multicentre cohort consisting of adults with community-onset bacteraemia was conducted. The [...] Read more.

To compare prognoses and adverse events between bacteraemic patients in the emergency department (ED) who received an early antimicrobial IV-to-PO switch and those treated with late or no IV-to-PO switch, an 8-year multicentre cohort consisting of adults with community-onset bacteraemia was conducted. The clinical characteristics and outcomes were compared in matched cohorts by the closest propensity score calculated based on the independent determinants of 30-day mortality identified by the multivariate regression model. Of the 6664 hospitalised patients who received no or late IV-to-PO switch, 2410 were appropriately matched with 482 patients treated with early IV-to-PO switch and discharged from the ED. There were no significant differences between the two matched groups in their baseline characteristics, including the patient demographics, severity and types of comorbidities, severity and sources of bacteraemia, and the 15- and 30-day mortality rates. Notably, in addition to the shorter lengths of intravenous antimicrobial administration and hospital stay, less phlebitis and lower antimicrobial costs were observed in patients who received an early IV-to-PO switch. Similarity was observed in the clinical failure rates between the two groups. Furthermore, the inappropriate administration of empirical antibiotics and inadequate source control were identified as the only independent determinants of the post-switch 30-day crude mortality in patients who received an early IV-to-PO switch. In conclusion, for less critically ill adults with community-onset bacteraemia who received appropriate empirical antimicrobial therapy and adequate source control, an early IV-to-PO switch might be safe and cost-effective after a short course of intravenous antimicrobial therapy. Full article

(This article belongs to the Special Issue Antibiotic Use in the Communities)

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12 pages, 1098 KiB

Open AccessStudy Protocol

Effectiveness of Pharmacist-Led Brief Educational Intervention for Adherence to the Antibiotics for Lower Respiratory Tract Infections (EATSA) in Post-Conflict Rural Areas of Pakistan: Study Protocol for a Randomized Controlled Trial

by Faiz Ullah Khan and Yu Fang

Antibiotics 2021, 10(10), 1147; https://doi.org/10.3390/antibiotics10101147 - 23 Sep 2021

Cited by 5 | Viewed by 2386

Abstract

Globally, lower respiratory infections (LRTIs) are one of the most common infectious diseases whichaffect majority of the population and as a result of inappropriate antibiotics practices lead to antibiotic resistance (AR). An individual randomized control trial will be conducted in the post-conflict areas [...] Read more.

Globally, lower respiratory infections (LRTIs) are one of the most common infectious diseases whichaffect majority of the population and as a result of inappropriate antibiotics practices lead to antibiotic resistance (AR). An individual randomized control trial will be conducted in the post-conflict areas of Swat, Pakistan, through a random sampling method. Patients aged > 18 years will be recruited from five community pharmacies and assigned to equally sized groups to receive either pharmacist-led education interventions or usual care with no intervention. A total of 400 (control = 200, study = 200) patients will be included, with prescriptions comprised of antibiotics for LRTIs. The outcomes measured in both groups will be a combination of treatment cure rate and adherence, which will be assessed using the Morisky Medication Adherence Scale and pill count. The trial comprises pharmacist-led educational interventions to improve treatment outcomes for patients with LRTIs. This study might establish the groundwork for pharmaceutical care of LRTIs patients with antibacterial therapy and the future delivery of a care strategy for the improvement of LRTIs treatment outcomes in post-conflict, remote areas of the third world and LMICs. Full article

(This article belongs to the Special Issue Antibiotic Use in the Communities)

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