International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2008
Survey of antibiotic use of individuals visiting public healthcare facilities in Indonesia.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Hadi Usman, Duerink D Offra, Lestari Endang Sri, Nagelkerke Nico J, Werter Susanne, Keuter Monique, Suwandojo Eddy, Rahardjo Eddy, van den Broek Peterhans, Gyssens Inge C, Antimicrobial Resistance in Indonesia 'Prevalence and Prevention' study group
Аннотация
OBJECTIVES: To estimate the antibiotic use of individuals visiting public healthcare facilities in Indonesia and to identify determinants of use against a background of high resistance rates.
METHODS: Patients on admission to hospital (group A), visiting a primary health center (group B), and healthy relatives (group C) were included in the study. A questionnaire on demographic, socioeconomic, and healthcare-related items including health complaints and consumption of antibiotics was used. Logistic regression was performed to determine the co-variables of antibiotic use.
RESULTS: Of 2996 individuals interviewed, 486 (16%) had taken an antibiotic. Compared to group C (7% consumption), groups B and A exhibited a three-fold and four-fold higher use of antibiotics, respectively. Respiratory (80%) and gastrointestinal (13%) symptoms were most frequent. Aminopenicillins and tetracyclines accounted for 80% of the prescribed antibiotics. Similar antibiotics were self-medicated (17% of users). Age less than 18 years and health insurance were independent determinants of antibiotic use. Urban provenance, being adult, male, and having no health insurance were independent determinants of self-medication.
CONCLUSIONS: In addition to health complaints, other factors determined antibiotic consumption. In view of the likely viral origin of respiratory complaints and the resistance of intestinal pathogens, most antibiotic use was probably unnecessary or ineffective. Future interventions should be directed towards healthcare providers.
METHODS: Patients on admission to hospital (group A), visiting a primary health center (group B), and healthy relatives (group C) were included in the study. A questionnaire on demographic, socioeconomic, and healthcare-related items including health complaints and consumption of antibiotics was used. Logistic regression was performed to determine the co-variables of antibiotic use.
RESULTS: Of 2996 individuals interviewed, 486 (16%) had taken an antibiotic. Compared to group C (7% consumption), groups B and A exhibited a three-fold and four-fold higher use of antibiotics, respectively. Respiratory (80%) and gastrointestinal (13%) symptoms were most frequent. Aminopenicillins and tetracyclines accounted for 80% of the prescribed antibiotics. Similar antibiotics were self-medicated (17% of users). Age less than 18 years and health insurance were independent determinants of antibiotic use. Urban provenance, being adult, male, and having no health insurance were independent determinants of self-medication.
CONCLUSIONS: In addition to health complaints, other factors determined antibiotic consumption. In view of the likely viral origin of respiratory complaints and the resistance of intestinal pathogens, most antibiotic use was probably unnecessary or ineffective. Future interventions should be directed towards healthcare providers.
Предметные рубрики MeSH
AdolescentAdultAgedAged, 80 and overAnti-Bacterial AgentsChildChild, PreschoolFemaleGastrointestinal DiseasesHealth Care SurveysHospitalizationHospitals, TeachingHumansIndonesiaInfantInfant, NewbornInterviews as TopicMaleMiddle AgedPractice Patterns, Physicians'Public PolicyRespiratory Tract InfectionsRural Health ServicesSurveys and QuestionnairesUrban Health ServicesYoung Adult