The University of Southampton
University of Southampton Institutional Repository

Knowledge, attitude, and practice with respect to antibiotic use among Chinese medical students: A multicentre cross-sectional study

Knowledge, attitude, and practice with respect to antibiotic use among Chinese medical students: A multicentre cross-sectional study
Knowledge, attitude, and practice with respect to antibiotic use among Chinese medical students: A multicentre cross-sectional study

Objective: Inappropriate antibiotic use leads to antibiotic resistance. This has become a serious global crisis, with more multi-drug resistant infections and fewer effective antibiotics available. This study aims to understand knowledge, attitude, and practice (KAP) with respect to antibiotic use for self-limiting illnesses among medical students in China. Methods: An online cross-sectional survey instrument questionnaire was distributed in six regional universities in China from September to November 2015. Overall, 1819 medical students were enrolled. A pre-tested questionnaire was delivered by the researchers. KAP scores were calculated to determine the appropriation. Chi-squared and multivariable logistic regression and adjusted odd ratios (aORs) with 95% confidence interval (CI) were used to assess the relationship between the demographic characteristics and antibiotic use knowledge and behaviour. Results: In total, 11,192 students completed the questionnaires, with a response rate of 95%. In total, 529 (29%) medical students reported at least one self-limiting illness in the prior month. Of those with a self-limiting illness, 285 (54%) self-medicated, with 77 (27%) using antibiotics; 111 (21%) went to see a doctor, of which 64 (58%) were prescribed antibiotics, and 133 did nothing (25%). In the past year, 279 (15%) of medical students had used antibiotics as prophylaxis, and 273 (15%) of medical students had demanded an antibiotic from a doctor. Meanwhile, 1166 (64%) of them kept a personal stock of antibiotics, and 1034 (57%) of them had bought antibiotics at a pharmacy, of which 97% were purchased without a prescription. Students with high KAP scores with respect to antibiotics were significantly less likely to self-medicate with antibiotics (aOR 0.37, 95% CI 0.15–0.91, p = 0.031), use antibiotics for prophylaxis (aOR 0.35, 95% CI 0.21–0.60, p < 0.0001), or demand an antibiotic (aOR 0.46, 95% CI 0.26–0.81, p = 0.007) from the doctor. Logistical regression showed that students whose fathers had a higher education level, whose mothers had medical background, who were from urban areas were more likely to stock antibiotics and self-medicate with antibiotics. Conclusion: High rates of antibiotic self-medication for self-limiting illness and stocking of antibiotics among medical students were observed. Along with the high rates of medical students receiving unnecessary antibiotics from their doctors were observed. The students’ knowledge and attitude towards to antibiotics, which drive prescribing, highlight the urgent need for effective antibiotic stewardship and training programs in Chinese healthcare institutes and medical schools.

Antibiotic use, Knowledge and attitude, Medical students, Multicentre
1661-7827
Hu, Yanhong
26b1c2ef-2b36-41d9-972c-3101f67582f8
Wang, Xiaomin
2d09b53c-cc8f-461a-b489-4a724732b3b6
Tucker, Joseph D.
3b2506a6-9770-4f64-beb3-fbed42c06a19
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Fukuda, Keiji
bf10f6f4-9e20-4e74-92b6-5d37613bcf00
Zhou, Xudong
83b8512a-f3cf-45a8-bc09-94bd7c09c9fe
Hu, Yanhong
26b1c2ef-2b36-41d9-972c-3101f67582f8
Wang, Xiaomin
2d09b53c-cc8f-461a-b489-4a724732b3b6
Tucker, Joseph D.
3b2506a6-9770-4f64-beb3-fbed42c06a19
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Fukuda, Keiji
bf10f6f4-9e20-4e74-92b6-5d37613bcf00
Zhou, Xudong
83b8512a-f3cf-45a8-bc09-94bd7c09c9fe

Hu, Yanhong, Wang, Xiaomin, Tucker, Joseph D., Little, Paul, Moore, Michael, Fukuda, Keiji and Zhou, Xudong (2018) Knowledge, attitude, and practice with respect to antibiotic use among Chinese medical students: A multicentre cross-sectional study. International Journal of Environmental Research and Public Health, 15 (6), [1165]. (doi:10.3390/ijerph15061165).

Record type: Article

Abstract

Objective: Inappropriate antibiotic use leads to antibiotic resistance. This has become a serious global crisis, with more multi-drug resistant infections and fewer effective antibiotics available. This study aims to understand knowledge, attitude, and practice (KAP) with respect to antibiotic use for self-limiting illnesses among medical students in China. Methods: An online cross-sectional survey instrument questionnaire was distributed in six regional universities in China from September to November 2015. Overall, 1819 medical students were enrolled. A pre-tested questionnaire was delivered by the researchers. KAP scores were calculated to determine the appropriation. Chi-squared and multivariable logistic regression and adjusted odd ratios (aORs) with 95% confidence interval (CI) were used to assess the relationship between the demographic characteristics and antibiotic use knowledge and behaviour. Results: In total, 11,192 students completed the questionnaires, with a response rate of 95%. In total, 529 (29%) medical students reported at least one self-limiting illness in the prior month. Of those with a self-limiting illness, 285 (54%) self-medicated, with 77 (27%) using antibiotics; 111 (21%) went to see a doctor, of which 64 (58%) were prescribed antibiotics, and 133 did nothing (25%). In the past year, 279 (15%) of medical students had used antibiotics as prophylaxis, and 273 (15%) of medical students had demanded an antibiotic from a doctor. Meanwhile, 1166 (64%) of them kept a personal stock of antibiotics, and 1034 (57%) of them had bought antibiotics at a pharmacy, of which 97% were purchased without a prescription. Students with high KAP scores with respect to antibiotics were significantly less likely to self-medicate with antibiotics (aOR 0.37, 95% CI 0.15–0.91, p = 0.031), use antibiotics for prophylaxis (aOR 0.35, 95% CI 0.21–0.60, p < 0.0001), or demand an antibiotic (aOR 0.46, 95% CI 0.26–0.81, p = 0.007) from the doctor. Logistical regression showed that students whose fathers had a higher education level, whose mothers had medical background, who were from urban areas were more likely to stock antibiotics and self-medicate with antibiotics. Conclusion: High rates of antibiotic self-medication for self-limiting illness and stocking of antibiotics among medical students were observed. Along with the high rates of medical students receiving unnecessary antibiotics from their doctors were observed. The students’ knowledge and attitude towards to antibiotics, which drive prescribing, highlight the urgent need for effective antibiotic stewardship and training programs in Chinese healthcare institutes and medical schools.

Text
ijerph-15-01165 - Version of Record
Available under License Creative Commons Attribution.
Download (521kB)

More information

Accepted/In Press date: 30 May 2018
e-pub ahead of print date: 4 June 2018
Keywords: Antibiotic use, Knowledge and attitude, Medical students, Multicentre

Identifiers

Local EPrints ID: 421675
URI: http://eprints.soton.ac.uk/id/eprint/421675
ISSN: 1661-7827
PURE UUID: 1da94007-51eb-4138-9087-317c581bf176
ORCID for Michael Moore: ORCID iD orcid.org/0000-0002-5127-4509

Catalogue record

Date deposited: 21 Jun 2018 16:30
Last modified: 17 Dec 2019 01:46

Export record

Altmetrics

Contributors

Author: Yanhong Hu
Author: Xiaomin Wang
Author: Joseph D. Tucker
Author: Paul Little
Author: Michael Moore ORCID iD
Author: Keiji Fukuda
Author: Xudong Zhou

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×