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.
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DOI：
10.3390/ijerph15061165
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发表时间：
2018-06-04
影响因子：
--
通讯作者：
Zhou X
中科院分区：
文献类型：
--
作者：
Hu Y;Wang X;Tucker JD;Little P;Moore M;Fukuda K;Zhou X
目的：抗生素的不适当使用导致抗生素耐药性。这已成为一个严重的全球危机，多重耐药感染越来越多，有效的抗生素越来越少。本研究旨在了解中国医学生对抗生素治疗自限性疾病的知识、态度和行为（KAP）。研究方法：2015年9月至11月，在中国六所区域性大学分发了在线横断面调查工具问卷。共招收医学生1819名。研究人员提交了一份预先测试的问卷。计算KAP分数以确定拨款。采用卡方和多变量logistic回归以及调整的比值比（aOR）和95%置信区间（CI）评估人口统计学特征与抗生素使用知识和行为之间的关系。结果：共有11，192名学生完成了问卷调查，回复率为95%。总共有529名（29%）医学生在上个月报告了至少一种自限性疾病。在患有自限性疾病的患者中，285人（54%）自我治疗，77人（27%）使用抗生素; 111人（21%）去看医生，其中64人（58%）开了抗生素，133人（25%）什么也没做。在过去的一年里，279名（15%）医学生使用抗生素作为预防措施，273名（15%）医学生要求医生提供抗生素。同时，1166人（64%）持有抗生素，1034人（57%）曾在药房购买抗生素，其中97%是在没有处方的情况下购买的。与抗生素相关的KAP得分高的学生使用抗生素的可能性显著降低（aOR 0.37，95% CI 0.15-0.91，p = 0.031），使用抗生素预防（aOR 0.35，95% CI 0.21-0.60，p < 0.0001），或要求医生使用抗生素（aOR 0.46，95% CI 0.26-0.81，p = 0.007）。Logstrom回归分析显示，父亲文化程度高、母亲有医学背景、来自城市的学生更有可能储备抗生素和自行使用抗生素。结论：医学生抗生素自限性疾病的自用药率和抗生素库存率较高。沿着的是医学生从医生那里接受不必要的抗生素的比率很高。学生们对抗生素的知识和态度推动了处方，这突出表明中国医疗机构和医学院迫切需要有效的抗生素管理和培训计划。
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.
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