Antibiotic use in rural China: a cross-sectional survey of knowledge, attitudes and self-reported practices among caregivers in Shandong province.
Antibiotic use in rural China: a cross-sectional survey of knowledge, attitudes and self-reported practices among caregivers in Shandong province.
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DOI：
10.1186/s12879-015-1323-z
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发表时间：
2015-12-21
影响因子：
3.7
通讯作者：
Dyar OJ
中科院分区：
文献类型：
--
作者：
Ding L;Sun Q;Sun W;Du Y;Li Y;Bian X;He G;Bai H;Dyar OJ
为了在全球范围内改善抗生素的使用，我们必须加深对公众有关抗生素的知识、态度和实践（KAP）的理解。儿童是抗生素的频繁使用者，他们的照顾者在决定如何使用抗生素方面发挥着重要作用。本研究的目的是描述在中国东部的一个农村省份的照顾者的KAP，并确定与抗生素使用不当的社会人口学因素。采用横断面问卷调查方法，对山东省某县12个自然村进行了调查。共有727名0-7岁儿童的主要日常照顾者被随机选择并邀请参加。所有的照顾者进行了面对面的调查，使用半结构化的问卷调查，重点是在儿童中使用抗生素。几乎所有被邀请的照顾者（99.3%）都完整地完成了问卷。照顾者对抗生素治疗常见儿童症状的期望过高，指出当儿童发烧（46%）或干咳（42%）时，抗生素总是或通常是必要的。大多数照顾者（93%）知道在给孩子服用抗生素时应该听从医生的建议。然而，许多人报告说，他们以前偏离了建议;这是最常见的通过间歇性而不是定期使用抗生素，但也通过增加和减少剂量。年龄较大和受教育程度较低的护理人员自我报告的依从性水平较高（p < 0.01）。三分之一的照顾者承认在家里储存了剩余的抗生素，几乎所有这些照顾者（97%）都曾为孩子第二次使用过抗生素。我们已经确定了在农村人口的照顾者中有关抗生素的知识，态度和做法的重要差距。显然需要采取多方面的干预措施，以乡村医生为目标，改善处方和沟通，并改善公众的就医行为，促进个人负责任地使用抗生素。本文的在线版本（doi：10.1186/s12879-015-1323-z）包含补充材料，可供授权用户使用。
To improve antibiotic use globally, we must deepen our understanding of the public’s knowledge, attitudes and practices (KAP) concerning antibiotics. Children are frequent users of antibiotics, and their caregivers play important roles in determining how antibiotics are used. The purpose of this study was to describe caregivers’ KAP in a rural province in eastern China, and to identify socio-demographic factors associated with inappropriate antibiotic use. A cross-sectional questionnaire based survey was conducted in 12 villages in one county in Shandong Province. A total of 727 individuals who were the primary day-to-day caregiver for a child aged 0–7 years were randomly selected and invited to participate. All caregivers were surveyed face-to-face using a semi-structured questionnaire focusing on the use of antibiotics in children. Almost all invited caregivers (99.3 %) completed the questionnaire in full. Caregivers expressed high levels of over-expectation for antibiotics for common childhood symptoms, stating that antibiotics were always or usually necessary when a child has a fever (46 %) or dry cough (42 %). Most caregivers (93 %) were aware that they should follow the doctor’s advice when giving their children antibiotics. Many, however, reported that they had previously deviated from advice; this was most commonly through using antibiotics intermittently rather than regularly, but also by increasing and decreasing doses. Caregivers that were older and that had less formal education had higher levels of self-reported adherence (p < 0.01). A third of caregivers admitted to storing leftover antibiotics at home, and almost all of these caregivers (97 %) had used the antibiotics on a second occasion for their child. We have identified important gaps in knowledge, attitudes and practices concerning antibiotics among this rural population of caregivers. There is a clear need for multifaceted interventions that target village doctors, to improve prescribing and communication, as well as the general public, to improve health-seeking behaviours and promote responsible individual use of antibiotics. The online version of this article (doi:10.1186/s12879-015-1323-z) contains supplementary material, which is available to authorized users.