Assessment of Recent Knowledge, Attitude, and Practice Towards Antimicrobial Resistance and Their Consumption During COVID-19 in Balochistan

Fatima  Mumtaz; Mah Gul  Summan; Aasia  Kalsoom; Awais  Altaf; Ghulam  Shabbir

doi:10.54112/bcsrj.v6i7.1919

Authors

Fatima Mumtaz Pakistan Council of Scientific and Industrial Research, Islamabad, Pakistan
Mah Gul Summan Department of ENT, General Hospital Lahore, Pakistan
Aasia Kalsoom Pakistan Council of Scientific and Industrial Research, Islamabad, Pakistan
Awais Altaf Institute of Molecular Biology and Biotechnology, The University of Lahore, Pakistan
Ghulam Shabbir Pakistan Council of Scientific and Industrial Research, Islamabad, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i7.1919

Keywords:

Antibiotics, Antimicrobial resistance, Microbes, Self-medication

Abstract

Antimicrobial resistance is one of the biggest problems across the world. This condition threatens the effectiveness of treatments against infectious diseases. Most people are less aware of the causes of antimicrobial resistance. The irrational use of antibiotics during the COVID era has further aggravated the situation. In the current study, the recent knowledge, attitudes, and practices related to antibiotic resistance during the COVID-19 era were assessed among the people of Balochistan. Methods: The World Health Organization questionnaire on antimicrobial resistance, with certain modifications, was used in this study. The population was divided into two categories: the general population and healthcare professionals, including doctors, pharmacists, and medical students. The population of each category was sampled randomly among the different districts of Balochistan. The responses to each question were recorded and statistically analyzed to evaluate the significance of knowledge about antimicrobial resistance. Results: A total of 250 questionnaires' responses, consisting of males 103 (41.2%) and females 147 (58.8%), were analyzed in this study. Most of the participants (69.8%) were familiar with the term "antibiotic resistance. 57.6% of respondents agreed that improper use of antibiotics causes resistance in microbes. Only 33.2% of people expressed concern that antibiotic resistance was one of the major issues worldwide. The percentage of self-medication was found to be 26.6%. Our study also showed a correlation between education level and knowledge of antibiotic resistance. The overall mean knowledge score in our study was 3.67. Conclusion: Our findings suggest that the people of Balochistan lack knowledge about antimicrobial resistance. Their attitude and practices toward the usage of antibiotics were not promising. There is a need to raise awareness among the public about the responsible use of antibiotics and the issue of antibiotic resistance. Our study also indicated a danger-related increase in antibiotic resistance due to the overuse of antibiotics during the COVID period.

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References

Sultan I, Rahman S, Jan AT, Siddiqui MT, Mondal AH, Haq QMR. Antibiotics, resistome and resistance mechanisms: A bacterial perspective. Front Microbiol. 2018;9:2066. https://doi.org/10.3389/fmicb.2018.02066

Coates AR, Halls G, Hu Y. Novel classes of antibiotics or more of the same? Br J Pharmacol. 2011;163(1):184–94. https://doi.org/10.1111/j.1476-5381.2011.01250.x

Ashbolt NJ, Amézquita A, Backhaus T, Borriello P, Brandt KK, Collignon P, et al. Human Health Risk Assessment (HHRA) for Environmental Development and Transfer of Antibiotic Resistance. Environ Health Perspect. 2013;121(9):993–1001. https://doi.org/10.1289/ehp.1206316

Vivas R, Barbosa AAT, Dolabela SS, Jain S. Multidrug-resistant bacteria and alternative methods to control them: An overview. Microb Drug Resist. 2019;25(6):890–908. https://doi.org/10.1089/mdr.2018.0319

Africa Centers for Disease Control and Prevention. Africa CDC Framework for Antimicrobial Resistance, 2018–2023. 2018.

Qiu Z, Yu Y, Chen Z, Jin M, Yang D, Zhao Z, et al. Nanoalumina promotes the horizontal transfer of multiresistance genes mediated by plasmids across genera. Proc Natl Acad Sci U S A. 2012;109(13):4944–9. https://doi.org/10.1073/pnas.1107254109

Taylor NG, Verner-Jeffreys DW, Baker-Austin C. Aquatic systems: Maintaining, mixing and mobilising antimicrobial resistance? Trends Ecol Evol. 2011;26(6):278–84. https://doi.org/10.1016/j.tree.2011.03.004

World Health Organization. Global action plan on antimicrobial resistance. Geneva: WHO; 2015.

Chaw PS, Höpner J, Mikolajczyk R. The knowledge, attitude and practice of health practitioners towards antibiotic prescribing and resistance in developing countries: A systematic review. J Clin Pharm Ther. 2018;43(5):606–13. https://doi.org/10.1111/jcpt.12620

Spellberg B. The maturing mantra of antibiotics: "Shorter is still better.” J Hosp Med. 2018;13(5):361. https://doi.org/10.12788/jhm.2925

Ur Rahman S, Mohsin M. The under-reported issue of antibiotic resistance in food-producing animals in Pakistan. Pak Vet J. 2019;39(2):175–9. https://doi.org/10.29261/pakvetj/2019.037

Akhund R, Jamshed F, Jaffry HA, Hanif H, Fareed S. Knowledge and attitude of the general Pakistani population towards antibiotic resistance. Cureus. 2019;11(3):e4266. https://doi.org/10.7759/cureus.4266

Hameed A, Naveed S, Qamar F, Alam T, Abbas S, Sharif N. Irrational use of antibiotics: Different age groups of Karachi—A wakeup call for antibiotic resistance and future infections. J Bioequiv Availab. 2016;8:242–5. https://doi.org/10.4172/jbb.1000302

Ilktac M, Tarabishi MT, Ozbirtan P, Gulcan C, Celik G. A public awareness study about antibiotic consumption habits and antibacterial resistance in the north-eastern region of Cyprus. J Infect Dev Ctries. 2020;14(5):463–70. https://doi.org/10.3855/jidc.11936

Mouhieddine TH, Olleik Z, Itani MM, Kawtharani S, Nassar H, Hassoun R, et al. Assessing the Lebanese population for their knowledge, attitudes, and practices of antibiotic usage. J Infect Public Health. 2015;8(1):20–31. https://doi.org/10.1016/j.jiph.2014.07.010

Chukwu EE, Oladele DA, Awoderu OB, Afocha EE, Lawal RG, Abdus-Salam I, et al. A national survey of public awareness of antimicrobial resistance in Nigeria. Antimicrob Resist Infect Control. 2020;9:1–10. https://doi.org/10.1186/s13756-020-00823-2

World Health Organization. Antibiotic resistance: Multi-country public awareness survey. Geneva: WHO; 2015.

Solangi MA, Ali M, Mushtaq D, Zaid M, Riaz M, Nasir A. Parent-based self-medication in Pakistani children: A qualitative cross-sectional survey. Bangladesh J Med Sci. 2016;15(1):33–8. https://doi.org/10.3329/bjms.v15i1.22055

Ameko E, Achio S, Alhassan S. Effects of antibiotic self-medication on the efficacy of four antibiotics commonly used in Ghana on clinically isolated microorganisms. Int J Pure Appl Sci Technol. 2012;10(2):62–8.

Morgan DJ, Okeke IN, Laxminarayan R, Perencevich EN, Weisenberg S. Non-prescription antimicrobial use worldwide: A systematic review. Lancet Infect Dis. 2011;11(9):692–701. https://doi.org/10.1016/S1473-3099(11)70054-8

Javed MP. Self-Medication with Antibiotics among University Students in Islamabad: Prevalence, Knowledge, and Attitudes. IOSR J Pharm Biol Sci. 2013;6(4):1–4.

Arshad MS, Ijaz M, Hussain A. Evaluation of antibiotic use behavior in cold and flu amongst the students of Bahauddin Zakariya University, Multan, Pakistan. Pak J Pharm. 2010;23(2):15–22.

Hussain S, Malik F, Hameed A, Ahmad S, Riaz H. Exploring health-seeking behavior, medicine use, and self-medication in urban and rural Pakistan. South Med Rev. 2010;3(2):32–4.

Khan H, Maheen S, Alamgeer GA, Mahmood A, Sarfraz RM, Ashraf Z, et al. Determinants of the increasing trend of self-medication in a Pakistani community. Trop J Pharm Res. 2014;13(3):437–43.

Khan FU, Khan FU, Hayat K, Chang J, Saeed A, Khan Z, et al. Knowledge, attitude, and practices among consumers regarding antibiotic use and antibiotic resistance in Swat, Khyber-Pakhtunkhwa, Pakistan. Expert Rev Anti Infect Ther. 2020;18(9):937–46. https://doi.org/10.1080/14787210.2020.1769477

Giacomelli A, Ridolfo AL, Oreni L, Vimercati S, Albrecht M, Cattaneo D, et al. Consumption of antibiotics at an Italian university hospital during the early months of the COVID-19 pandemic: Were all antibiotic prescriptions appropriate? Pharmacol Res. 2021;164:105403. https://doi.org/10.1016/j.phrs.2020.105403

Mahajan M, Dudhgaonkar S, Deshmukh S. A questionnaire-based survey on the knowledge, attitude, and practices about antimicrobial resistance and usage among the second-year MBBS students of a teaching tertiary care hospital in central India. Int J Pharmacol Res. 2014;4(4):175–9.

Khan E, Hafeez A, Ikram A. Situation analysis report on antimicrobial resistance in Pakistan: Findings and recommendations for antibiotic use and resistance. Global Antibiotic Resistance Partnership (GARP), Pakistan. 2018.

Ghanchi NK, Khan E, Farooqi JQ, Fasih N, Dojki M, Hughes MA. Knowledge and practices of laboratory workers on standardized antimicrobial susceptibility testing and biosafety practices to prevent the spread of superbugs in Pakistan. Am J Infect Control. 2014;42(9):1022–4. https://doi.org/10.1016/j.ajic.2014.06.006