Suchergebnisse

Antibiotic resistance is a global public health issue with several anthropogenic drivers, including antibiotic consumption. Recent studies have highlighted that the relationship between antibiotic consumption and antibiotic resistance is contextualised by a variety of socioeconomic, cultural, and governance-related drivers of consumption behaviour and contagion that have been underexamined. A potential complication for research and policy is that measures of antibiotic consumption are often reliant on prescribing or sales data which may not easily take into account the dynamics of community consumption that include self-medication; for example, the preservation and use of leftover medication or the obtaining of antibiotics without a prescription. This study uses repeated cross-sectional survey data to fulfil two core aims: firstly, to examine the individual-level and national-contextual determinants of self-medication among antibiotic consumers in European countries, and secondly, to examine the relationship between self-medication behaviour and antibiotic resistance at the national level.
This study is particularly novel in its application of a multilevel modelling specification that includes individual-level factors with both time-variant and persistent national characteristics to examine antibiotic consumption behaviours. The key findings of the study are that survey respondents in countries with persistently higher levels of inequality, burdens of out-of-pocket health expenditure, and corruption have an increased probability of self-medicating with antibiotics. The study also highlights that overall levels of antibiotic consumption and antibiotic self-medication do not correlate and are associated heterogeneously with changes in different pathogen/antibiotic pairs. In summary, the study emphasises that antibiotic stewardship and antibiotic resistance, whilst related by biological mechanisms, are also inherently social issues. Attempts to improve antibiotic stewardship and address the challenge of antibiotic resistance should also attend to structural challenges that underlie challenges to antibiotic stewardship in the community, such as the effects of inequality and reduced access to healthcare services.

Antibiotic resistance is an emerging global health threat which is linked to the overuse and misuse of antibiotics. This study was conducted to understand the knowledge and practices of smallholder pig farmers on antibiotic use and resistance in Timor-Leste. A cross-sectional study using a structured face-to-face interview was conducted in three municipalities. The interview was piloted and implemented in the local Tetun language. This study found that knowledge of antibiotics was very poor as only 12.7% (95% CI: 6.3–23.9) of farmers reported knowing what antibiotics were, and of these only one was able to correctly explain how an antibiotic worked. None of the farmers knew about antibiotic resistance and were able to explain the concept correctly. After the definition of antibiotic was explained to the farmer, only 3.6% (95% CI: 0.8–14.9) reported that their pigs had ever received antibiotics, and the majority of farmers whose pigs had not received antibiotics reported the lack of access to veterinary services. When used, antibiotics were only used for treatment with no reported use for disease prevention or growth promotion. None of the commonly used antibiotics were critically important antimicrobials. Compliance with withdrawal periods was not routinely followed. There is a need to improve access to government veterinary services for farmers in Timor-Leste, while addressing identified knowledge gaps on antibiotics and promoting prudent use practices. The findings from this study serve as baseline information to inform future interventions.