Cross-sectional study of the use of antimicrobials following common infections by rural residents in Anhui, China

Jing Chai, Caroline Coope, Jing Cheng, Isabel Oliver, Anthony Kessel*, Zhi Hu, Debin Wang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Objective To describe help seeking behaviour from a medical doctor and antimicrobial use for common infections among rural residents of Anhui province, China. Design A cross-sectional retrospective household survey. Setting 12 administrative villages from rural Anhui, China. Participants 2760 rural residents selected through cluster-randomised sampling using an interviewer administered questionnaire. Method Logistic regression models were used to estimate associations between exposures (health insurance and antimicrobial-related knowledge), adjusted for confounders (sex, age and education), and help-seeking behaviour from a medical doctor and antimicrobial use following common infections, including acute respiratory tract infections (ARTIs), gastrointestinal tract infections (GTIs) and urinary tract infections (UTIs). Results In total 2611 (94.6%) rural residents completed the questionnaire. Help seeking from a medical doctor was highest for ARTIs (59.4%) followed by GTIs (42.1%), and UTIs (27.8%). Around two-thirds (82.3% for ARTIs, 87.0% for GTIs and 66.0% for UTIs) of respondents sought help within 3 days following symptom onset and over three quarters (88% for ARTIs, 98% for GTIs and 77% for UTIs) reported complete recovery within 7 days. Of the help-seeking respondents, 94.5% with ARTI symptoms recalled being prescribed either oral or intravenous antimicrobials (GTIs 81.7% and UTIs 70.4%). Use of antimicrobials bought from medicine shops without prescriptions ranged from 8.8% for GTIs to 17.2% for ARTIs; while use of antimicrobials leftover from previous illnesses or given by a relative ranged from 7.6% for UTIs to 13.4% for ARTIs. Multivariate logistic regression analysis revealed that respondents with a higher antimicrobial-related knowledge score and lack of insurance were associated with lower levels of help-seeking for ARTIs; while respondents with a higher antimicrobial-related knowledge score were less likely to be prescribed either oral or intravenous antimicrobials. Conclusions Excessive antimicrobial use in the studied primary care settings is still prevalent.

Original languageEnglish
Article numbere024856
JournalBMJ Open
Volume9
Issue number4
DOIs
Publication statusPublished - 1 Apr 2019

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords

  • antimicrobial resistance
  • antimicrobial use
  • pharmacoepidemiology
  • prescription
  • self-medication

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