The associations between poor antibiotic and antimicrobial resistance knowledge and inappropriate antibiotic use in the general population are modified by age

• Main Authors: GUO, Huiling, HILDON, Zoe Jane-Lara, LYE, David Chien Boon, STRAUGHAN, Paulin Tay, CHOW, Angela
• Format: text
• Language: English
• Published: Institutional Knowledge at Singapore Management University 2022
• Subjects: antimicrobial resistance; public knowledge; inappropriate antibiotic use; populationbased survey; effect modification; Chemicals and Drugs; Community-Based Research; Health and Medical Administration
• Online Access: https://ink.library.smu.edu.sg/soss_research/3483; https://ink.library.smu.edu.sg/context/soss_research/article/4741/viewcontent/antibiotics_11_00047_v2.pdf
• Institution: Singapore Management University

Objectives: Understanding factors influencing inappropriate antibiotic use can guide the design of interventions to improve antibiotic practices and reduce antimicrobial resistance (AMR). Methods: A nationally representative cross-sectional survey (N = 2004) was conducted between November 2020 and January 2021. Knowledge of antibiotic use and AMR using the World Health Organization’s Multi-Country AMR Survey questionnaire, and antibiotic practices were examined. Multivariable logistic regression was performed to identify factors associated with inappropriate antibiotic use and examine effect measure modifications. Results: After adjusting for potential confounding, poor knowledge of antibiotic use was associated with a 3x increased odds of inappropriate antibiotic use in adults aged ≥50 years (aOR 3.11, 95% CI [2.24–4.32]), 5× increased odds in those aged 35–49 years (aOR 4.88, 95% CI [3.32–7.16]), and 7× increased odds in those aged 21–34 years (aOR 6.58, 95% CI [4.19–10.33]). While there was no statistically significant association in adults aged ≥50 years, poor knowledge of AMR increased the odds of inappropriate antibiotic use by 4 times in adults aged 35–49 years (aOR 3.73, 95% CI [1.53–9.11]) and 5 times in those aged 21–34 years (aOR 4.90, 95% CI [1.84–13.02]). Conclusions: Targeted educational interventions for specific age groups are needed in conjunction with empowering the public with knowledge of antibiotic use and AMR.