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Official Journal of the Australasian College for Infection Prevention and Control
RESEARCH ARTICLE

Knowledge, attitudes and perceptions regarding antibiotic use and self-medication: a cross-sectional study among Australian Chinese migrants

Jie Hu A B and Zhiqiang Wang A
+ Author Affiliations
- Author Affiliations

A Centre for Chronic Disease, School of Medicine, University of Queensland, Herston, Qld 4029, Australia.

B Corresponding author. Email: j.hu1@uq.edu.au

Healthcare Infection 20(1) 23-28 https://doi.org/10.1071/HI14034
Submitted: 30 September 2014  Accepted: 15 December 2014   Published: 23 February 2015

Abstract

Background: Self-medication of antibiotics can promote antibiotic resistance. This study aimed to investigate the practice of self-medication with antibiotics to treat URTIs in Australian Chinese migrants and to understand whether their knowledge of antibiotics, attitudes to and perceptions of antibiotic use was associated with self-medication of antibiotics.

Methods: Four hundred and seventeen participants were recruited in an online health survey involving a bilingual questionnaire through several Australian-based Chinese social websites. Multiple logistic regressions were performed to explore the associations between self-medication and antibiotic-related knowledge, attitudes, and perception factors.

Results: Around 24.2% of Chinese migrants used antibiotics without medical consultation for URTIs. Almost 70% of Chinese migrants indicated that they would stop taking antibiotics when symptoms improved; around 61% would use leftover antibiotics if they had similar symptoms. Furthermore, participants who would use leftover antibiotics (OR: 3.1, 95% CI: 1.7–5.6), or who would take an incomplete course of antibiotics (OR: 1.7, 95% CI: 1.0–3.1) were more likely to report self-medication with antibiotics. Participants who perceived it was appropriate to use antibiotics for fever, cough and sore throat were at a greater risk of self-medication with antibiotics for URTIs.

Conclusion: A considerable number of Chinese migrants used antibiotics for URTIs without medical consultation in Australia. Misperceptions about antibiotic use were significantly associated with the practice of self-medicating in this group. The findings provided important information for developing culturally responsive interventions for the correct use of antibiotics in Australian Chinese communities.


References

[1]  Albrich WC, Monnet DL, Harbarth S. Antibiotic selection pressure and resistance in Streptococcus pneumoniae and Streptococcus pyogenes. Emerg Infect Dis 2004; 10 514–7.
Antibiotic selection pressure and resistance in Streptococcus pneumoniae and Streptococcus pyogenes.Crossref | GoogleScholarGoogle Scholar | 15109426PubMed |

[2]  Huttner B, Goossens H, Verheij T, Harbarth S. Characteristics and outcomes of public campaigns aimed at improving the use of antibiotics in outpatients in high-income countries. Lancet Infect Dis 2010; 10 17–31.
Characteristics and outcomes of public campaigns aimed at improving the use of antibiotics in outpatients in high-income countries.Crossref | GoogleScholarGoogle Scholar | 20129146PubMed |

[3]  Chang SC, Shiu MN, Chen TJ. Antibiotic usage in primary care units in Taiwan after the institution of national health insurance. Diagn Microbiol Infect Dis 2001; 40 137–43.
Antibiotic usage in primary care units in Taiwan after the institution of national health insurance.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3Mvls12rsg%3D%3D&md5=e1d6da503c2e97c60c801d4a5c19ac82CAS | 11502383PubMed |

[4]  Yang YH, Fu SG, Peng H, Shen AD, Yue SJ, Go YF, Yuan L, Jiang ZF. Abuse of antibiotics in China and its potential interference in determining the etiology of pediatric bacterial diseases. Pediatr Infect Dis J 1993; 12 986–7.
Abuse of antibiotics in China and its potential interference in determining the etiology of pediatric bacterial diseases.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2c7ltFWisw%3D%3D&md5=a7a52f79d971d82ff7fe1a1438cc33eaCAS | 8108225PubMed |

[5]  Chan GC, Tang SF. Parental knowledge, attitudes and antibiotic use for acute upper respiratory tract infection in children attending a primary healthcare clinic in Malaysia. Singapore Med J 2006; 47 266–70.
| 1:STN:280:DC%2BD287nvVGhsA%3D%3D&md5=f74de0d02dea03f7c83b000b24aebfbeCAS | 16572235PubMed |

[6]  Kim SS, Moon S, Kim EJ. Public knowledge and attitudes regarding antibiotic use in South Korea. Journal of Korean Academy of Nursing 2011; 41 742–9.
Public knowledge and attitudes regarding antibiotic use in South Korea.Crossref | GoogleScholarGoogle Scholar | 22310858PubMed |

[7]  Jassim AM. In-home drug storage and self-medication with antimicrobial drugs in Basrah, Iraq. Oman Med J 2010; 25 79–87.
In-home drug storage and self-medication with antimicrobial drugs in Basrah, Iraq.Crossref | GoogleScholarGoogle Scholar | 22125705PubMed |

[8]  Harrigan P. Australia: rational prescribing in general practice. Lancet 1991; 338 1448–9.
Australia: rational prescribing in general practice.Crossref | GoogleScholarGoogle Scholar |

[9]  Zwar N, Wolk J, Gordon J, Sanson-Fisher R, Kehoe L. Influencing antibiotic prescribing in general practice: a trial of prescriber feedback and management guidelines. Fam Pract 1999; 16 495–500.
Influencing antibiotic prescribing in general practice: a trial of prescriber feedback and management guidelines.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c%2FgtFGisQ%3D%3D&md5=4b071790b290143c047faaa9c84641acCAS | 10533946PubMed |

[10]  Steinke DT, Bain DJ, MacDonald TM, Davey PG. Practice factors that influence antibiotic prescribing in general practice in Tayside. J Antimicrob Chemother 2000; 46 509–12.
Practice factors that influence antibiotic prescribing in general practice in Tayside.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD3cXmvV2ktbw%3D&md5=4a235b7dff2985fd7402f673dd6d7017CAS | 10980184PubMed |

[11]  Radyowijati A, Haak H. Improving antibiotic use in low-income countries: an overview of evidence on determinants. Soc Sci Med 2003; 57 733–44.
Improving antibiotic use in low-income countries: an overview of evidence on determinants.Crossref | GoogleScholarGoogle Scholar | 12821020PubMed |

[12]  Vanden Eng J, Marcus R, Hadler JL, Imhoff B, Vugia DJ, Cieslak PR, Zell E, Deneen V, McCombs KG, Zansky SM, Hawkins MA, Besser RE. Consumer attitudes and use of antibiotics. Emerg Infect Dis 2003; 9 1128–35.
Consumer attitudes and use of antibiotics.Crossref | GoogleScholarGoogle Scholar | 14519251PubMed |

[13]  Wutzke SE, Artist MA, Kehoe LA, Fletcher M, Mackson JM, Weekes LM. Evaluation of a national programme to reduce inappropriate use of antibiotics for upper respiratory tract infections: effects on consumer awareness, beliefs, attitudes and behaviour in Australia. Health Promot Int 2007; 22 53–64.
Evaluation of a national programme to reduce inappropriate use of antibiotics for upper respiratory tract infections: effects on consumer awareness, beliefs, attitudes and behaviour in Australia.Crossref | GoogleScholarGoogle Scholar | 17046966PubMed |

[14]  Norris P, Ng L, Kershaw V, Hanna F, Wong A, Talekar M, Oh J, Azer M, Cheong L. Knowledge and reported use of antibiotics amongst immigrant ethnic groups in New Zealand. J Immigr Minor Health 2010; 12 107–12.
Knowledge and reported use of antibiotics amongst immigrant ethnic groups in New Zealand.Crossref | GoogleScholarGoogle Scholar | 19139990PubMed |

[15]  Mangione-Smith R, Elliott MN, Stivers T, McDonald L, Heritage J, McGlynn EA. Racial/ethnic variation in parent expectations for antibiotics: implications for public health campaigns. Pediatrics 2004; 113 e385–94.
Racial/ethnic variation in parent expectations for antibiotics: implications for public health campaigns.Crossref | GoogleScholarGoogle Scholar | 15121979PubMed |

[16]  Reflecting a Nation: Stories from the 2011 Census 2013. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/2071.0main+features902012-2013 [Verified December 2014]

[17]  Hu J, Wang Z. In-home antibiotic storage among Australian Chinese migrants. Int J Infect Dis 2014; 26 103–6.
In-home antibiotic storage among Australian Chinese migrants.Crossref | GoogleScholarGoogle Scholar | 25046273PubMed |

[18]  StataCorp. Stata Statisical Software: Release 13. College Station, TX: StataCorp LP; 2013.

[19]  Wong WC, Lee A, Lam AT, Li KT, Leung CY, Leung PC, Wong EL, Tang JL. Effectiveness of a Chinese herbal medicine preparation in the treatment of cough in uncomplicated upper respiratory tract infection: a randomised double-blinded placebo-control trial. Cough 2006; 2 5
Effectiveness of a Chinese herbal medicine preparation in the treatment of cough in uncomplicated upper respiratory tract infection: a randomised double-blinded placebo-control trial.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD28risVyntw%3D%3D&md5=082797ffb41b3beebc1fe5c3d0c98e5dCAS | 16790070PubMed |

[20]  Huang Y, Wu T, Zeng L, Li S. Chinese medicinal herbs for sore throat. Cochrane Database Syst Rev 2012; 3 Cd004877
| 22419300PubMed |

[21]  Jiang L, Deng L, Wu T. Chinese medicinal herbs for influenza. Cochrane Database Syst Rev 2013; 3 Cd004559
| 23543533PubMed |

[22]  Spinks A, Glasziou PP, Del Mar CB. Antibiotics for sore throat. Cochrane Database Syst Rev 2013; 11 Cd000023
| 24190439PubMed |

[23]  Kenealy T, Arroll B. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Syst Rev 2013; 6 Cd000247
| 23733381PubMed |

[24]  Grigoryan L, Burgerhof JG, Degener JE, Deschepper R, Lundborg CS, Monnet DL, Scicluna EA, Birkin J, Haaijer-Ruskamp FM, Self-Medication with Antibiotics and Resistance (SAR) Consortium Determinants of self-medication with antibiotics in Europe: the impact of beliefs, country wealth and the healthcare system. J Antimicrob Chemother 2008; 61 1172–9.
Determinants of self-medication with antibiotics in Europe: the impact of beliefs, country wealth and the healthcare system.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD1cXksF2ltrw%3D&md5=57bc59ca52ecb9ed7b56669d9454bdfbCAS | 18296694PubMed |

[25]  Napolitano F, Izzo MT, Di Giuseppe G, Angelillo IF. Public knowledge, attitudes, and experience regarding the use of antibiotics in Italy. PLoS ONE 2013; 8 e84177
Public knowledge, attitudes, and experience regarding the use of antibiotics in Italy.Crossref | GoogleScholarGoogle Scholar | 24376793PubMed |

[26]  Belongia EA, Naimi TS, Gale CM, Besser RE. Antibiotic use and upper respiratory infections: a survey of knowledge, attitudes, and experience in Wisconsin and Minnesota. Prev Med 2002; 34 346–52.
Antibiotic use and upper respiratory infections: a survey of knowledge, attitudes, and experience in Wisconsin and Minnesota.Crossref | GoogleScholarGoogle Scholar | 11902851PubMed |

[27]  Ghadeer ARYS. A cross-sectional study on knowledge, attitude and behavior related to antibiotic use and resistance among medical and non-medical university students in Jordan. African Journal of Pharmacy and Pharmacology 2012; 6 763–70.

[28]  Zafar SN, Syed R, Waqar S, Zubairi AJ, Vaqar T, Shaikh M, Yousaf W, Shahid S, Saleem S. Self-medication amongst university students of Karachi: prevalence, knowledge and attitudes. J Pak Med Assoc 2008; 58 214–7.
| 18655436PubMed |

[29]  McNulty CAM, Boyle P, Nichols T, Clappison P, Davey P. Don’t wear me out – the public’s knowledge of and attitudes to antibiotic use. J Antimicrob Chemother 2007; 59 727–38.
Don’t wear me out – the public’s knowledge of and attitudes to antibiotic use.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD2sXltVKgsLs%3D&md5=a3c756c2db3e1fa95b23de6ab57c8bb7CAS |