Assessment of Rational Use of Antibiotics: A Nationwide Cross-Sectional Study among People of Nepal

Abstract

AbstractIntroductionThis research was conducted with the objective to accentuate antimicrobial misuse across knowledge, behaviour and practice domains among general people of Nepal.Materials and MethodsIt was a nationwide cross-sectional survey conducted among 385 participants in Nepal from February 2022 to May 2022. Statistical analysis was done through SPSS® v21 and MedCalc for Windows v12.3.0. Modified Bloom’s cut-off point was utilized to categorize the participants’ overall knowledge, behaviour, and practice. The chi-square test and odds ratio (OR) using binary logistic regression at 95% CI, and Spearman’s rank correlation coefficient test (r) was calculated wherever appropriate.ResultsMore than three-fifths of the participants (248, 64.42%) demonstrated good behaviour, whereas less than half of the participants showed good knowledge (137, 35.58%) and practice (161, 41.82%) about rational use of antibiotics. Health professionals had higher knowledge (OR: 1.07, 95% CI: 0.70-1.62) and good behaviour (OR: 0.42, 95% CI: 0.27-0.64) than other professions (P-value< 0.05). Those with higher income (≥ 50,000 NRs) had good behaviour (OR: 3.37, 95% CI: 1.65-6.87) and good practice (OR: 2.58, 95% CI: 1.47-4.50) scores than those with less monthly income (P-value< 0.05). Similarly, higher educational degrees viz., master and/or above had good behaviour (OR: 4.13, 95% CI: 2.62-6.49) and good practice scores (OR: 2.55, 95% CI: 1.68-3.87). Additionally, there were significant positive correlations between knowledge (K), behaviour (B) and practice (P) scores (r = 0.331 for K & B, r = 0.259 for K & P, and r = 0.618 for B & P respectively; P-value< 0.05).ConclusionsOur findings imply the demand of effective legislature, strict enforcement of the drug act and proper implementation of plans and policies to curb the antibiotic misuse. Lack of execution of existing laws and unawareness of the public lead to extravagant use of antibiotics.