Patterns of antibiotic use in the population of various regions of the Russian Federation: a qualitative, comparative analysis

Abstract

Objective. To assess the practice of using antibiotics (AB) by the population of various regions of the Russian Federation (RF), by studying attitudes, behavior and knowledge about AB. Materials and Methods. The survey was conducted from February to June 2022 as part of a multicenter qualitative study in the form of a semi-structured interview among respondents from 18 to 74 years old who used systemic ABs of any group with or without a doctor’s prescription for the treatment of symptoms of a confirmed or probable infectious disease for 3 months prior to the study. Individual inclusion criteria or respondents were developed for each of the participating centers (8 Federal Districts (FD) of the RF, Moscow, St. Petersburg), considering gender, age, education and place of residence to ensure the representativeness of the sample of the general population. Results. The study interviewed 300 respondents. Among them are 151 interviews with respondents who have a prescription for AB. A variety of reasons were identified for which the respondents did not go to the doctor: lack of time, fear of contact with additional infections in health facilities, positive experience with the use of a particular AB, confidence in the free purchase of AB in a pharmacy without a prescription. The data obtained testify to the high level of confidence of the interviewees in the experience and advice of others in the matter of starting AB therapy. A large role in the spread of resistance to AB belongs to the non-compliance of pharmacy workers with the requirements for the prescription sale of AB. As a rule, the respondents had no difficulty in purchasing AB without a doctor’s prescription. Among ABs, combinations of penicillins with beta-lactamase inhibitors, penicillins, and macrolides were in greatest demand. An insufficient level of knowledge about the mechanism of action and indications for the use of AB was revealed. Data were obtained on the insufficient percentage of coverage of the population with information campaigns on the rational use of AB. A significant impact of the COVID-19 pandemic on an increase in the incidence of AB self-treatment has been demonstrated. Conclusions. The problem of excessive and irrational use of AB among the population in the RF still exists despite the ongoing measures. A lack of knowledge about antibiotics and low awareness of the problem of antimicrobial resistance were identified, and factors contributing to self-medication were identified. The data obtained can serve as a basis for the development of future initiatives to ensure the proper use of AB and, therefore, help to reduce the rate of selection of resistant microorganisms in the regions of the RF.