■公众不合理使用抗生素是抗菌素耐药性(AMR)的主要原因,这是一个严重的全球威胁。先前的研究表明,公众对抗生素使用有不同的行为模式,针对具有不同行为模式的亚组的针对性干预可能更有效。因此,本研究旨在明确公众对上呼吸道感染(URTIs)抗生素使用的行为模式及其影响因素.
■对重庆市普通人群进行了横断面调查,中国。消费者决策(消费者行为模型,CBM)用于评估公众对抗生素使用的行为,包括需要识别,信息搜索,替代评估,获得抗生素,抗生素消费,和使用后评估。此外,使用潜在类别分析来确定公众的潜在行为模式。确定的抗生素使用行为模式进一步与个体能力相关,机会,基于多因素逻辑回归的抗生素使用动机因素,探讨可能的决定因素。
■共有815名受访者参加了这项研究。公众对抗生素的不合理使用普遍存在,包括抗生素自我药物治疗(39.63%),非处方抗生素采购(59.02%),和早期停止抗生素处方(76.56%)。参与者对抗生素的了解不足(平均值=2.33,SD=1.71),报告抗生素的高可用性(平均值=7.13,SD=2.41),对抗生素的有效性抱有强烈的信念(平均值=10.29,SD=2.71),并显示出高感知的AMR威胁(平均值=12.30,SD=3.20)。确定了关于URTIs抗生素使用的四种行为模式,即,“抗生素自我治疗者”(n=165,20.25%),“正规医疗寻求者”(n=216,26.50%),“各种治疗用户”(n=198,24.20%),和“无抗生素自我用药”(n=236,28.96%)。个人使用抗生素的自我效能,相信抗生素的有效性,对抗生素副作用的认识,感知到的抗生素可用性,社会影响力,和人口统计学(年龄,教育,医疗保险,并且具有医学背景)与公众对URTIs使用抗生素的不同行为模式显着相关。
■这项研究呼吁公众共同努力,医师,政策制定者,并实施精准、多方面的干预措施,有效减少公众不合理使用抗生素。这些干预措施包括在公众中确定亚组,以提供有关抗生素和URTI管理的更有针对性的教育,加强抗生素配药的监管,改善医生合理的抗生素处方。
The irrational use of antibiotics among the public is a major contributor to antimicrobial resistance (AMR), which is a serious global threat. Prior studies have demonstrated that there are different behavioural patterns regarding antibiotic use among the public, and targeted interventions for subgroups with different behavioural patterns may be more effective. Thus, this study aimed to identify the public\'s behavioural patterns of antibiotic use for upper respiratory tract infections (URTIs) and their influencing factors.
A cross-sectional survey was conducted among the general population in Chongqing,
China. Consumer decision-making (Consumer Behaviour Model, CBM) was used to assess the public\'s behaviours regarding antibiotic use, including need recognition, information searching, alternative evaluation, obtaining antibiotics, antibiotic consumption, and postuse evaluation. Furthermore, a latent class analysis was used to identify the underlying behavioural patterns among the public. The identified behavioural patterns of antibiotic use were further linked with individuals\' capacity, opportunity, and motivation factors of antibiotic use based on a multinominal logistic regression to explore possible determinants.
A total of 815 respondents were enrolled in the study. The public\'s irrational use of antibiotics was prevalent, including antibiotic self-medication (39.63%), nonprescription antibiotic purchasing (59.02%), and early stopping of antibiotic prescriptions (76.56%). Participants had inadequate knowledge of antibiotics (Mean = 2.33, SD = 1.71), reported high availability to antibiotics (Mean = 7.13, SD = 2.41), held strong belief in antibiotic effectiveness (Mean = 10.29, SD = 2.71), and demonstrated a high perceived threat of AMR (Mean = 12.30, SD = 3.20). Four behavioural patterns regarding antibiotic use for URTIs were identified, namely, \"antibiotic self-medicators\" (n = 165, 20.25%), \"formal health care seekers\" (n = 216, 26.50%), \"various treatment users\" (n = 198, 24.20%), and \"self-medication without antibiotics\" (n = 236, 28.96%). Individuals\' self-efficacy of antibiotic use, belief in antibiotic effectiveness, awareness of antibiotic side effects, perceived antibiotic availability, social influence, and demographics (age, education, medical insurance, and having a medical background) were significantly associated with the public\'s different behavioural patterns of antibiotic use for URTIs.
This study calls for collaborative efforts among the public, physicians, policy makers, and the implementation of precise and multifaceted interventions to effectively reduce irrational use of antibiotics in the public. Such interventions include identifying subgroups within the public to provide more targeted education about antibiotics and the management of URTIs, reinforcing the regulation of antibiotic dispensing, and improving physicians\' rational antibiotic prescriptions.