Antibiotic Usage Patterns of Community-Dwelling Adults in Thailand: A Cross-Sectional Study

IF 3.4 3区医学 Q1 NURSING Journal of Advanced Nursing Pub Date : 2025-03-04 DOI:10.1111/jan.16870

Pannipa Boontein, Ketsarin Utriyaprasit, Autchariya Poungkaew, Somying Pumtong, Sasima Tongsai

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Abstract

Aim

To investigate factors predictive of antibiotic use behaviour in the community.

Design

A cross-sectional study was conducted from May to November 2023.

Method

Standardised instruments were administered to patients who had received services from nurses in sub-district health-promoting hospitals in Thailand for at least one of the three diseases: (1) upper respiratory infection, (2) acute diarrhoea or (3) fresh traumatic wounds. Antibiotic use behaviour was modelled using the generalised estimating equation with an independent error component to account for the clustering of the hospitals.

Results

Five hundred and eighty-five participants (556 patients and 29 nurses) met the inclusion criteria in this study. Of the 556 adult patients who were surveyed, the majority had upper respiratory infections, reported an appropriate level of antibiotic use, a moderate level of awareness of appropriate antibiotic use and antibiotic resistance, and an inadequate literacy level of Rational Drug Use. The generalised estimating equation analysis revealed that factors predictive of antibiotic use behaviour were rational drug use literacy, awareness, process of care, nurses' experience and rate of rational antibiotic prescribing for acute diarrhoea.

Conclusions

The nurses and healthcare providers should focus on enhancing the quality of care by educating and collaborating with the community to ensure appropriate antibiotic use behaviour.

Impact

This study indicated that healthcare policymakers should prioritise patient education on antibiotic use behaviour while also ensuring that healthcare workers adhere to strict caregiving protocols.

Implications for the Profession and/or Patient Care

Providing services by monitoring symptoms and home visits can help patients gain confidence in the treatment approach and lead to a rational change in antibiotic use.

Reporting Method

We adhere to the STROBE checklist.

Patient or Public Contribution

No patient or public involvement.

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泰国社区居住成人抗生素使用模式：一项横断面研究。

目的：探讨社区抗生素使用行为的预测因素。设计：横断面研究于2023年5月至11月进行。方法：对在泰国街道健康促进医院接受护士服务的患者进行标准化仪器管理，这些患者至少患有三种疾病：(1)上呼吸道感染，(2)急性腹泻或(3)新鲜创伤。使用具有独立误差成分的广义估计方程对抗生素使用行为进行建模，以解释医院的聚类。结果：585名参与者（556名患者和29名护士）符合本研究的纳入标准。在接受调查的556名成年患者中，大多数患有上呼吸道感染，报告了适当的抗生素使用水平，适度的抗生素使用和抗生素耐药性意识，以及合理用药的文化水平不足。广义估计方程分析显示，预测急性腹泻患者抗生素使用行为的因素有合理用药素养、用药意识、护理过程、护士经验和合理处方率。结论：护士和卫生保健提供者应注重通过教育和与社区合作来提高护理质量，以确保适当的抗生素使用行为。影响：本研究表明，卫生保健政策制定者应优先考虑对患者进行抗生素使用行为教育，同时确保卫生保健工作者遵守严格的护理协议。对专业和/或患者护理的影响：通过监测症状和家访提供服务可以帮助患者获得对治疗方法的信心，并导致抗生素使用的合理改变。报告方法：我们遵循STROBE检查表。患者或公众贡献：无患者或公众参与。

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来源期刊

Journal of Advanced Nursing 医学-护理

CiteScore

6.40

自引率

7.90%

发文量

369

审稿时长

3 months

期刊介绍： The Journal of Advanced Nursing (JAN) contributes to the advancement of evidence-based nursing, midwifery and healthcare by disseminating high quality research and scholarship of contemporary relevance and with potential to advance knowledge for practice, education, management or policy. All JAN papers are required to have a sound scientific, evidential, theoretical or philosophical base and to be critical, questioning and scholarly in approach. As an international journal, JAN promotes diversity of research and scholarship in terms of culture, paradigm and healthcare context. For JAN’s worldwide readership, authors are expected to make clear the wider international relevance of their work and to demonstrate sensitivity to cultural considerations and differences.