{"title":"公众自行使用抗生素是否是全球关注的问题:混合方法系统综述。","authors":"Tenghao Wang, Jianxiong Wu, Jinxi Li, Pengfei Zhou, Qinnan Li, Xiaomin Xu, Yanhong Gong, Xiaoxv Yin","doi":"10.1080/14787210.2024.2419607","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Irrational use of antibiotics is a major driver of antimicrobial resistance. Self-medication with antibiotics (SMA) may exacerbate antimicrobial resistance in the community without professional diagnosis by physicians, due to the complexity of the pharmacological mechanisms. There is still a lack of assessment of the global prevalence of SMA. We have evaluated the global prevalence of SMA and its associated factors, which could provide more reliable data to support global action.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Web of Science, and EBSCO CINAHL Plus. Quantitative studies were combined using meta-analysis with random-effects models, and qualitative synthesis was performed using interpretive meta-ethnographic methods.</p><p><strong>Results: </strong>A total of 242 studies were included in this study. The pooled prevalence of SMA was 27.7% (95%CI: 24.9%-30.5%). Quantitative studies indicate that high income level, having family members working in the healthcare system, storing antibiotics at home, and purchasing antibiotics without prescriptions were associated with a greater likelihood of SMA. Qualitative findings revealed the following four factors: individual characteristics, healthcare, pharmacy, and social networks.</p><p><strong>Conclusions: </strong>The prevalence of global SMA among the public remains high level. Multisectoral and community-based interventions are needed to reduce SMA, including targeted health education, improved access to healthcare, and regulation of antibiotics sales in pharmacies.</p><p><strong>Registration: </strong>PROSPERO (CRD42023402206).</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":null,"pages":null},"PeriodicalIF":4.2000,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Is self-medication with antibiotics among the public a global concern: a mixed-methods systematic review.\",\"authors\":\"Tenghao Wang, Jianxiong Wu, Jinxi Li, Pengfei Zhou, Qinnan Li, Xiaomin Xu, Yanhong Gong, Xiaoxv Yin\",\"doi\":\"10.1080/14787210.2024.2419607\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Irrational use of antibiotics is a major driver of antimicrobial resistance. Self-medication with antibiotics (SMA) may exacerbate antimicrobial resistance in the community without professional diagnosis by physicians, due to the complexity of the pharmacological mechanisms. There is still a lack of assessment of the global prevalence of SMA. We have evaluated the global prevalence of SMA and its associated factors, which could provide more reliable data to support global action.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Web of Science, and EBSCO CINAHL Plus. Quantitative studies were combined using meta-analysis with random-effects models, and qualitative synthesis was performed using interpretive meta-ethnographic methods.</p><p><strong>Results: </strong>A total of 242 studies were included in this study. The pooled prevalence of SMA was 27.7% (95%CI: 24.9%-30.5%). Quantitative studies indicate that high income level, having family members working in the healthcare system, storing antibiotics at home, and purchasing antibiotics without prescriptions were associated with a greater likelihood of SMA. Qualitative findings revealed the following four factors: individual characteristics, healthcare, pharmacy, and social networks.</p><p><strong>Conclusions: </strong>The prevalence of global SMA among the public remains high level. Multisectoral and community-based interventions are needed to reduce SMA, including targeted health education, improved access to healthcare, and regulation of antibiotics sales in pharmacies.</p><p><strong>Registration: </strong>PROSPERO (CRD42023402206).</p>\",\"PeriodicalId\":12213,\"journal\":{\"name\":\"Expert Review of Anti-infective Therapy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2024-10-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Expert Review of Anti-infective Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/14787210.2024.2419607\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Anti-infective Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/14787210.2024.2419607","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
摘要
背景:不合理使用抗生素是导致抗菌药耐药性的主要原因。由于药理机制的复杂性,在未经医生专业诊断的情况下,抗生素自我药疗(SMA)可能会加剧社区中的抗菌药耐药性。目前仍缺乏对 SMA 全球流行率的评估。我们对 SMA 的全球流行率及其相关因素进行了评估,这将为支持全球行动提供更可靠的数据:我们检索了 PubMed、Embase、Web of Science 和 EBSCO CINAHL Plus。采用随机效应模型荟萃分析法对定量研究进行综合,并采用解释性荟萃人种学方法对定性研究进行综合:本研究共纳入 242 项研究。汇总的 SMA 患病率为 27.7%(95%CI:24.9%-30.5%)。定量研究表明,高收入水平、有家庭成员在医疗系统工作、在家中储存抗生素以及在没有处方的情况下购买抗生素与发生 SMA 的可能性较高有关。定性研究结果显示了以下四个因素:个人特征、医疗保健、药房和社会网络:全球公众的 SMA 患病率仍然很高。需要采取多部门和基于社区的干预措施来减少 SMA,包括开展有针对性的健康教育、改善医疗保健服务和规范药店的抗生素销售:PROCROPERO(CRD42023402206)。
Is self-medication with antibiotics among the public a global concern: a mixed-methods systematic review.
Background: Irrational use of antibiotics is a major driver of antimicrobial resistance. Self-medication with antibiotics (SMA) may exacerbate antimicrobial resistance in the community without professional diagnosis by physicians, due to the complexity of the pharmacological mechanisms. There is still a lack of assessment of the global prevalence of SMA. We have evaluated the global prevalence of SMA and its associated factors, which could provide more reliable data to support global action.
Methods: We searched PubMed, Embase, Web of Science, and EBSCO CINAHL Plus. Quantitative studies were combined using meta-analysis with random-effects models, and qualitative synthesis was performed using interpretive meta-ethnographic methods.
Results: A total of 242 studies were included in this study. The pooled prevalence of SMA was 27.7% (95%CI: 24.9%-30.5%). Quantitative studies indicate that high income level, having family members working in the healthcare system, storing antibiotics at home, and purchasing antibiotics without prescriptions were associated with a greater likelihood of SMA. Qualitative findings revealed the following four factors: individual characteristics, healthcare, pharmacy, and social networks.
Conclusions: The prevalence of global SMA among the public remains high level. Multisectoral and community-based interventions are needed to reduce SMA, including targeted health education, improved access to healthcare, and regulation of antibiotics sales in pharmacies.
期刊介绍:
Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.