Household Knowledge of Clinical Risks, Storage, and Disposal of Leftover Antibiotics: A Multinational Study in Seven...

Area of Science:

• Global Health
• Infectious Diseases
• Public Health Policy

Background:

• Self-medication with leftover antibiotics (SMLA) significantly contributes to antimicrobial resistance (AMR), especially in developing nations.
• Understanding the knowledge-practice gap in antibiotic use and handling is crucial for effective AMR containment strategies.

Purpose of the Study:

• To investigate the knowledge and practices surrounding antibiotic use, storage, and disposal among individuals with a history of SMLA.
• To identify disparities in knowledge and practices across seven developing countries.

Main Methods:

• A cross-sectional study involving 3191 adults from seven countries (Bangladesh, Brazil, Egypt, India, Jordan, Lebanon, Serbia) who reported prior SMLA.
• Questionnaires assessed knowledge of antibiotic use, resistance, and SMLA risks, alongside evaluation of storage and disposal practices.

Main Results:

• Participants had above-average theoretical knowledge but significant gaps in safe practices, with only 21.9% properly disposing of leftover antibiotics.
• Inappropriate storage was reported by 32.6%, and 47.0% disposed of antibiotics in household garbage.
• Higher AMR knowledge correlated paradoxically with poorer disposal practices (OR = 0.97, p < 0.001).

Conclusions:

• A critical knowledge-practice gap exists, indicating that theoretical knowledge alone does not ensure safe antibiotic handling.
• Education-focused AMR strategies may be insufficient; interventions must address behavioral change beyond knowledge deficits.
• Effective strategies require consideration of structural, cultural, and individual health belief factors to combat AMR effectively.