Related Experiment Video
Updated: Jan 7, 2026
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Household Knowledge of Clinical Risks, Storage, and Disposal of Leftover Antibiotics: A Multinational Study in Seven
Katia Iskandar1,2,3, Reham Kotb4,5, Michelle Cherfane3,6
1Department of Biomedical Sciences, School of Pharmacy, Lebanese International University, Beirut P.O. Box 146404, Lebanon.
Background:
Self-medication with leftover antibiotics (SMLA) drives antimicrobial resistance (AMR), particularly in developing countries. This study examined knowledge-practice gaps regarding antibiotic use and handling among individuals with prior SMLA across seven developing countries.
Methods:
A cross-sectional study (February 2023-February 2024) included 3191 adults from Bangladesh, Brazil, Egypt, India, Jordan, Lebanon, and Serbia who reported previous leftover antibiotic use. The questionnaires assessed knowledge of antibiotic use (15 items), resistance (12 items), and SMLA risks (15 items). Storage and disposal practices were evaluated using dichotomized correct/incorrect measures.
Results:
Participants demonstrated above-average knowledge scores as follows: antibiotic use (54.4 ± 8.4), resistance (43.3 ± 6.1), and SMLA risks (58.4 ± 10.3). However, substantial practice gaps emerged. Only 21.9% properly disposed of leftover antibiotics, while 47.0% used household garbage. For storage, 55.1% used appropriate methods, but 32.6% stored antibiotics inappropriately, and 12.8% lacked protocols. Serbian participants showed the highest SMLA risk knowledge (64.3 ± 10.6), Bangladeshi participants the lowest (52.0 ± 8.5, p < 0.001). Women had superior knowledge (59.6 ± 10.4 versus 56.5 ± 9.8, p < 0.001) and storage practices (56.6% versus 52.7%, p = 0.031). Paradoxically, higher AMR knowledge was associated with poorer disposal practices (OR = 0.97, p < 0.001).
Conclusions:
Despite extensive theoretical knowledge, unsafe medication practices persist, revealing a critical knowledge-practice gap. Our findings challenge education-focused AMR approaches, suggesting cognitive awareness alone cannot drive behavioral change. Effective interventions must address structural barriers, cultural factors, and individual health beliefs beyond traditional knowledge-deficit models.
Insights
Self-medication with leftover antibiotics (SMLA) is common, yet safe practices are not followed. Knowledge about antimicrobial resistance (AMR) doesn't always translate to safe antibiotic handling and disposal.
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.
Related Concept Videos
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:30Development of Antibiotic Resistance
01:26Standard Precaution
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
00:57Antibiotic Selection
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution