Knowledge, attitudes and practices regarding antibiotic use among internally displaced persons in conflict-affected...

Evidence on antibiotic use among internally displaced persons in conflict-affected Northwest Syria remains scarce.

To assess knowledge, attitudes and practices regarding antibiotic use among internally displaced persons in Northwest Syria.

We collected data from 630 individuals, aged ≥ 18 years, living in 12 internally displaced persons camps, in April 2022, through face-to-face interviews, using a WHO-validated questionnaire adapted for Syrian context. We analysed the data using SPSS version 26 and conducted univariate and multivariate logistic regression to assess associations between respondent characteristics and key outcomes. P < 0.05 was considered statistically significant.

Of the 630 participants (58.1% female; median age 38 years), 66.5% had received at least one antibiotic prescription in the past year. Females were more likely than males (odds ratio 2.89; 95% confidence interval 1.10-7.40; P = 0.02), and single participants less likely than married participants (OR = 0.29; 95% CI: 0.10-0.84, P = 0.02), to have used a prescribed antibiotic. Antibiotic misuse was common: 62.2% used antibiotics without a prescription, 51.6% used antibiotics prescribed for others and 39.4% did not complete their recommended dosage. The proportion of participants who obtained antibiotics without prescription increased from 64.8% before to 79.0% after displacement (P < 0.001). Of the participants, 69.8% had sufficient knowledge of, and 59.2% had positive attitude towards, antibiotic use.

Although most participants reported having sufficient knowledge of antibiotics, misconceptions and inappropriate use were common. Targeted and evidence-based interventions are needed to improve antibiotic use practices and to support antimicrobial stewardship among internally displaced persons in Northwest Syria and other similar settings.