Identifying Distinct Antibiotic Behavioural Profiles in Singapore's General Population: A Latent Class Analysis

Area of Science:

• Public Health
• Behavioral Science
• Infectious Disease Epidemiology

Background:

• Inappropriate antibiotic use for upper respiratory tract infections (URTIs) is a significant public health concern.
• Existing research often overlooks the complex, co-occurring nature of antibiotic misuse behaviors.
• Understanding distinct behavioral profiles is crucial for developing targeted interventions.

Purpose of the Study:

• To identify and characterize distinct antibiotic behavioral profiles within the general population of Singapore.
• To determine individual characteristics associated with these profiles.
• To inform the development of personalized interventions for antibiotic misuse.

Main Methods:

• A population-based study of adult Singapore residents (N=2004) conducted from November 2020 to January 2021.
• Latent class analysis was employed to identify distinct antibiotic behavioral profiles.
• Multinomial logistic regression was used to examine factors associated with each profile.

Main Results:

• Three primary profiles were identified: "antibiotic appropriates" (53.0%), "antibiotic avoiders" (24.9%), and "antibiotic seekers" (22.2%).
• "Antibiotic seekers" demonstrated behaviors such as expecting antibiotics for colds/flu, doctor-hopping, using leftover antibiotics, and premature discontinuation of courses.
• Factors associated with being an "antibiotic seeker" included poor knowledge of antibiotic use and antimicrobial resistance, low eHealth literacy, and high trust in doctors. Older adults with lower education were also more likely to be seekers.

Conclusions:

• Nearly one in five Singapore residents are "antibiotic seekers," highlighting a substantial public health issue.
• Targeted educational interventions during clinic visits, leveraging high patient trust in doctors, can address knowledge gaps and misperceptions.
• Reducing antibiotic misuse requires tailored strategies addressing specific behavioral profiles.