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Antimicrobial resistance: Knowledge towards antibiotics in a Mexican population - 05/07/18

Doi : 10.1016/j.respe.2018.05.482 
L. Upegui a, , I. Álvarez-Solorza b, M. Böcker a
a Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen, Aachen, Germany 
b Faculty of Nursing and Obstetrics, Faculty of Nursing and Obstetrics, Universidad Autónoma del Estado de México, Toluca, Mexico 

Corresponding author.

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Résumé

Introduction

The increasing prevalence rate of resistant and multiresistant bacterial strains to antibiotics is a threat to public health and requires a rapid multifunctional answer. It has been reported that globally, more than 50% of the medicaments are prescribed, dispensed or sold inappropriately. The use of antibiotics over the last 75 years has caused a selective pressure over the bacteria that is characterized by the competition between resistant and sensitive strains. There have been identified risk factors that are related to the misuse and overuse of antibiotics, like sociodemographic characteristics and psychological aspects of the individuals that have not been explored objectively due to a lack of valid and reliable instruments for their measurement.

Objective

To validate a questionnaire for the evaluation of the levels of knowledge related to the use of antibiotics in a Mexican population.

Materials and methods

Analytical cross-sectional observational study. The questionnaire was developed in a previous study by Lim et al. This consisted of 12 items to evaluated knowledge (1=no, 2=not sure, 3=yes) regarding to the antibiotics. The direction of the measure was positive, the higher score corresponded to a higher level of knowledge. These are preliminary results and correspond to the pilot-test of 30 respondents. The validation of the instrument was done by Rasch analysis, the Chi2 and statistical residuals were estimated to measure the adjustment to the model. Unidimensionality and local independence were evaluated by principal component analysis of the residuals. Internal consistency was evaluated with Cronbach Alpha. Also, was evaluated the presence of Differential Item Functioning (DIF) by age and gender. The software Rumm2030 and the SPSS were used for the analyses.

Results

The participants presented an average age of 32 years±12.6 and 53% were women. The items presented a good fit to the Rasch model (Chi2=12.8; P=0.3795) as well as unidimensional and local independence (number of significant t-tests of 3%). The reliability was of 0.63 and the presence of DIF was not observed. The statements on role of antibiotics showed the highest inappropriate response, where most of the respondents did not know that antibiotics would not work against viral infections (70%) and that could also cause side effects (87%). The knowledge score ranged from 0 to 12 points, with a mean of 7.03±2.6.

Conclusions

The instrument showed good psychometric proprieties. The low scores of knowledge about antibiotics suggest that misinterpretations on the use of these medicaments were prevalent, which could influence the production of antibiotic resistance. The application of this questionnaire will allow the objective identification of “high-risk groups”, which will be the target population for future educational campaigns, to reduce the knowledge gaps on the general population as an effort against antibiotic resistance.

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© 2018  Publié par Elsevier Masson SAS.
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Vol 66 - N° S5

P. S413 - juillet 2018 Retour au numéro
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