'They eat it like sweets': A mixed methods study of antibiotic perceptions and their use among patients, prescribers and pharmacists in a district hospital in Kabul, Afghanistan.

<h4>Background</h4>Antibiotic resistance is a growing public health threat. In Afghanistan, high levels of indiscriminate antibiotic use exist, and healthcare programmes are not informed by understanding of local attitudes towards rational antibiotic use. Médecins Sans Frontières is an i...

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Autores principales:	Doris Burtscher, Rafael Van den Bergh, Masood Nasim, Gbane Mahama, Sokhieng Au, Anita Williams, Abdul Sattar, Suzanne Penfold, Catherine Van Overloop, Sahar Bajis
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5427dbc8d22646439ec7a6553f9f9afb
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spelling	oai:doaj.org-article:5427dbc8d22646439ec7a6553f9f9afb2021-12-02T20:12:37Z'They eat it like sweets': A mixed methods study of antibiotic perceptions and their use among patients, prescribers and pharmacists in a district hospital in Kabul, Afghanistan.1932-620310.1371/journal.pone.0260096https://doaj.org/article/5427dbc8d22646439ec7a6553f9f9afb2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0260096https://doaj.org/toc/1932-6203<h4>Background</h4>Antibiotic resistance is a growing public health threat. In Afghanistan, high levels of indiscriminate antibiotic use exist, and healthcare programmes are not informed by understanding of local attitudes towards rational antibiotic use. Médecins Sans Frontières is an international non-governmental organization providing healthcare services to the Ahmad Shah Baba (ASB) District Hospital in Kabul, Afghanistan, since 2009. This mixed-methods study aimed to explore the perceptions and attitudes toward antibiotics among patients, prescribers, and pharmacists in the ASB District hospital outpatient department.<h4>Methods and findings</h4>Knowledge of antibiotics including their purpose and function, how and why they are used, and drivers for choice of antibiotic was examined at patient, prescriber, and provider-level. The first phase of the study, an exploratory qualitative component using an interpretative approach, was used to inform the second phase, a structured survey. Thirty-six interviews were conducted with 39 participants (21 patients or caretakers and 18 hospital health workers). Three hundred and fifty-one (351) patients and caretakers completed the second phase, the structured survey. This study found that poor knowledge of antibiotics and antibiotic resistance is a driving factor for inappropriate use of antibiotics. Participant perceptions of living in a polluted environment drove the high demand and perceived 'need' for antibiotics: patients, doctors and pharmacists alike consider dirty and dusty living conditions as causes of 'disease' in the body, requiring antibiotics to 'clean' and 'strengthen' it.<h4>Conclusions</h4>Findings highlight the need for strategies to improve awareness and knowledge of the general public, improve practice of doctors and pharmacists, regulate antibiotic dispensing in private pharmacies, and implement antibiotic stewardship in hospitals.Doris BurtscherRafael Van den BerghMasood NasimGbane MahamaSokhieng AuAnita WilliamsAbdul SattarSuzanne PenfoldCatherine Van OverloopSahar BajisPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0260096 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Doris Burtscher Rafael Van den Bergh Masood Nasim Gbane Mahama Sokhieng Au Anita Williams Abdul Sattar Suzanne Penfold Catherine Van Overloop Sahar Bajis 'They eat it like sweets': A mixed methods study of antibiotic perceptions and their use among patients, prescribers and pharmacists in a district hospital in Kabul, Afghanistan.
description	<h4>Background</h4>Antibiotic resistance is a growing public health threat. In Afghanistan, high levels of indiscriminate antibiotic use exist, and healthcare programmes are not informed by understanding of local attitudes towards rational antibiotic use. Médecins Sans Frontières is an international non-governmental organization providing healthcare services to the Ahmad Shah Baba (ASB) District Hospital in Kabul, Afghanistan, since 2009. This mixed-methods study aimed to explore the perceptions and attitudes toward antibiotics among patients, prescribers, and pharmacists in the ASB District hospital outpatient department.<h4>Methods and findings</h4>Knowledge of antibiotics including their purpose and function, how and why they are used, and drivers for choice of antibiotic was examined at patient, prescriber, and provider-level. The first phase of the study, an exploratory qualitative component using an interpretative approach, was used to inform the second phase, a structured survey. Thirty-six interviews were conducted with 39 participants (21 patients or caretakers and 18 hospital health workers). Three hundred and fifty-one (351) patients and caretakers completed the second phase, the structured survey. This study found that poor knowledge of antibiotics and antibiotic resistance is a driving factor for inappropriate use of antibiotics. Participant perceptions of living in a polluted environment drove the high demand and perceived 'need' for antibiotics: patients, doctors and pharmacists alike consider dirty and dusty living conditions as causes of 'disease' in the body, requiring antibiotics to 'clean' and 'strengthen' it.<h4>Conclusions</h4>Findings highlight the need for strategies to improve awareness and knowledge of the general public, improve practice of doctors and pharmacists, regulate antibiotic dispensing in private pharmacies, and implement antibiotic stewardship in hospitals.
format	article
author	Doris Burtscher Rafael Van den Bergh Masood Nasim Gbane Mahama Sokhieng Au Anita Williams Abdul Sattar Suzanne Penfold Catherine Van Overloop Sahar Bajis
author_facet	Doris Burtscher Rafael Van den Bergh Masood Nasim Gbane Mahama Sokhieng Au Anita Williams Abdul Sattar Suzanne Penfold Catherine Van Overloop Sahar Bajis
author_sort	Doris Burtscher
title	'They eat it like sweets': A mixed methods study of antibiotic perceptions and their use among patients, prescribers and pharmacists in a district hospital in Kabul, Afghanistan.
title_short	'They eat it like sweets': A mixed methods study of antibiotic perceptions and their use among patients, prescribers and pharmacists in a district hospital in Kabul, Afghanistan.
title_full	'They eat it like sweets': A mixed methods study of antibiotic perceptions and their use among patients, prescribers and pharmacists in a district hospital in Kabul, Afghanistan.
title_fullStr	'They eat it like sweets': A mixed methods study of antibiotic perceptions and their use among patients, prescribers and pharmacists in a district hospital in Kabul, Afghanistan.
title_full_unstemmed	'They eat it like sweets': A mixed methods study of antibiotic perceptions and their use among patients, prescribers and pharmacists in a district hospital in Kabul, Afghanistan.
title_sort	'they eat it like sweets': a mixed methods study of antibiotic perceptions and their use among patients, prescribers and pharmacists in a district hospital in kabul, afghanistan.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/5427dbc8d22646439ec7a6553f9f9afb
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'They eat it like sweets': A mixed methods study of antibiotic perceptions and their use among patients, prescribers and pharmacists in a district hospital in Kabul, Afghanistan.

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