A study conducted in four Indonesian emergency departments (EDs) found that patients who expected antibiotics for a respiratory infection were more likely to receive them, even during the COVID-19 pandemic, researchers reported today in the Journal of Global Antimicrobial Resistance.
The cross-sectional study examined adult patients with uncomplicated upper respiratory tract infections (URTIs) who were treated in one of the four EDs from March 2021 to March 2022. The patients were asked to complete a survey questionnaire post-consultation that asked about their demographics, health status, health-seeking behavior, and their expectations, knowledge, and attitudes on the use of antibiotics. Using multivariable logistics regression models, the researchers assessed the factors associated with the expectation for receipt of antibiotics.
Of the 681 patients recruited for the study, 31% were expecting antibiotics and 8.7%—whether they expected them or not—received antibiotics during the ED visit. Of the patients expecting antibiotics, 15.6% received them. Patients expecting antibiotics during their ED visit were more than 10 times likelier (adjusted odds ratio [aOR], 10.64, 95% confidence interval [CI], 5.34 to 21.17) to receive antibiotics. Patients who received antibiotics during a prior consultation were nearly three times as likely (aOR, 2.97, 95% CI 1.26 to 7.00) to receive antibiotics compared with patients with no prior consultation.
Our findings highlighted an opportunity for leveraging the COVID-19 mass communication channels to educate the public on the non-necessity of antibiotics for URTI.
Patients who received antibiotics during a prior consultation were more than six times likelier (aOR, 6.56; 95% CI, 3.30 to 13.11) to expect antibiotics compared with those with no prior consultation, while patients with poor (aOR, 2.16; 95% CI, 1.26 to 3.68) to moderate (aOR, 2.26; 95% CI, 1.33 to 3.84) knowledge of antibiotics and antimicrobial resistance (AMR) were twice as likely to expect antibiotics compared with patients with good knowledge of antibiotics.
The top reasons for expecting antibiotics were the perceived severity of the illness and the effectiveness of antibiotics in speeding up recovery.
"Our findings highlighted an opportunity for leveraging the COVID-19 mass communication channels to educate the public on the non-necessity of antibiotics for URTI to address the problem of antibiotic misuse and AMR," the study authors wrote.