Knowledge, attitudes and perceptions of antibiotic use and resistance among patients in South Africa: A cross-sectional study

Elise Farley; Dena van den Bergh; Renier Coetzee; Annemie Stewart; Tom Boyles

doi:10.4102/sajid.v34i1.118

Knowledge, attitudes and perceptions of antibiotic use and resistance among patients in South Africa: A cross-sectional study

S Afr J Infect Dis. 2019 Aug 28;34(1):118. doi: 10.4102/sajid.v34i1.118. eCollection 2019.

Authors

Elise Farley¹, Dena van den Bergh², Renier Coetzee³, Annemie Stewart⁴, Tom Boyles⁵

Affiliations

¹ Public Health and Family Medicine Department, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
² Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital University of Cape Town, Cape Town, South Africa.
³ School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Cape Town, South Africa.
⁴ UCT Clinical Research Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
⁵ Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa.

Abstract

Background: Antibiotic resistance (ABR) is a global health crisis. We conducted a cross-sectional survey to describe South African patients' (n = 782) ABR knowledge, attitudes and perceptions (KAP), differences in KAP between public (n = 379, 48%) and private (n = 403, 52%) practice respondents and associations between attitudes, perceptions and knowledge scores.

Methods: Knowledge scores (15 questions) were placed into low (0% - 53%) and high (> 54%) categories (below and above overall mean). Comparisons were conducted using chi-squared and t-tests.

Results: Of all respondents, 72% believed it was the human body that becomes resistant to antibiotics, 66% stated that antibiotics are good for treating viruses and 25% of patients believed that people should be given antibiotics on demand. Mean knowledge scores were lower in public sector respondents (public 45%, s.d. 15%; private 60%, s.d. 30%; p ≤ 0.001). Public practice patients with high knowledge scores were more likely to report both negative KAP (antibiotic prescriptions justify doctors' visits, scientists will discover new antibiotics) and protective KAP (finishing a course of antibiotics, antibiotics do not treat all illnesses). Private practice patients with high knowledge scores were marginally less likely to report negative KAP (wanting antibiotics after long illnesses or when very sick) and more likely to report protective KAP (antibiotics have side effects and are a strong treatment).

Conclusion: Our study shows differences in KAP by practice type and that greater knowledge increases the likelihood of protective attitudes, perceptions and behaviours.

Keywords: Antibiotic resistance; Antimicrobial resistance; Attitudes; Knowledge; Patient; Perceptions; South Africa.