Year of Publication
Master of Public Health (M.P.H.)
April Young, PhD, MPH
W. Jay Christian, PhD, MPH
Wayne T. Sanderson, PhD, MS, CIH
Aim: To identify sociodemographic, knowledge, and attitudinal correlates to antibiotic diversion among a community-based sample of adults (age 18 and older) in a low-income setting of the Philippines and to explore community-level data on informal antibiotic distribution in sari-sari stands.
Methods: Participants (n=307) completed self-administered surveys. Correlates to antibiotic diversion were assessed using logistic regression with Firth’s bias-adjusted estimates. Availability and characteristics of antibiotics in the sari-sari stands (n=106) were observed through site visits.
Results: A majority (78%) had shared antibiotics in their lifetime, most often with family members. In multivariable analysis, agreement with the belief that it is safe to prematurely stop an antibiotic course (OR: 2.8, CI: 1.3-5.8) and concerns about antibiotic side effects (OR: 2.1, CI: 1.1-4.4) were significantly associated with increased odds of reported antibiotic diversion. Antibiotic diversion was not associated with sociodemographic characteristics or antibiotic knowledge. Antibiotics were widely available in sari-sari stores (60%), where antibiotic expiration dates were often unaccounted for (59%), and a full course of antibiotics was usually unavailable (68%).
Conclusions: Antibiotic diversion was common and was associated with misconceptions about proper antibiotic use. Antibiotics were widely available in sari-sari stands, but usually without expiration information or full dosages. Although more research is needed, it is clear that efforts to curb antibiotic resistance must include an understanding of location-specific antibiotic misconceptions and individual access to legitimate pharmaceutical outlets.
Barber, Daniel Alexander, "Correlates of Antibiotic Diversion in the Philippines: Misconceptions and Community-Level Access to Nonmedical Sources of Antibiotics" (2016). Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.). 74.