Year of Publication

2016

College

Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

April Young, PhD, MPH

Committee Member

W. Jay Christian, PhD, MPH

Committee Member

Wayne T. Sanderson, PhD, MS, CIH

Abstract

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.

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