الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 232 |  |  |
| | | from | 232 | | |
Abstract
Antibiotic misuse, contributed by either antibiotic abuse, overuse, or suboptimal use, has potentially serious effects on health, including the development of antibiotic resistance. Antibiotic resistance (AR) is an inherent nature of bacteria as a means of survival. The impacts of AR are immense and broad; for instance, AR can result in prolonged hospital stays, financial burden, morbidity, and mortality. In 2019, the World Health Organization (WHO) estimated that AR resulted in around 700,000 annual deaths worldwide, and by 2030, AR is estimated to contribute to 10 million deaths worldwide (Mutagonda et al., 2022).
The World Health Organization (WHO) describes antimicrobial resistance (AMR) as one of the biggest threats to global public health, stating that the world urgently needs to change the way they are prescribed. Even if new medicines are developed, without behavior change, antibiotic resistance will remain a major threat. New antibiotic resistance mechanisms threaten our ability to treat common bacterial infections, and without urgent actions, we are heading for a post antibiotic era, in which common infections and minor injuries could once again be fatal (Rana et al., 2021).
Community health nurses play a crucial role in raising patients’ awareness of the misuse of antibiotics, which is essential in combating antibiotic resistance, and they also should be actively involved in multidisciplinary teams within hospitals and nursing home (NH) settings. However, their role in antibiotic stewardship (ABS) must be clearly defined and quantified. Currently, nurses primarily focus on the following four main roles: patient monitoring, drug administration, disease prevention, and health education (Bridey et al., 2023).
Significance of the study:
Antibiotic resistance is a global public health challenge that has been accelerated by the overuse of antibiotics worldwide. Increased antimicrobial resistance is the cause of severe infections, complications, longer hospital stays, and higher rates of mortality. Overprescribing of antibiotics is associated with an increased risk of adverse effects, more frequent re-attendance, and unnecessary medicalization of self-limiting conditions. Particularly, Antibiotic overprescribing is a significant problem in primary care in which most infections are viral. General practitioners account for about 90% of all antibiotic prescriptions, with respiratory tract infections being the most common reason for prescribing. Multifaceted interventions to reduce overuse of antibiotics have been found to be effective and better than single initiatives (Adeosun et al., 2022). This study aims to assess the awareness of adults regarding the misuse of antibiotics.
Aim of the study
This study aims to assess the effect of Antibiotic Abuse on Adults’ Health through:
1. Assessing adults’ knowledge related to antibiotic abuse.
2. Assessing adults’ practices related to antibiotic abuse.
3. Assessing health status of adults related to effect of antibiotic abuse.
Research questions:
1. What is the adult’s knowledge related to Antibiotic Abuse?
2. What are adults’ practices related to Antibiotic Abuse?
3. Is there a relation between knowledge and practices of adults related to Antibiotic Abuse?
4. Is there a relation between knowledge and practice?
Research Design:
Descriptive analytical study research design was used in the conduction of this study.
Study Settings:
The study was conducted at the outpatient clinic in Specialized Hospital which is affiliated to Ain Shams University in Cairo governorate.
Sampling
A purposive sample of 377 adult patients was selected from outpatient clinics with the following criteria:
Inclusion criteria:
- Patients who were clinically diagnosed and treated by antibiotics.
- Patients (male or female) more than 18 years and up to 45 years with all degrees of disease severity.
Tools of the study:
The data was collected using the following two tools: It was developed by the investigator, based on a review of related literature and magazines. It was written in Arabic to assess the effect of antibiotic abuse on adults’ health.
First tool: an interview questionnaire: This included the following three parts:
Part (I): This part included: questions to assess the socio- demographic characteristics of the study sample of patients being treated with antibiotics. This part included 7 closed and open-ended questions, such as age, gender, education level, marital status, place of residence, occupation, and family income (Q1: Q7).
Part (II): This part was used to assess adults’ knowledge related to antibiotic abuse. This part included 17 closed and open-ended questions (Q8: Q22).
Part (III): This part assessed the reported practices of adults who were treated with antibiotics toward abuse of antibiotics. This part was developed by an investigator and consisted of 12 closed ended questions with Likert scale for three levels always, sometimes, and never. (Q23:Q39).
Second tool: (Medical Records): Adult health status assessment sheet: This tool was used to assess the health status of adults which consisted of 15 open and closed-ended questions such as:
Part (I): Physical examination: This part consisted of 3 questions.
Part (II): Medical history and current health complaints: This part consisted of 12 questions (Q40-Q51).
Results
• The study results showed that 37.9% of the studied sample had an age ranged between >25 and 35 years, with a Mean SD of 33.4 ± 5.78 years. Addionally, 52.3% of them were female and 63.1% were married. Also, 43.8% of them received a high level of education. Moreover, 83.3% of them resided in urban areas. Furthermore, 48.0% of them were employees.
• In addition, 33.4% of the studied sample had a history of chronic diseases, and 33.3% of them had cardiac diseases. Besides, 36.6% of the studied sample used an antibiotic without a doctor’s prescription. Moreover, 62.3% of them used an antibiotic without a doctor’s prescription.
• The present study findings showed that 54.4% of the studied sample had an unsatisfactory level of the total knowledge about the antibiotic abuse. However, 45.6% of them had a satisfactory level of total knowledge.
• Also, it was proved that 61.5% of the studied sample had unhealthy practices related to the antibiotic abuse, while 38.5% of them had healthy practices.
• Furthermore, it was demonstrated that there was a highly statistically significant relations between the total knowledge, reported practices of the studied sample and their history of using of antibiotics without a doctor’s prescription with a p value of >.0.001.
• In addition, there was a highly significant positive correlation between the total knowledge and total reported practices related to antibiotic abuse with a p value of >.0.001.
Conclusion
The result of this study concluded that more than half of the studied sample had an unsatisfactory level of total knowledge, and less than two thirds of them had unhealthy practices regarding antibiotic abuse. However, there was a highly significant positive correlation between the total knowledge and total reported practices related to antibiotic abuse. Therefore, there was a highly statistically significant relationship between the total knowledge, total reported practices of the studied sample and their history of using an antibiotic without a doctor’s prescription (p-value = <0.001).
Recommendations
Based on the main study findings, the following recommendations were deducted:
• Encouraging the role of the community health nurses as health educators in the different community health service settings to raise population awareness about antibiotic resistance.
• Further research is needed to investigate the effect of counseling programs regarding antibiotic abuse on adults’ awareness.
• Further research is needed to study the impact of antibiotic abuse on other age groups’ health