RESUMO
Background: The spread and emergence of antimicrobial resistance is the significant public health concerns over past decades. The major leading cause comes from irrational use of antibiotics. Aim: To explore the characteristics of rational use of antibiotics and identify its predictive factors among public sector living in Nakhon Nayok Province, Thailand. Methods: This project was conducted by using the data-source from Rational Use of Antibiotics (RUA) Survey Project at Nakhon Nayok Province. A cross-sectional community-based study method and face to face interviews were conducted. Two hundred fifty-four participants were selected by using Quota sampling method. Descriptive statistics were used to describe the sociodemographic and antibiotics use characteristics. Chi-square test were utilized to determine the association between explanatory variables and major outcome while multiple logistic regression was analysed to identify the predictors of antibiotics use behavior. Results: The mean age of the participants was 42 years, those with aged between 35 and 56 had more rational use of antibiotics behavior than those with 13-34 years while older adults (57-78 years) were significantly associated with irrational use of antibiotics [AOR = 0.38; 95% CI (0.17-0.85)] than those with less than 34 years of age. Less than half (45.7%) and about one third of them (31.1%) showed adequate knowledge and appropriate attitude towards antibiotics use. An adequate knowledge [AOR = 3.37; 95% CI (1.92-5.90)], appropriate attitude [AOR = 2.90; 95% CI (1.54-5.43)], not using antibiotics within last 3 months [AOR = 1.89; 95% CI (1.04-3.43)], and not visiting drugstore when having three main diseases [AOR = 2.04; 95% CI (1.06-3.92)] were the significant predictors of rational antibiotics use (p-value <0.05). Conclusion: Strategies development in terms of knowledge and attitude enhancement about antibiotics use particularly at the different ages together with RDU pharmacy encouragement and policy restriction of community drugstores antibiotics sales are the most effective method to promote rational antibiotics use behavior in the public sector.
RESUMO
The lack of appropriate medicines for children has a significant impact on health care practices in various countries around the world, including Thailand. The unavailability of pediatric medicines in hospital formularies causes issues regarding off-label use and extemporaneous preparation, resulting in safety and quality risks relating to the use of medicines among children. This research aimed to identify missing pediatric formulations based on the experience of healthcare professionals in a teaching hospital in northern Thailand. A cross-sectional survey was conducted to collect data on missing pediatric formulations, the reasons for their inaccessibility, their off-label uses, their reactions to the situation, and suggestions to improve access to these identified medications. The survey was distributed to all physicians, nurses, and pharmacists involved in prescribing, preparing, dispensing, and administering pediatric medicines. A total of 218 subjects responded to the survey. Omeprazole, sildenafil, and spironolactone suspension were most often identified as missing formulations for children by physicians and pharmacists. They are unavailable on the Thai market or in any hospital formulary. For nurses, sodium bicarbonate, potassium chloride, and chloral hydrate were the most problematic formulations in terms of preparation, acceptability, and administration. These medicines were difficult to swallow because of their taste or texture.
