چکیده (انگلیسی):

Background:Patients’ expectations can influence antibiotic prescription by primary healthcare physicians. We assessed
knowledge, attitude and practices towards antibiotic use for upper respiratory tract infections (URTIs), and whether
knowledge is associated with increased expectations for antibiotics among patients visiting primary healthcare services
in Singapore.
Methods:Data was collected through a cross-sectional interviewer-assisted survey of patients aged≥21 years waiting
to see primary healthcare practitioners for one or more symptoms suggestive of URTI (cough, sore throat, runny nose
or blocked nose) for 7 days or less, covering the demographics, presenting symptoms, knowledge, attitudes, beliefs
and practices of URTI and associated antibiotic use. Univariate and multivariate logistic regression was used to assess
independent factors associated with patients’ expectations for antibiotics.
Results:Nine hundred fourteen out of 987 eligible patients consulting 35 doctors were recruited from 24 private sector
primary care clinics in Singapore. A third (307/907) expected antibiotics, of which a substantial proportion would ask the
doctor for antibiotics (121/304, 40 %) and/or see another doctor (31/304, 10 %) if antibiotics were not prescribed. The
majority agreed“antibiotics are effective against viruses”(715/914, 78 %) and that “antibiotics cure URTI faster”(594/912,
65 %). Inappropriate antibiotic practices include“keeping antibiotics stock at home”(125/913, 12 %), “taking leftover
antibiotics”(114/913, 14 %) and giving antibiotics to family members (62/913, 7 %). On multivariate regression, the
following factors were independently associated with wanting antibiotics (odds ratio; 95 % confidence interval): Malay
ethnicity (1.67; 1.00–2.79), living in private housing (1.69; 1.13–2.51), presence of sore throat (1.50; 1.07–2.10) or fever (1.46;
1.01–2.12), perception that illness is serious (1.70; 1.27–2.27), belief that antibioticscure URTI faster (5.35; 3.76–7.62) and not
knowing URTI resolves on its own (2.18; 1.08–2.06), while post-secondary education (0.67; 0.48–0.94) was inversely
associated. Those with lower educational levels were significantly more likely to have multiple misconceptions about
antibiotics.
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* Correspondence:mark.chen.ic@gmail.com
†
Equal contributors
2
Saw Swee Hock School of Public Health, National University Health System,
National University of Singapore, 12 Science Drive 2, 117549 Singapore,
Singapore
3
Institute of Infectious Diseases & Epidemiology, Communicable Disease
Centre, Tan Tock Seng Hospital, 308433 Singapore, Singapore
Full list of author information is available at the end of the article
© The Author(s). 2016Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Panet al. BMC Family Practice (2016) 17:148
DOI 10.1186/s12875-016-0547-3
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Conclusion:Majority of patients seeking primary health care in Singapore are misinformed about the role of antibiotics in
URTI. Agreeing with the statement that antibiotics cure URTI faster was most strongly associated with wanting antibiotics.
Those with higher educational levels were less likely to want antibiotics, while those with lower educational levels more
likely to have incorrect knowledge.