Factors Associated with Irrational Use of Antibiotics. A Cross-Sectional Study in the City of Marrakech Morocco

Abstract

Overuse and inappropriate use of antibioticsleads to the emergence of antibiotic-resistant bacteria. This resistance leadsto longer hospital stays, higher medical costs, and increased mortality. Therefore,its control must be a priority as it poses a threat to all nations, regardlessof their territory and economic status.In Marrakech too, antibioticresistance is a real public health problem, limiting treatment options. Thepopulation plays a crucial role in the irrational use of antibiotics. Anappropriate analysis of the factors influencing correct use is of interest forany effective improvement intervention.Consequently, the aim of thiscross-sectional study was to investigate the factors associated with theirrational use of antibiotics in the population of the city of Marrakech, witha view to proposing strategies for the proper use of these drugs adapted to thecontext of the study. The study population includes the generalpopulation of the city of Marrakech attending health centers and pharmacies. Atotal of 300 participants familiar with the term "antibiotic" wereincluded in this study. They were selected using a stratified sampling method.The aim was to achieve a balanced distribution by gender, age, and place ofresidence. Regression analysis was performed to identify socio-demographicfactors associated with knowledge, attitudes, and behaviors. Using Spearman'sanalysis, we examined the correlation between responses to questions on knowledge,attitudes, and behavior. A total of 269 questionnaires were analyzed. 69.9% ofthe participants had received antibiotics in the last year before the survey.Only 61.8% of the users were taking them on prescription. The reasons fortaking antibiotics were mainly respiratory infections (50.8%). 56.3% ofparticipants think antibiotics are effective against viruses, 35.1% think theyshould stop taking an antibiotic when they feel better and 57.9% have alreadystored antibiotics at home for future use. The use of a multiple logisticregression model showed that age between 30 and 49 years and family structurewere associated with a good knowledge of antibiotics. Social security coverageand female gender were associated with good attitude. Nuclear family structurewas associated with good behavior. Improving knowledge is a key factor inimproving people's behavior towards the appropriate use of antibiotics. Ourresults show an irrational use of antibiotics. People aged between 14-29 years,over 50 years, and people living in extended family structures, as well aspeople without social security coverage, are the most predisposed to irrationaluse of antibiotics. What's more, the study showed a significant and positiverelationship between knowledge, attitudes, and behavior. There is therefore anurgent need to organize awareness campaigns for the general public,particularly extended families and the under-29 and over-50 age groups. It is also important to strengthenpolicies relating to the use of antibiotics and the prescription, distribution,and sale of medicines.