OBJECTIVE: The objective of the study was to assess public knowledge and attitudes regarding antibiotic utilization in Putrajaya, Malaysia.
METHODS: A self-administered questionnaire survey was conducted among public attending a local hospital. The four-part questionnaire collected responses on demographic characteristics, recent use of antibiotics, knowledge and attitude statements. Cronbach's alpha for knowledge and attitude statements were 0.68 and 0.74 respectively. Only questionnaires with complete responses were analysed. General linear modelling was used to identify demographic characteristics which contributed significantly to knowledge and attitude. Multiple logistic regression was used to determine the adjusted odds ratios of obtaining an inappropriate response for each knowledge and attitude statement. The relationship between antibiotic knowledge and attitude was examined using Pearson's correlation and correlation between related statements was performed using the Chi-square test. In all statistical analyses, a p-value of < 0.05 was considered statistically significant.
RESULTS: There was positive correlation (p<0.001) between mean knowledge (6.07±2.52) and attitude scores (5.59±1.67). Highest education level (p<0.001) and healthcare-related occupation (p=0.001) contributed significantly to knowledge. Gender (p=0.010), race (p=0.005), highest education level (p<0.001), employment status (p=0.016) and healthcare-related occupation (p=0.005) contributed significantly to attitude. The differences in score between demographic groups were small. Misconceptions that antibiotics would work on both bacterial and viral infections were reported. Approximately three quarters of respondents expected antibiotics for treatment of coughs and colds. Close to two thirds (60%) believed that taking antibiotics would improve recovery. Several demographic groups were identified as 'high risk' with respect to gaps in knowledge and attitude.
CONCLUSIONS: This study has identified important knowledge and attitude gaps as well as people 'at risk'. These findings would be useful in strategizing targeted antibiotic awareness campaigns and patient counselling.
KEYWORDS: Malaysia; antibiotic; attitude; knowledge; public; survey
Study site: outpatient pharmacy department of Putrajaya Hospital, Malaysia
The objective of the present study was to evaluate the toxic effect of Averrhoa carambola (star fruit) juice at different storage conditions in Sprague Dawley (SD) rats. Twenty female rats weighing 180 +/- 20 g were randomly assigned into four groups with five rats per group (n = 5). First group served as the control group, fed with distilled water (vehicle). Second, third and fourth groups were orally treated with juice of A. carambola stored for 0, 1 and 3 h respectively for 14 days. Cage-side observations were done daily after each treatment. Body weight, food consumption and water intake were recorded on day-0, day-3, day-7 and day-14. All rats were fasted overnight prior to blood collection through cardiac puncture on day-15. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), urea and creatinine in blood serum were measured. Data were analyzed using Dunnett's test. From the results obtained, there was no lethality found and LD(50) could not be determined. Increment of ALT levels (P<0.05) was reported in those rats treated with A. carambola juice stored for 3 h. On the basis of these results, we can conclude that A. carambola juice stored for 0 hand 1 h are safe to be consumed. However, juice stored for 3 h exerts toxic effect on rat liver at hepatocellular level.