Healthcare System Distrust and Non-Prescription Antibiotic Use: A Cross-Sectional Survey of Adult Antibiotic Users

Brooke A. Hawkes, Sana M. Khan, Melanie L. Bell, Jill Guernsey de Zapien, Kacey C. Ernst, Katherine D. Ellingson

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Antibiotic resistance is a major public health concern driven by antibiotic overuse. Antibiotic stewardship programs are often limited to clinical settings and do little to address non-prescription antibiotic use in community settings. This study investigates the association between non-prescription antibiotic use and healthcare system distrust in the United States and Mexico. An online survey was deployed in the United States and Mexico with enhanced sampling through in-person recruiting in the border region. Non-prescription antibiotic use was defined as having bought or borrowed non-prescription oral or injectable antibiotics within the last 3 years. The survey included a previously validated 10-item scale to measure healthcare system distrust. Logistic regression was used to model the use of non-prescription antibiotics by the level of healthcare system distrust, adjusted for demographic characteristics and antibiotic knowledge. In total, 568 survey participants were included in the analysis, 48.6% of whom had used non-prescription oral or injectable antibiotics in the last 3 years. In the fully adjusted regression model, the odds of using non-prescription antibiotics were 3.2 (95% CI: 1.8, 6.1) times higher for those in the highest distrust quartile versus the lowest. These findings underscore the importance of community-based antibiotic stewardship and suggest that these programs are particularly critical for communities with high levels of healthcare system distrust.

Original languageEnglish (US)
Article number79
JournalAntibiotics
Volume12
Issue number1
DOIs
StatePublished - Jan 2023

Keywords

  • antimicrobial resistance
  • antimicrobial stewardship
  • non-prescription antibiotic use
  • trust in healthcare system

ASJC Scopus subject areas

  • General Pharmacology, Toxicology and Pharmaceutics
  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)
  • Biochemistry
  • Microbiology

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