UC Irvine

Background Increasing resistance of bacterial infections to current treatment threatens to derail progress made to reduce the global burden of diseases. Inadequate knowledge about prudent use of antibiotics is considered a determinant of increasing risks of antibiotic resistance. However, there is insufficient research on effective ways to target information that could increase public knowledge toward improvement of antibiotics stewardship. The aim of this study was to assess the association between knowledge and use of antibiotics in Ghana. Methods Four hundred residents of the Greater Accra and Upper West regions of Ghana, aged 18 years and older, who had previously used antibiotics, completed a standardized questionnaire survey during the months of September-October 2018. The survey collected information on individual knowledge, attitudes, and practices related to antibiotics and antibiotic resistance. Principal component and multivariate analyses were conducted to determine the different components of knowledge and their association with antibiotic use. Results Two main principal components were identified; (i) knowledge about treatment of common illnesses (ii) knowledge about prudent use of antibiotics. There was a significant association between gender and the first component, with women having higher knowledge about the treatment of malaria, headaches, and body aches (beta, b= 0.25; P<0.05; 95% confidence interval, CI=0.01-0.48). Similarly, older individuals aged 25-54 years scored significantly higher than the referent 18-24-year group. The second component revealed significant differences in age, education, and residence, with older adults, persons with higher educational attainment, and Greater Accra residents exhibiting better knowledge about the prudent use of antibiotics for bacterial infections. Likewise, the odds of using antibiotics appropriately was 1.4 times higher for individuals with knowledge about the prudent use of antibiotics (adjusted odds ratio, AOR=1.40; P<0.01; 95% CI=1.15-1.69). Participants who had received a medical prescription during the last occurrence of illness had better knowledge about the treatment of gonorrhea and bladder/urinary tract infections and were knowledgeable about the risks of sharing and buying antibiotics, compared to individuals who had not received a prescription. Conclusions Age, gender, residence, education, as well as experience with antibiotics therapy were identified as determinants associated with knowledge of antibiotics and their uses, thereby providing opportunities to improve community-level antibiotics stewardship.