Abstract
The antimicrobial resistance (AMR) crisis is rising continuously, which has accelerated by the inappropriate use of antimicrobials either unnecessary or overuse and misuse. To better understand about the appropriate use of antibiotics and monitor as well as evaluate of implementing the National Strategic Plan on Antimicrobial Resistance 2017-2021, the National Statistical Office (NSO) and the International Health Policy Program (IHPP) jointly developed a module to assess the levels of knowledge on antimicrobials and awareness of antimicrobial resistance among the Thai population. The 27,762 adults older than 15 years were asked to self-administer this module. The module was integrated into the decade long National Health and Welfare Survey (HWS) conducted by the National Statistical Office. HWS 2017 was the first time in Thailand that introduced a modified version of the Eurobarometer antimicrobial resistance module into the survey. The module consisted of four sections including antimicrobial use profiles, antimicrobial literacy, public information on proper use of antimicrobial and antimicrobial resistance, and awareness on the use of antimicrobial in farm animals. The key findings showed that 7.9% of Thai adults older than 15 years received antimicrobial drugs in the last month. The majority of Thai people (70.3%) obtained antimicrobial drugs from health facilities (both private and public sectors at all levels), followed by drug stores (26.7%). Respiratory track symptoms were the most commonly reported reasons for taking antimicrobials; 62.7% of the total. In addition, the antimicrobial literacy is probed using five true and false statements. Poor level of knowledge on antimicrobials was alarmingly found in Thai population, only 3.1% gave correct answers to all statements and the most misunderstood statements were “antimicrobials kill viruses” and “antimicrobials are effective against colds and flu”. Moreover, only 17.8% of Thai people received information about proper use of antimicrobials in the last 12 months. Three common sources of the information were doctors (36.1%), other health professionals such as nurses and health workers (24.8%) and pharmacists (17.7%). Almost two-thirds of respondents were not aware of antimicrobial use in food producing animals and about 68.2% of adults did not know that Thailand had banned the use of antimicrobials as growth promoters in food animals. The Ministry of Public Health and the relevant authorities need to steward appropriate use of antimicrobials by health professionals, pharmacists and veterinarians (supply side) as well as create effective public communication and awareness program on antimicrobials use and AMR in general population through new channels such as social media for increasing the potential reach of the information (demand side). The progress of antimicrobials use and literacy should be monitored continuously as part of improving knowledge on antimicrobial resistance and awareness of appropriate use of antimicrobials and monitoring the progress of the National Strategic Plan on Antimicrobial Resistance.
