Knowledge, Attitudes, and Practices (KAP) About Antibiotic Use in Hemodialysis Patients with Chronic Kidney Disease and Their Household Contacts, Medellín-Colombia

Figures & data

Table 1 Sociodemographic Characteristics of Hemodialysis Patients and Their Household Contacts

Characteristic	All Participants (n=130) n (%)	Patients (n=35) n (%)	Household Contacts (n=95) n (%)
Female	83 (63.8)	17 (48.6)	66 (69.5)
Age - Median (IQR)	48 (32–62)	58 (45.5–69.5)	41 (26–59)
Years of life in the area of residence - Median (IQR)	20 (6–36.7)	22 (4.5–42.5)	20 (6.5–33.5)
Participant type
Adult	121 (93.1)	35 (100)	86 (90.5)
Pediatric	9 (6.9)	0 (0.0)	9 (9.5)
Residence area (municipality)
Medellín
Commune 1	5 (3.9)	1 (2.9)	4 (4.2)
Commune 2	3 (2.3)	1 (2.9)	2 (2.1)
Commune 3	13 (10.0)	3 (8.6)	10 (10.5)
Commune 4	24 (18.5)	7 (20.0)	17 (17.9)
Commune 5	15 (11.5)	3 (8.6)	12 (12.6)
Commune 6	9 (6.9)	3 (8.6)	6 (6.3)
Commune 7	8 (6.2)	2 (5.7)	6 (6.3)
Commune 8	3 (2.3)	1 (2.9)	2 (2.1)
Commune 9	6 (4.6)	1 (2.9)	5 (5.3)
Commune 10	20 (15.4)	6 (17.1)	14 (14.7)
Commune 11	2 (1.5)	0 (0.0)	2 (2.1)
Commune 12	3 (2.3)	1 (2.9)	2 (2.1)
Commune 13	5 (3.9)	1 (2.9)	4 (4.2)
Commune 15	3 (2.3)	1 (2.9)	2 (2.1)
Commune 16	2 (1.5)	1 (2.9)	1 (1.1)
Bello	6 (4.6)	2 (5.7)	4 (4.2)
Sabaneta	3 (2.3)	1 (2.9)	2 (2.1)
Educational level
None	4 (3.1)	2 (5.7)	2 (2.1)
Complete Primary	19 (14.6)	10 (28.6)	9 (9.5)
Incomplete Primary	15 (11.5)	5 (14.3)	10 (10.5)
Completed secondary	23 (17.7)	4 (11.4)	19 (20.0)
Incomplete Secondary	22 (16.9)	5 (14.3)	17 (17.9)
Complete technical or technological studies	18 (13.9)	4 (11.4)	14 (14.7)
Incomplete technical or technological studies	2 (1.5)	0 (0.0)	2 (2.1)
Complete University	19 (14.6)	4 (11.4)	15 (15.8)
Incomplete University	8 (6.2)	1 (2.9)	7 (7.4)

Figure 1 Participant inclusion process.

Table 2 Knowledge About the Antibiotic Use and Antimicrobial Resistance of Hemodialysis Patients and Their Household Contacts

Questions	All Participants (n=130) n (%)	Patients (n=35) n (%)	Household Contacts (n=95) n (%)
1. Have you heard about antibiotics?
Yes	130 (100)	35 (100)	95 (100)
2. Who has taught you about antibiotics? ^a
College/school	12 (9.2)	0 (0.0)	12 (12.6)
Internet	6 (4.6)	0 (0.0)	6 (6.3)
Doctor	76 (58.5)	24 (68.6)	52 (54.7)
Pharmacist	15 (11.5)	6 (17.1)	9 (9.5)
Relatives	35 (26.9)	6 (17.1)	29 (30.5)
Friends	10 (7.7)	5 (14.3)	5 (5.3)
TV and radio	17 (13.1)	6 (17.1)	11 (11.6)
Other	33 (25.4)	13 (37.1)	20 (21.1)
3. When should antibiotics be used? ^b
Correct profile	18 (13.8)	7 (20.0)	11 (11.6)
Wrong profile	108 (83.1)	26 (74.3)	82 (86.3)
Does not know	4 (3.1)	2 (5.7)	2 (2.1)
4. When do you decide to see the doctor? ^a
When present something strange that had not happened before	39 (30.0)	13 (37.1)	26 (27.4)
When start to feel sick	29 (22.3)	9 (25.7)	20 (21.1)
When feel very sick	94 (72.3)	19 (54.3)	75 (78.9)
Other	18 (13.8)	7 (20.0)	11 (11.6)
5. What can antibiotics cure? ^c
Correct profile	20 (15.4)	3 (8.6)	17 (17.9)
Wrong profile	105 (80.8)	29 (82.8)	76 (80.0)
Does not know	5 (3.8)	3 (8.6)	2 (2.1)
6. Do you know why antibiotics are used in agriculture, poultry or livestock?
Yes	55 (42.3)	12 (34.3)	43 (45.3)
7. Have you heard about antibiotic resistance?
Yes	78 (60.0)	22 (62.9)	56 (58.9)
8. If you take antibiotics every time you get sick, what can it cause? ^a
Absolutely nothing	4 (3.1)	2 (5.7)	2 (2.1)
It relieves us of the disease quickly	33 (25.4)	6 (17.1)	27 (28.4)
The antibiotic will not help us against other infections	57 (43.8)	13 (37.1)	44 (46.3)
It will always keep us healthy	10 (7.7)	4 (11.4)	6 (6.3)
Does not know	18 (13.8)	5 (14.3)	13 (13.7)
Other	25 (19.2)	10 (28.6)	15 (15.8)
9. Do antibiotics have harmful effects?
Yes	96 (73.8)	27 (77.1)	69 (72.6)
10. Should children receive antibiotics whenever there is a fever?
Yes	85 (65.4)	23 (65.7)	62 (65.2)
No	36 (27.7)	10 (28.6)	26 (27.4)
Does not know	9 (6.9)	2 (5.7)	7 (7.4)
11. Do you think antibiotics can stop working?
Yes	94 (72.3)	24 (68.6)	70 (73.7)
12. Do you know how often a new antibiotic is developed?
Every Month	14 (10.8)	6 (17.1)	8 (8.4)
Every 6 months	6 (4.6)	2 (5.7)	4 (4.2)
Every year	12 (9.2)	4 (11.4)	8 (8.4)
Every 3 years	4 (3.1)	1 (2.9)	3 (3.2)
Every 5 years	1 (0.8)	0 (0.0)	1 (1.1)
There has not been in the last 10 years	3 (2.3)	1 (2.9)	2 (2.1)
Does not know	90 (69.2)	21 (60.0)	69 (72.6)
13. Do you think infections spread between people and pets?
Yes	119 (91.5)	33 (94.3)	86 (90.5)
No	5 (3.9)	0 (0.0)	5 (5.3)
Does not know	6 (4.6)	2 (5.7)	4 (4.2)

Notes: ^aThe question admits multiple answers. ^bThe correct profile was established by selecting at least one of the following categories: “When we get tonsillitis”, “when I have pain to urinate”, “when I have an infected wound”. The wrong profile was set with the selection of at least one of the missing categories. ^cThe correct profile was established with the option: “Bladder infections”. The wrong profile was set with the selection of at least one of the missing categories.

Table 3 Attitudes About the Antibiotic Use and Antimicrobial Resistance of Hemodialysis Patients and Their Household Contacts

Questions	All Participants (n=130) n (%)	Patients (n=35) n (%)	Household Contacts (n=95) n (%)
14. Where do you go if you have a fever or suspected infection? ^a
Pharmacy	28 (21.5)	5 (14.3)	23 (24.2)
Hospital	25 (19.2)	16 (45.7)	9 (9.4)
Neighborhood medical center	4 (3.1)	1 (2.9)	3 (3.2)
Where a relative	3 (2.3)	1 (2.9)	2 (2.1)
HPC	72 (55.4)	21 (60.0)	51 (53.7)
Nowhere	16 (12.3)	2 (5.7)	14 (14.7)
Other	6 (4.6)	0 (0.0)	6 (6.3)
15. When you are given treatment for several days, do you take all the pills that the doctor prescribes?
Yes	95 (73.1)	26 (74.3)	69 (72.6)
No	35 (26.9)	9 (25.7)	26 (27.4)
16. When you are given treatment for several days, do you stop when you get better?
Yes	48 (36.9)	14 (40.0)	34 (35.8)
No	82 (63.1)	21 (60.0)	61 (64.2)
17. Do you keep medications in your home?
Yes	89 (68.5)	30 (85.7)	59 (62.1)
No	41 (31.5)	5 (14.3)	36 (37.9)
18. Do you agree to keep antibiotics in the house for any infection?
Yes	57 (43.8)	12 (34.3)	45 (47.4)
No	73 (56.2)	23 (65.7)	50 (52.6)
19. Are there people in the neighborhood who prescribe antibiotics for any illness?
Yes	29 (22.3)	12 (34.3)	17 (17.9)
No	85 (65.4)	17 (48.6)	68 (71.6)
Does not know	16 (12.3)	6 (17.1)	10 (10.5)
20. Do you take the medications that the pharmacist recommends?
Yes	52 (40.0)	9 (25.7)	43 (45.3)
No	71 (54.6)	22 (62.9)	49 (51.5)
Does not recommend anything	7 (5.4)	4 (11.4)	3 (3.2)

Note: ^aThe question admits multiple answers.

Table 4 Practices Regarding the Antibiotic Use and Antimicrobial Resistance of Hemodialysis Patients and Their Household Contacts

Questions	All Participants (n=130) n (%)	Patients (n=35) n (%)	Household Contacts (n=95) n (%)
21. Does anyone in your family prescribe medications such as antibiotics?
Yes	31 (23.9)	8 (22.9)	23 (24.2)
No	97 (74.6)	27 (77.1)	70 (73.7)
Does not know	2 (1.5)	0 (0.0)	2 (2.1)
22. Who has prescribed antibiotics to you? ^a
The doctor	104 (80.0)	34 (97.1)	70 (73.7)
The pharmacist	28 (21.5)	4 (11.4)	24 (25.3)
Friends	2 (1.5)	0 (0.0)	2 (2.1)
Relatives	31 (23.9)	5 (14.3)	26 (27.4)
Myself	9 (6.9)	2 (5.7)	7 (7.4)
Other	5 (3.9)	5 (14.3)	0 (0.0)
23. Why have you been prescribed antibiotics? ^a
Tonsillitis	23 (17.7)	5 (14.3)	18 (18.9)
Diarrhea	16 (12.3)	2 (5.7)	14 (14.7)
Flu	27 (20.8)	6 (17.1)	21 (22.1)
Urinary infection	32 (24.6)	7 (20.0)	25 (26.3)
Earache	7 (5.4)	1 (2.9)	6 (6.3)
Does not remember	12 (9.2)	4 (11.4)	8 (8.4)
Other	64 (49.2)	23 (65.7)	42 (44.2)
24. When was the last time you took antibiotics?
Does not remember	35 (26.9)	9 (25.7)	26 (27.4)
At the moment	16 (12.3)	7 (20.0)	9 (9.4)
Last month	11 (8.5)	4 (11.4)	7 (7.4)
In the last 6 months	32 (24.6)	5 (14.3)	27 (28.4)
Last year	16 (12.3)	6 (17.1)	10 (10.5)
Over a year ago	14 (10.8)	3 (8.6)	11 (11.6)
Never	6 (4.6)	1 (2.9)	5 (5.3)
26. Where do you get antibiotics? ^a
In pharmacy	80 (61.5)	20 (57.1)	60 (63.1)
From the home medicine cabinet	1 (0.8)	0 (0.0)	1 (1.1)
In a chain store	2 (1.5)	0 (0.0)	2 (2.1)
The HPC gives them	71 (54.6)	25 (71.4)	46 (48.4)
Other	7 (5.4)	2 (5.7)	5 (5.3)

Note: ^aThe question admits multiple answers.

Abbreviation: HPC, Health Promotion Company.

Figure 2 Antibiotics used by the study population. *Category composed of azithromycin, penicillin G benzathine, penicillin, clindamycin, metronidazole, dicloxacillin, erythromycin, gentamicin, lincomycin, meropenem, piperacillin, tetracycline.