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PLoS One. 2017 Jul 10;12(7):e0180799. doi: 10.1371/journal.pone.0180799. eCollection 2017.

Is the level of knowledge a predictor of rational antibiotic use in Serbia?

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Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine Novi Sad, University of Novi Sad, Novi Sad, Serbia.
Center for Applied Statistics, University of Novi Sad, Novi Sad, Serbia.
Department of Planning, Analysing and Statistics, Primary Health Care Center, Pančevo, Serbia.



The objective of this study was to investigate the knowledge, attitudes and behavior regarding antibiotics of the general population.


The study sample consisted of adult subjects who consulted general practitioners at health centers in Serbia and agreed to complete the questionnaire. A total of 668 questionnaires were distributed; 500 respondents completed the entire questionnaire (response rate 74.85%).


The average age was 51.65 ± 16.56 years, 60.80% of the respondents were women. The median antibiotic knowledge score was 9. Predictors of adequate antibiotic knowledge were higher education level and a family member whose ocuppation was related to health-care. Overall, 58.4% of respondents believed that antibiotics could be used to treat common cold. Around a half of the respondents (47.2%) self-medicated with antibiotics at least once during their life-time, and around a quarter (24.2%) during the last treatment of infection. Patients with inadequate knowledge had 3 times higher chances of self-medicating with antibiotics compared to those with adequate knowledge. Although 98.20% of respondents claimed that antibiotic treatment should be started after a visit to a doctor and receiving a prescription, only 65.8% obtained antibiotics with prescription from a doctor during the last infection.


Although these results demonstrate that respondents had a relatively adequate level of knowledge regarding antibiotics use, some areas of misconceptions and improper behavior were identified. Therefore, further rationalization should be focused on educational campaigns targeting the behavior of patients with regard to antibiotic use.

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