Consumo de antibióticos na população adulta de Coari, Amazonas, Brasil

Abstract

Introduction: Antibiotics play a crucial role in world health, but there is global concern about the excessive or indiscriminate consumption of these substances, whether through over- prescription or self-medication, which can lead to various problems such as bacterial resistance. Objective: To analyze antibiotic consumption in the adult population of the municipality of Coari, Amazonas, Brazil. Method: This is a cross-sectional analysis of antibiotic consumption from a cohort study entitled “Climatic events and health conditions of adults in the Amazon region: a population-based study”. The study was carried out in the urban area of the municipality of Coari, located in the central region of the state of Amazonas, Brazil. The sample consisted of 394 adults, and data collection took place during the Amazon River's ebb and flow, between October and November 2021. A structured form was used, with sections on sociodemographic information, access to health services, self-reported illnesses and medication consumption. Antibiotics were classified according to the Anatomical Therapeutical Chemical Classification System (ATC) and the WHO AWaRE classification. The data was analyzed using the Statistical Package for Social Science for Windows 2.0 (SPSS) software, and the variables were presented as absolute and relative frequencies. Poisson Regression with robust variance was used to estimate Prevalence Ratios (PR) and their respective 95% Confidence Intervals (CI). Multivariate regression was performed, with significance p≤0.20, and variables with p≤0.05 were retained. The study was approved by the Human Research Ethics Committee of the Federal University of Amazonas (CAAE: 43767420.9.0000.5020). Results: Of the 394 adults, 70.5% were female with an average age of 45.3 ± 15.2. The prevalence of antibiotic consumption was 14.7% (n=58). Azithromycin (26.9%) was the most commonly used antibiotic for sore throats, COVID-19, flu and to "prevent" COVID-19. Most antibiotics were prescribed (65.5%). In the regression model, the age group between 18 and 39 remained associated with antibiotic use (PR= 3.73; CI=1.37-10.09), having a case of hospitalization in the family (PR= 2.61; CI=1.39-4.89) and having contracted COVID-19 (PR= 2.41; CI=1.40-4.15) with the highest prevalence rates. Having reported no illness in the last three months (PR= 0.31; CI=0.12-0.77) and having received a home visit from the CHW more than once a month (PR= 0.35; CI=0.15-0.81) reduced the prevalence of antibiotic use. Conclusions: The study showed a prevalence of antibiotic use in the urban area of Coari and the need to control use in public health establishments in order to optimize prescriptions, as well as to restrict dispensing without a prescription and raise awareness of the risks of self-medication with antibiotics, especially among young adults.