title: Prevalence and correlates of antibiotic sharing in the Philippines: antibiotic misconceptions and community-level access to non-medical sources of antibiotics.
abstract: To identify sociodemographic, knowledge and attitudinal correlates to antibiotic sharing among a community-based sample of adults (age 18 and older) in a low-income setting of the Philippines and to explore community-level data on informal antibiotic distribution in roadside stands (i.e., sari-sari stands).
  
  
  
  Participants (n = 307) completed self-administered surveys. Correlates to antibiotic sharing were assessed using logistic regression with Firth's bias-adjusted estimates. Study staff also visited 106 roadside stands and collected data on availability and characteristics of antibiotics in the stands.
  
  
  
  78% had shared antibiotics in their lifetime, most often with family members. In multivariable analysis, agreement with the belief that it is safe to prematurely stop an antibiotic course (OR: 2.8, CI: 1.3-5.8) and concerns about antibiotic side effects (OR: 2.1, CI: 1.1-4.4) were significantly associated with increased odds of reported antibiotic sharing. Antibiotic sharing was not associated with sociodemographic characteristics or antibiotic knowledge. Antibiotics were widely available in 60% of sampled sari-sari stands, in which 59% of antibiotics were missing expiration dates. Amoxicillin and cephalexin were the most commonly available antibiotics for sale at the stands (60% and 21%, respectively).
  
  
  
  Antibiotic sharing was common and was associated with misconceptions about proper antibiotic use. Antibiotics were widely available in sari-sari stands, and usually without expiration information. This study suggests that multipronged and locally tailored approaches to curbing informal antibiotic access are needed in the Philippines and similar Southeast-Asian countries.
authors.affiliation: Department of Epidemiology, University of Kentucky, Lexington, KY, USA.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Barber
authors.affiliation: Island Ventures, Inc., Lapu-Lapu City, Cebu, Philippines.
authors.forename: Efren
authors.initials: E
authors.lastname: Casquejo
authors.affiliation: Island Ventures, Inc., Lapu-Lapu City, Cebu, Philippines.
authors.forename: Purita L
authors.initials: PL
authors.lastname: Ybañez
authors.affiliation: Island Ventures, Inc., Lapu-Lapu City, Cebu, Philippines.
authors.forename: Magdaleno T
authors.initials: MT
authors.lastname: Pinote
authors.affiliation: Island Ventures, Inc., Lapu-Lapu City, Cebu, Philippines.
authors.forename: Luz
authors.initials: L
authors.lastname: Casquejo
authors.affiliation: Island Ventures, Inc., Lapu-Lapu City, Cebu, Philippines.
authors.forename: Lucia S
authors.initials: LS
authors.lastname: Pinote
authors.affiliation: Island Ventures, Inc., Lapu-Lapu City, Cebu, Philippines.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Estorgio
authors.affiliation: Department of Epidemiology, University of Kentucky, Lexington, KY, USA.
authors.forename: April M
authors.initials: AM
authors.lastname: Young
mesh_terms: D000328:Adult; D000658:Amoxicillin; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002506:Cephalexin; D003132:Commerce; D011307:Drug Prescriptions; D005190:Family; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D063046:Patient Medication Knowledge; D010679:Philippines; D011203:Poverty; D055553:Prescription Drugs / Q000627:therapeutic use*; D012111:Residence Characteristics; D012651:Self Medication; D012919:Social Behavior; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents; D055553:Prescription Drugs; D000658:Amoxicillin; D002506:Cephalexin
keywords: Asie du sud-est; Filipinas; Philippines; Southeast Asia; Sudeste asiático; antibiotic resistance; antibiotics; antibiotiques; antibióticos; automedicación; automédication; desviación de medicamentos recetados; déviation des médicaments sous prescription; prescription drug diversion; resistencia a antibióticos; résistance aux antibiotiques; self-medication