Adherence to antibiotics among adults at state sector primary care in a district of Sri Lanka – a descriptive cross sectional study

Objectives: To assess the adherence and factors associated with oral antibiotic prescriptions among adults in state sector primary care while assessing the intention to use leftover antibiotics (LOAB).Methodology: A descriptive cross sectional study was conducted in outpatient departments including 407 adults (18-75) using an interviewer administered questionnaire at consultation and a telephone interview at due completion of antibiotic. Adherence was measured by a self-report supplemented by remaining pill count. Factors associated with adherence were determined. The statistical significance was considered as p≤0.05.Results: Adherence to antibiotic prescription was 45.5%. Female gender (p=0.029, OR=1.86) and awareness on the current antibiotic prescription (p=0.000, OR=6.37) were positive associations. Adherence was inversely proportionate to increasing daily dosage frequency (p=0.001). Patient’s belief, they can stop medicine once they feel better (p=0.000), fast improvement of symptoms with medication (p=0.000), interference to lifestyle by the antibiotic dosage schedule (p=0.000) and using LOAB in the past (p=0.000,) were negatively associated. Of the non-adherent patients 20.3% intended to use LOAB later.Conclusions: Adherence to oral antibiotic prescriptions was poor. Patient’s gender, patient beliefs and practices towards medicine and complexity of dosage schedule were associated factors. Patient awareness on the current prescription promoted adherence. Intension to use LOAB was high.Recommendations: Primary care prescribers should make patients aware on antibiotic prescriptions while using less complex regimens.