The Relation between Knowledge and Belief with Adult Patient’s Antibiotics Use Adherence

April Nuraini(1*), Rika Yulia(2), Fauna Herawati(3), Setiasih Setiasih(4)

(1) Student of Graduate Program of Pharmacy, Faculty of Pharmacy, Surabaya University
(2) Department of Clinical Pharmacy and Community, Faculty of Pharmacy, Surabaya University
(3) Department of Clinical Pharmacy and Community, Faculty of Pharmacy, Surabaya University
(4) Department/Laboratory of Developmental Psychology, Faculty of Psychology, Surabaya University
(*) Corresponding Author


The inappropriate use of antibiotics has resulted in bacterial resistance to antibiotics. One of the factors supporting this phenomenon is the lack of patient knowledge and belief of antibiotics. The study aimed to know the relationship between knowledge and belief with adherence in using antibiotics in adult patients at Syarifah Ambami Rato Ebu Hospital, Bangkalan, based on the Health Belief Model theory. This research is observational analysis using cross-sectional study. There were 103 patients chosen by incidental sampling. Data collection about knowledge was obtained through questionnaires containing 13 questions, while one about belief used a questionnaire containing 30 valid and reliable questions. Adherence was measured by the pill count method. The relationship between knowledge and belief to adherence was analyzed using logistic regression test. The relationship between demography and adherence was analyzed using Spearman correlation test with α = 0.05. The result of this research shows that most patients had sufficient knowledge (57,2%), sufficient belief (69,9%) and adherence (55,3%). There was a significant relationship between knowledge with adherence in the use of antibiotics (p = 0.011) and a significant relationship between belief and adherence in the use of antibiotics (p = 0.046). In terms of belief, perceived benefits have a significant effect on adherence. The conclusions of this study is that there is a relationship between knowledge and belief with adherence in the use of antibiotics and in accordance with health belief model (HBM) theory.

Full Text:



1. Rocci Jack Parse, Eva Mardiana Hidayat B aisjahbana. Knowledge , Attitude and Behavior Related to Antibiotic Use in Community Dwellings. Althea Med Journal 2017;4(2). 2017;4(2):271-277.

2. Axelsson M. Report on personality and adherence to antibiotic therapy: a population-based study. BMC Psychol. 2013;1(1):24. doi:10.1186/2050-7283-1-24

3. Michael CA, Dominey-Howes D, Labbate M. The Antimicrobial Resistance Crisis: Causes, Consequences, and Management. Front Public Heal. 2014;2(September):1-8. doi:10.3389/fpubh.2014.00145

4. Hadi U, Duerink DO, Lestari ES, Nagelkerke NJ, Keuter M, Huis D. Audit of antibiotic prescribing in two governmental teaching hospitals in Indonesia. 2008.

5. Shaw D, Pan T, Huang JH, et al. Knowledge , attitudes and practices towards antibiotic use in upper respiratory tract infections among patients seeking primary health care in Singapore. BMC Fam Pract. 2016:1-9. doi:10.1186/s12875-016-0547-3

6. Abu Taha A, Abu-Zaydeh AH, Ardah RA, et al. Public Knowledge and Attitudes Regarding the Use of Antibiotics and Resistance: Findings from a Cross-Sectional Study Among Palestinian Adults. Zoonoses Public Health. 2016;63(6):449-457. doi:10.1111/zph.12249

7. Shehadeh MB, Suaifan GARY, Hammad EA. Active educational intervention as a tool to improve safe and appropriate use of antibiotics. Saudi Pharm J. 2016;24(5):611-615. doi:10.1016/j.jsps.2015.03.025

8. Ferri M, Ranucci E, Romagnoli P, Giaccone V. Antimicrobial resistance: A global emerging threat to public health systems. Crit Rev Food Sci Nutr. 2017;57(13):2857-2876. doi:10.1080/10408398.2015.1077192

9. CDC. Antibiotic resistance threats in the United States, 2013. Current. 2013:114. doi:CS239559-B

10. Menkes RI. Permenkes RI No. 8 Tahun 2015 tentang Program Pengendalian Resistensi Antimikroba di Rumah Sakit. Hukor Depkes RI. 2015:23-24. doi:10.1017/CBO9781107415324.004

11. Ghadeer A. R. Y. Suaifan. A cross-sectional study on knowledge, attitude and behavior related toantibiotic use and resistance among medical and non-medical university students in Jordan. African J Pharm Pharmacol. 2012;6(10). doi:10.5897/AJPP12.080

12. Castro-sánchez E, Moore LSP, Husson F, Holmes AH. What are the factors driving antimicrobial resistance ? Perspectives from a public event in London , England. BMC Infect Dis. 2016:1-5. doi:10.1186/s12879-016-1810-x

13. Pavydė E, Veikutis V, Mačiulienė A, Mačiulis V, Petrikonis K, Stankevičius E. Public knowledge, beliefs and behavior on antibiotic use and self-medication in Lithuania. Int J Environ Res Public Health. 2015;12(6):7002-7016. doi:10.3390/ijerph120607002

14. Karen Glanz BKRK. Health and Health. 2013.

15. Maria R. Gualano, Renata Gili, Giacomo Scaioli, FabrizioBert RS. General population’s knowledge and attitudes about antibiotics: a systematic review and meta-analysis Maria. Publ online 24 Sept 2014 Wiley Online Libr DOI 101002/pds3716 Rev. 2015;6(5):2-10. doi:10.1002/pds

16. Huang Y, Gu J, Zhang M, et al. Knowledge, attitude and practice of antibiotics: a questionnaire study among 2500 Chinese students. BMC Med Educ. 2013;13(1):163. doi:10.1186/1472-6920-13-163

17. Kandrotaite K, Smigelskas K, Janusauskiene D, et al. the risk of nonadherence to antibiotic treatment Original article Development of a short questionnaire to identify the risk of nonadherence to antibiotic treatment No p Un t yr au fo ig th r ht di or S sp ize a la d le © y , us vi e o d p ibi om In rin te. 2013;7995(October 2015). doi:10.1185/03007995.2013.835255

18. Yarza HL, Irawati L. Artikel Penelitian Hubungan Tingkat Pengetahuan dan Sikap dengan Penggunaan Antibiotik Tanpa Resep Dokter. 2015;4(1):151-156.

19. Muñoz EB, Dorado MF, Guerrero JE, Martínez FM. The effect of an educational intervention to improve patient antibiotic adherence during dispensing in a community pharmacy. Atención Primaria. 2014;46(7):367-375. doi:10.1016/j.aprim.2013.12.003

20. Lv B, Zhou Z, Xu G, et al. Knowledge , attitudes and practices concerning self-medication with antibiotics among university students in western China. 2014;19(7):769-779. doi:10.1111/tmi.12322

21. Enander, Gagnon, Gute. Besar Sampel dan Teknik Sampling. 2011;97(5):1-11. doi:10.1016/j.jbankfin.2012.03.021

22. Jamhour A, El-kheir A, Pharmd PS, Hanna PA, Mansour H, Bcps P. Antibiotic knowledge and self-medication practices in a developing country: A cross-sectional study. AJIC Am J Infect Control. 2017;(January). doi:10.1016/j.ajic.2016.11.026

23. Price L, Gozdzielewska L, Young M, et al. Effectiveness of interventions to improve the public’s antimicrobial resistance awareness and behaviours associated with prudent use of antimicrobials: a systematic review 1. 2018;(March):1464-1478. doi:10.1093/jac/dky076

24. Fernandes M, Leite A, Basto M, Arau M, Nogueira P, Jorge P. Non-adherence to antibiotic therapy in patients visiting community pharmacies. 2014:86-91. doi:10.1007/s11096-013-9850-4

25. Pham JA, Pierce W, Muhlbaier L. A randomized , controlled study of an educational intervention to improve recall of auxiliary medication labeling and adherence to antibiotics. 2013;(22). doi:10.1177/2050312113490420

26. Kandelaki K, Lundborg CS, Marrone G. Antibiotic use and resistance: a cross-sectional study exploring knowledge and attitudes among school and institution personnel in Tbilisi, Republic of Georgia. BMC Res Notes. 2015;8(1):495. doi:10.1186/s13104-015-1477-1

27. Candrakanth, Mohammad Salem, Madhan Mohan G. Assessment of Public Knowledge and Attitude Regarding Antibiotic Use in a Tertiary Care Hospital. Asian J Pharm Clin Res. 2016;9(1):118-122.


Article Metrics

Abstract views : 2573 | views : 23422


  • There are currently no refbacks.

Copyright (c) 2019 JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

©Jurnal Manajemen dan Pelayanan Farmasi
Faculty of Pharmacy
Universitas Gadjah Mada
Creative Commons License
View My Stats