2016. Antibiotic Misuse of Rural Residents and Pilot Project of Antibiotic Take-Back Program

BACKGROUND: Self-medication with antibiotics (SMA) is a major form of antibiotic misuse behaviors contributing to increasing antimicrobial resistance (AMR). The main source of SMA usually comes from in-home leftover antibiotics which usually disposed as household waste without classification. Therefore, an antibiotic take-back program (ATBP) is urgently needed. METHODS: A pilot ATBP was launched in Liantang Village, Zhejiang Province from January to March, 2019. A total of 50 households were randomly selected for the baseline survey. A questionnaire was used to investigate their knowledge and antibiotic use behaviors. Health education leaflets and posters were distributed to each household. A village Wechat group was set up for health communication. Residents were encouraged to hand over those unused or expired antibiotics at home to the village clinic to redeem a commodity. The pilot ATBP was implemented for 30 days. The type, name, and amount of antibiotics were collected as after intervention data. RESULTS: All of 50 households finished the questionnaire. Although 27 (52.9%) agreed that keeping antibiotics at home would potentially increase risk of SMA, there were still 32 (64.0%) residents reported that they kept antibiotics at home and 25 (49%) residents indicated that their leftover antibiotics usually disposed as household waste. After the 30-day intervention, 10 (20.0%) households handed their in-home antibiotics or medicine to the village clinic. In total, 32 boxes of medicine including 17 (53.1%) boxes of antibiotics were recycled. All of 32 boxes of medicine could be classified into 19 specific types, of which there were 8 (42.1%) types of antibiotics, belonging to four broad categories: Cephalosporins, Penicillins, Macrolides, and Nitroimidazoles. In addition, there were also antifungal drug, antiviral agent, anti-inflammatory drug, and paracetamol tablets handed over by the villagers as antibiotics. CONCLUSION: Using leaflets and social media to promote health education can reduce the risk of keeping antibiotics at home. Rural residents could not identify commonly used antibiotics even after health education. To conduct a broader intervention to recycle antibiotics, further study needs to focus on improving the antibiotic identification among the rural residents. DISCLOSURES: All authors: No reported disclosures.