Prevalence and factors associated with the irrational use of antibiotics by pregnant women in the city of Marrakech, Morocco: a cross-sectional study.

backgroundAntibiotics are essential drugs for preventing maternal and neonatal morbidity and mortality. However, their excessive and inappropriate use is leading to the emergence of antibiotic resistance, a major public health problem worldwide. Pregnant women's attitudes and knowledge about the use of antibiotics have a significant impact on their practice and, consequently, on maternal and infantile child health. This study therefore aims to assess the knowledge, attitudes and self-reported practices of pregnant women regarding the appropriate use of antibiotics. It also seeks to identify the factors associated with the irrational use of antibiotics by pregnant women in the city of Marrakech.

methodsThis was a cross-sectional study conducted between January and April 2022. The study population included all women receiving postnatal care in birthing centers or during vaccination sessions in health centers in the city of Marrakech. Using a self-administered questionnaire, we collected data on women's knowledge of antibiotic use, attitudes and self-reported practices during pregnancy. Regression analysis was performed to identify the factors associated with the irrational use of antibiotics by pregnant women in the city of Marrakech.

resultsOut of 292 women, 58.2% (n = 170) of pregnant women used antibiotics during their pregnancy. The use of prescription antibiotics represents 76.1% (n = 137) and 23.9% (n = 43) self-medicated. The most commonly used antibiotics were amoxicillin (n = 91, 53.5%) and amoxicillin clavulanic acid (n = 79, 46.5%). The symptoms most frequently reported by pregnant women were respiratory (n = 97, 53.9%), urinary (n = 38, 21.1%) and otorhinolaryngological (n = 24, 13.3%). The multiple logistic regression model showed that women's family structure and level of education were significantly associated with knowledge. The number of consultations was significantly associated with attitudes. Family structure, level of education, number of children, number of consultations and place of birth were significantly associated with practice.

conclusionThis study highlighted knowledge gaps and misconceptions about antibiotics among pregnant women, as well as inappropriate attitudes and practices that encourage suboptimal use of these drugs. These results indicate the need to develop targeted educational programs to improve understanding and appropriate practice of the use of antibiotics during pregnancy. At the same time, they reinforce the imperative need for more rigorous regulations on the distribution of antibiotics, to ensure their responsible use and preserve their long-term efficacy.