ArticleFrontiers in pharmacology2026
Factors associated with inappropriate antibiotic use in South African communities: findings from the CAMUS survey.
Article in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Inappropriate antibiotic use in the community is a primary driver of antimicrobial resistance (AMR), particularly in low- and middle-income countries (LMICs) where ambulatory care, including primary healthcare (PHC) facilities, is the main point of contact. While stewardship efforts in South Africa have focused largely on prescribers and hospitals, the behavioral drivers of community antimicrobial use, specifically the Methods: A cross-sectional survey was conducted among 1,283 adult patients attending 25 ambulatory care public-sector facilities in two provinces. Data was collected using the Community Antimicrobial Use Scale (CAMUS) and the Health Literacy Test for Limited Literacy Populations (HELT-LL). We quantified patterns of knowledge, social norms, expectations, and non-prescribed use. Multivariable logistic regression models examined determinants of misuse and antibiotic demand. Results: General awareness of antibiotics existed, but major misconceptions persisted regarding their role in viral infections. Notably, 76.5% of participants attending public-sector facilities believed antibiotics can treat colds and influenza. Non-prescribed use was reported by nearly a quarter of participants, with community pharmacies identified as the primary source (81.7%). While factual knowledge gaps were present, multivariable models revealed that social norms favoring non-prescribed use and inadequate health literacy were the strongest predictors of misuse. Patients with inadequate health literacy were significantly more likely to try and obtain antibiotics without a prescription compared to those with adequate literacy (aOR=13.86; 95% CI: 2.60-73.93). Conclusion: In this large sample of ambulatory care public-sector patients, inappropriate antibiotic use appeared to be linked with permissive social norms and health literacy gaps rather than knowledge deficits alone. Interventions that focus solely on correcting factual misconceptions may be insufficient to address inappropriate antibiotic use. Future stewardship strategies must explicitly target social norms, family influences, and pharmacy behavior, alongside strengthening patient-prescriber-pharmacy communication.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.