ANTIBIOTIC USE AMONG FOREIGN TRAVELERS IN THAILAND

Sarocha Nganwiwattavorn, Borimas Hanboonkunupakarn, Watcharapong Piyaphanee, Kesinee Chotivanich, Thundon Ngamprasertchai, and Chayasin Mansanguan

Abstract

Inappropriate antibiotic use can result in drug resistance. In this study, we aimed to determine the incidence of self-treatment with antibiotics among international travelers to Thailand in order to understand how common this practice is in this population. Study subjects were international travelers aged ?18 years who were fluent in English. The study instrument was an online questionnaire developed and pilot tested asking about demographics and antibiotic use during travel in Thailand. Subjects were recruited at popular tourist destinations and asked to complete the study instrument. The study was conducted during March - September 2019. A total of 503 subjects participated in the study, 57.8% male and the mean (± standard deviation) age of study subjects was 33.5 (± 12.2) years. Nationalities of study subjects included Asian (26.0%), European (42.1%), North American (23.5%), Oceania (3.4%), African (2.8%), and South American (2.2%). Of these 503 study subjects, 79 (15.7%) had standby antibiotics. During their trip in Thailand, 57 subjects (11.3% of the study subjects) used antibiotics; 15 subjects were those who had standby antibiotics while 42 did not. Of the 42 subjects who did not have standby antibiotics, 24 (57.1%) got antibiotics from doctor’s prescription, 12 (28.6%) sought their self-treatment without seeing a healthcare professional and 6 (14.3%) got antibiotics from unknown source (14.3%). Among those who took antibiotics during the trip, 39 (68.4%) finished the antibiotic course while 18 (31.6%) did not. Length of stay (p <0.01) and access to standby antibiotics (p=0.020) were significantly associated with antibiotic use among travelers. In our study, the incidence of antibiotic use among travelers was high and the proportion of those who did take antibiotics but did not finish the course of treatment was high. Those who brought standby antibiotics with them were more likely to take them. These activities increase the risk of developing antibiotic resistance. Pre-travel health consultations should include educating the travelers about this subject in order to reduce the risk of antibiotic resistance in this group of population.