Factors affecting antibiotics consumption among the elderly population in Thailand

Background: The consumption of antibiotic among the elderly population has raised concerns in Thailand due to its correlation with antimicrobial resistance (AMR) infections. Moreover, it is also related to adverse drug reactions resulting from impaired drug excretion and elimination. Contributing factors to antibiotic consumption in the elderly population are insufficiently understood in Thailand. Objectives: The purposes of this study were to determine the prevalence of antibiotic consumption behaviour among the elderly population and to identify associated factors. Methods: A cross-sectional study was conducted using survey data from the National Statistic Office, which included only elderly individuals. Bivariate analysis with a generalized linear mixed model (GLMM) was performed to screen for significant independent variables with a significance level below 0.05. All significant variables were included in the multivariable analysis, which revealed adjusted odds ratios (AOR) and 95% confidence intervals (CI). Results: Of 9,104 elderly people, the prevalence of antibiotic consumption was found to be 7.77% (95% CI: 7.21% - 8.31%). The multivariable GLMM analysis demonstrated that being free from underlying diseases (AOR= 2.16, 95% CI: 1.63-2.88, p-value < 0.001), having transportation expenses (AOR = 2.11, 95% CI:1.49-2.99, p-value < 0.001), experiencing pain and discomfort symptoms (AOR =1.66, 95%CI: 1.27-2.16, p-value < 0.001), having anxiety and depression (AOR = 1.66, 95%CI: 1.27-2.16, p-value = 0.012), having moderate to poor level of knowledge (AOR = 2.42 95% CI: 1.55-3.78 and (AOR=2.71, 95% CI:1.75-4.21), and not receiving information regarding antibiotic use and its resistance (AOR = 5.12, 95%CI: 4.12-6.36, p-value < 0.001) were the major contributing factors to antibiotic consumption behaviours in the elderly population. Conclusion: The prevalence of antibiotic consumption in the elderly population may contribute to emergence of AMR infections and increased mortality rates. Implementing clinical practice guidelines and health education programs is essential to control antibiotic prescriptions and discourage self-medication in Thailand.