Knowledge, attitude and practice towards rational use of antibiotics among Bangladeshi medical tourist in Bangkok, Thailand. 

Antibiotics are special drugs used for the prevention and treatment of bacterial infections. Antibiotic resistance tends to increase medical expenses, prolonged hospital stays, and increased death rate. Nowadays, antibiotic resistance is one of the most challenges to global public health. Excessive and inappropriate use of antibiotics plays an important role in increasing antibiotic resistance. Antibiotic resistance is becoming a global health problem, because the ease of international travel may increase the rapid spread of resistant microorganisms around the world. The aim of this study to strengthen the research gap and to describe the socio-demographic factor and to assess the level of knowledge, attitude, and practices of antibiotic use of Bangladeshi medical tourist in Bangkok, Thailand. A Cross-sectional study was conducted by a structured self -administered questionnaire which consist of 4 parts. Participants were selected according to convenience sampling method, the age limit was 18 to 75 years and able to response questionnaire. A total number of participants were 362. SPSS version 22 software was used for data analysis. Descriptive statistics, Chi-square and Spearman rank correlation test were used to analyze data. Most of the study participants were male 56.4 %, rest others are female 43.6%, majority 45.6% are age group 33-47 years old. Most of the participants 81.2% are believers in Islam, 70.4% are married,48.1%completed their master's degree or higher education, 39.2% mentioned business as a profession, majority 87.8% replied no family member related with health profession.58% used antibiotics within the last 1year, 55.2% used any other medication, majority 71.3% had the co-morbid disease. Majority 46.4% had a moderate level of knowledge followed by 44.2% of participants had a good level of knowledge. Mean knowledge score was 15.7±2.81, maximum knowledge score was 21 and minimum knowledge score was 8. Majority 67.7% of the study participants had a moderate level of attitude followed by 17.1 % had a good level of attitude. Mean attitude score was 83±7, maximum attitude score was 102 and the minimum score was 59. Majority 72.4% of the study participants had a moderate level of practice followed by 15.2% had good practice towards the rational use of antibiotics. Mean practice score was 71±6, Maximum practice score was 85 and the minimum score was 51. People who received antibiotics within the last 1year  had a significant association with knowledge (P = 0.002). People who were more educated (P = 0.004) , family member related with health profession(P = 0.001) and received antibiotic within last 1year (P = 0.008) had significant association with attitude. People who had family member related to the health profession(P=0.002) had a significant association with practices of antibiotics use. There was moderately strong positive correlation between knowledge and attitude which is statistically significant (r=0.473, P- <0.001), there was a moderately strong positive correlation between attitude and practice which is statistically significant (r=0.436, P- <0.001), study subjects who had good attitude more likely to have good practices towards antibiotic use. The issue of rational use of antibiotics have been seriously considered worldwide and the appropriate solution should be developed. It is very important to know the level of knowledge, attitude, and practices in people who use antibiotics and need awareness program to educate people more about antibiotic resistance.