Knowledge and Attitude of Antibiotic Use among Public in Rural Area of Cempaka, Banjarbaru, South Kalimantan

The high intensity of antibiotics relatively uses causes various problems for health, especially bacterial resistance to antibiotics. Lack of public knowledge about the rationale of antibiotics is a factor that can trigger bacterial resistance to antibiotics. This study aims to assess the public's knowledge and attitudes towards antibiotic use in rural areas Cempaka, Banjarbaru, South Kalimantan. This was a descriptive cross-sectional survey method in which closed-ended questionnaires were distributed to 380 rural residents in the village of Cempaka proportional stratified random sampling technique. Data analysis used univariate and bivariate with the Chi-Square statistical test method. In conclusion, the rural residents demonstrated moderate knowledge (83.2%) and a positive attitude towards antibiotic use (97.4%). There is no significant association between both knowledge level and of antibiotics on the attitude towards antibiotic use.


INTRODUCTION
Antibiotics are the most frequently prescribed, sold, and used drugs around the world 1 . In developing countries, many antibiotics are available without a prescription and cause someone to use antibiotics wisely 2, 3 . Careless use of antibiotics causes the organism to adapt to antibiotics.
Furthermore, it causes a decrease in the effectiveness of the antibiotics and resistance, which initially only occurs in hospitals but gradually also in the community 4,5 .
The latest report from the World Health Organization (WHO) in Antimicrobial Resistance: Global Report on Surveillance also shows that Southeast Asia has 64% of antibiotic use without a prescription and the highest in cases of antibiotic resistance. WHO released data that at least 2,049,442 cases were due to antibiotic resistance, and 23,000 of them died 6 . According to Riset Kesehatan Dasar to health services and medicines 11 . Limited access to health services and medicines, which is generally due to low-income levels, is one of the problems in rural areas. This is further exacerbated by the lack of availability of health personnel and drug information services in primary health facilities so that it has the potential to encourage the practice of antibiotic self-medication 12 .
The limited health facilities available in Cempaka District could be one of the causes of the lack of information about drugs, and this is thought to affect the use of appropriate antibiotics. Pratiwi et al. 13 reports that knowledge and attitudes influence the rationality of antibiotic use behavior. Therefore, the study aimed to investigate knowledge and the attitude toward using antibiotic use among the public in the Village of Cempaka, Banjarbaru.

Materials
Data collection was carried out using a questionnaire, which was adopted and modified according to the circumstances of the local population from several reports

Definition of antibiotics
Antibiotics fight bacterial infections with a correct answer of 97.1% (369); this was in line with research conducted by Oh et al. 15 , which reported that respondents understood that antibiotics were used for bacterial infections by 76.7%. It can be concluded that most of the Village of Cempaka residents understand that antibiotics were intended at fighting infections caused by bacteria.
However, on the other hand, as many as 80.3% (350) of the public believe that antibiotics could cure viral infections. This was different from Oh et al. 15 , which reported that respondents were unsure that antibiotics could cure viral infections. These findings might be due to people's ignorance of the difference between bacteria and viruses.

Example of antibiotics
The sub-dimension of antibiotic drug samples obtained results as much as 95.8% (364) answered correctly that amoxicillin was an antibiotic drug, so it was concluded that the majority of people know examples of antibiotics.
This was following previous research conducted by Fernandez 24 , who reported that most respondents knew that amoxicillin was an example of an antibiotic drug as much as 80.56%. Furthermore, 53.3% (202) of the public answered correctly that paracetamol was not an example of an antibiotic drug. This was the same as research conducted by Oh et al. 15 , which reported that 66.6% of respondents thought paracetamol was an antibiotic. This was possible. Because people were free to find antibiotics at the nearest food stall, the same thing as paracetamol which could be purchased at the nearest shop, and the use of antibiotics and paracetamol together when they were not feeling well. As many as 53.9% (209) of the public answered that the CTM/chlorpheniramine was not an example of an antibiotic. This follows the research by Oh et al. 15 , which reported that respondents disagreed that this allergy drug was included as an antibiotic. It can be concluded that the majority of the knowledge in the

Role of antibiotics
The results in the sub-dimension of the role of antibiotics show that as many as 77.4% (294) of the public understand that antibiotics were not used to treat pain and inflammation. This was different from research conducted by Oh et al. 15 , which reported that respondents answered incorrectly that antibiotics were used to treat pain and inflammation. The community misinterprets the role of antibiotics to treat fever as much as 63.4% (241).
This was in line with the research of Al Rasheed et al. 22 , which reported that people use antibiotics when they have a fever, and the public knows that digestive tract infections use antibiotics as much as 75.8% (288). This was in line with research by Mouhieddine et al. 16 , which reported that antibiotics (penicillin) were used for digestive infections (53.1%). It can be concluded that the majority of people are well-informed and understand the role of antibiotics.

Administration of antibiotics
The sub-dimension of antibiotic administration was 56.1% (213), in which the majority of people did not know that antibiotics should not be taken two tablets at the same time. This was in line with Kim et al. 14 , which reported that respondents believed that the dosage two times the effect was faster. It can be concluded that the irrational use of antibiotics, especially because of inappropriate doses, can lead to resistance to antibiotics in the future. Most people also did not know that antibiotics must be spent even though the condition has recovered from an illness by 61.1% (232). This is reinforced by WHO 6 , which reported that from 12 countries, including Indonesia, as many as 53-62% people stopped taking antibiotics when they felt they were better. This is due to laziness, which the community acknowledges retaking medicine when they feel cured even though the medicine is still left. The majority of people understand that the efficacy of antibiotics would decrease if the antibiotics were not consumed by 62.6% (234). This was in line with a study conducted by Mouhieddine et al. 16 , with 59% of people knowing that the efficacy of antibiotics would decrease if not spent.

Antibiotics resistance
The results in the sub-dimensions of knowledge about antibiotic resistance were 62.6% (238). Most people know that if antibiotics were not used up, the bacteria would be resistant to antibiotics. This was different from research conducted by Kim et al. 14 , which reported that only 42.5% of respondents know that bacteria would be resistant if the antibiotic were less than the prescribed dose. Most people did not know that if antibiotics were used less than the specified dose, it would cause bacteria resistance to antibiotics by 37.4% (144). This was in line with Kim et al. 14 , which reported that respondents knew as much as 42.5% the use of antibiotics less than the prescribed dose would cause the bacteria to become resistant to antibiotics. The majority of people know that excessive use of antibiotics would cause bacteria to be resistant to this antibiotic 58.4% (222). This is confirmed by Mouhieddine et al. 16 , which reported that people know that excessive use of antibiotics could cause bacteria to be resistant to antibiotics.

Adverse effects of antibiotics
The results in the sub-dimensions of knowledge about the side effects of antibiotics, 62.6% (238) of the public know that a person could experience allergies to antibiotics. This is in line with Mouhieddine et al. 16 , which reported that 66.7% of respondents know that a person can experience an antibiotic allergy. Most people did not know that antibiotics have side effects of 52. 1% (198). This is in contrast to research conducted by Kim et al. 14 , which reported that respondents know that 70.5% of antibiotics have side effects, with the results of interviews conducted reporting that they did not feel any side effects from the antibiotics they were taking. The community knew that nausea and vomiting were among the adverse effects of the antibiotics by 55.8% (212). It can be concluded that the sub-dimension of knowledge on the side effects of antibiotics in the Village of Cempaka community is quite good.

Place of antibiotics purchase
The results in the sub-dimensions of knowledge about the place of antibiotics purchase, the majority of people know that antibiotics could only be purchased at pharmacies by 53.4% (203). In comparison, only 15% (57) of the public knew that antibiotics could not be purchased at drugstores. Lastly, 23.9% (91) of the public knew that antibiotics could not be purchased at the shop.
The complete results of this section were presented in Table IV.

Attitude towards antibiotics use
The data shows that 35.8% of respondents (136) did not agree that they expect the physician to prescribe antibiotics if they had a headache. This proves that the public understands that there was no need for antibiotics for headaches, and as much as 51.8% (162) disagreed with taking antibiotics if you felt unwell. This is in line with Oh et al. 15 , who reported that 53.3% of respondents did not agree to take antibiotics when they felt unwell; this shows that people have understood that there is no need to take antibiotics when they are not feeling well.
The majority of the community, 59.7% (227), agree that they would see the expiration date before taking antibiotics. This is the same as research by Oh et al. 15 , which reported that 92.2% of respondents agreed to see an expired label on the package before taking antibiotics.
This confirms that the community is careful before taking antibiotics.The majority of people did not agree that if they catch the flu, they take antibiotics to get better quickly, as much as 26.1% (99). This is in line with research from Kim et al. 14 , which reported that respondents disagreed with the use of antibiotics when exposed to flu so that they quickly get well. People already understand that antibiotics cannot speed up the recovery of a person with flu.
Most people did not agree to keep antibiotic stocks at home for emergencies by 57.1% (217

Source of antibiotics
The data shows that respondents agreed to choose antibiotics prescribed by physicians rather than nurses, with 69.5% (264). Antibiotics must be obtained using a doctor's prescription because inappropriate use of antibiotics can cause resistance. His research also states that only 32% use prescriptions to get antibiotics. This suggests that most of the Village of Cempaka community understands that antibiotics could only be prescribed by physicians rather than nurses. As much as 40.8% (155) of respondents disagree with media statements that the internet helps determine the right antibiotic. This shows that respondents understand that the internet should not be used to determine the right antibiotic.

Antibiotics recommendations for colleagues and family
As many as 66.6% (253) of respondents disagree with giving antibiotics to sick families. This illustrates that respondents understood that there was no need to give antibiotics to families who were sick. As many as 58.4% (222) of respondents answered that they agree not to give antibiotics to sick friends. This illustrates that respondents understand that antibiotics did not need to be recommended to friends who were sick. As much as 57.6% (219) of respondents answered that they did not agree to give antibiotics to sick neighbors. This illustrates that respondents understand that antibiotics did not need to be handed over to sick neighbors. This is in line with a study conducted by Oh et al. 15 , which reported that as many as 88.2% did not agree to give antibiotics when their family was sick. This is appropriate because antibiotics can only be purchased at pharmacies with a doctor's prescription. The complete results of this section were presented in Table V.   collected data, contributed data or analysis tools.
Muhammad Zaini: collected data, contributed data or analysis tools.

DATA AVAILABILITY
None.