Knowledge, Attitude, and Practice Regarding Antibiotic use, Multidrug Resistance, and Herbal Drugs in Chronic Suppurative Otitis Media in Eastern India: A Cross-Sectional Study

The emergence of multidrug-resistant bacteria (MDR) in Chronic suppurative otitis media led to the search for alternative treatment strategies, particularly herbal formulations. However, there is a lack of patient and healthcare professional (HCP) perspectives, which are essential for guiding the adoption of such therapies. Therefore, this study evaluates the knowledge, attitudes, and practices (KAP) regarding antibiotic use, MDR bacteria, and herbal remedies in CSOM among patients and HCPs.

This cross-sectional study was conducted at a tertiary-care hospital in Eastern India. A total of 240 participants were included: 180 were adult CSOM-infected patients, and the remaining 60 were HCPs. A pre-validated self-structured questionnaire was used to collect data from the participants. Appropriate statistical tests were employed to summarize the responses. Chi-square and ANOVA tests were used to assess the association between KAP levels and demographic data, with p < 0.05 considered statistically significant.

Among CSOM-infected patients, 66.7% identified the causative bacterial organisms; 76.7% were aware of antibiotic resistance, whereas only 34.4% had heard of MDR bacteria. However, 90% of HCPs understood MDR bacteria, although 56.7% were still practising empirical antibiotic therapy. Both patients and HCPs had a positive attitude toward the use of standardised, safe herbal medicines for the treatment of CSOM infections. Education significantly influenced patient knowledge (p < 0.001), while years of practice influenced provider knowledge (p = 0.045).

The outcomes of the present study highlighted a knowledge gap and inconsistencies in treatment practices used for MDR-CSOM cases among both patients and HCPs. Nevertheless, both groups supported the use of herbal remedies to treat MDR CSOM cases.

The present study highlighted the significance of patient education, rational antibiotic use, and the scientific validation of herbal drugs as a complementary drug in the treatment of MDR-CSOM patients.