Antimicrobial self medication for reproductive tract infections in two provinces in Lao People's Democratic Republic

Abstract

Objectives: To describe antimicrobial self medication for reproductive tract infections (RTI) including sexually transmitted infections (STI), and to explore the understanding and use of health information among the adult population self medicating with antimicrobials for RTI/STI in two provinces of Laos. This could contribute to quality improvement of RTI/STI management. Methods: Cross sectional community based study. Structured interviews (household survey) were conducted among 500 subjects aged 18 or more, who had used antimicrobials as self medication for RTI/ STI during the past year. They were recruited among 3056 family members in Vientiane capital and Champasak province, divided equally between the two study sites, and between urban and rural areas. Results: Among the 500 respondents reporting self medication for RTI/STI, 91% had bought the antimicrobials from local private pharmacies without a physician's prescription. 58% of those were advised to buy the drugs from drug sellers. Ampicillin (not recommended as syndromic treatment for RTI/ STI) was used in 83% of all cases, in 28% combined with tetracycline. 79% of respondents used antimicrobials for a non-recommended duration of time. Most respondents had access to health messages for RTI/STI, largely from radio/television and drug sellers. However, only 17% of all respondents reported that they had ever used a condom. Conclusions: More than three quarters of respondents, self medicating for RTI/STI with antimicrobials, used inappropriate drugs bought from private pharmacies. There is a need to improve RTI/STI management, including health promotion, through interventions at community level, and to health providers, including private drug sellers.

Over-the-counter sales of antibiotics from community pharmacies in Abu Dhabi

“…Our results indicate that for this particular issue, the regulatory framework of the UAE is not effectively enforced. Antibiotic availability over-the-counter has been reported in many countries in Asia [9,[11][12][13][14][15], Africa [24,25], the Middle East [16,17,26,27], Latin America [18,28,29], Southern and Eastern Europe [19,[30][31][32][33], and America [20,21,34]. The high level of over-the-counter antibiotic sales is certainly not unique to the UAE.…”

“…Of these, only 35.8% were prescribed by doctors, 13.8% were recommended by pharmacists and about half (50.4%) were sold on customers' request without prescription or advice from the pharmacist [16]. In two provinces of Lao People's Democratic Republic, 91% of respondents purchased non-prescription antibiotics from private pharmacies to treat reproductive tract infections and sexually transmitted diseases [15]. Some of the established reasons for the sale and use of antibiotics without prescription include privacy and a preference for remaining anonymous [37], high patient demand [38], and lack of public awareness and misconceptions about the efficacy of antibiotics [39].…”

“…Clients' nationalities were identified from both their spoken dialects and attire, and then grouped into larger ethnicity groups: UAE nationals, Arab, Asian and other. Clients' age was obtained from prescriptions where presented otherwise estimated, then grouped into infants (0-2), toddlers (3)(4)(5), children (6)(7)(8)(9)(10)(11)(12), teenagers (13)(14)(15)(16)(17)(18)(19), adults ([20) and elders ([65).…”

“…Antibiotics, typically prescription only medicines, can be purchased over-the-counter from various drug outlets and private pharmacies in a range of countries around the world [8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Antibiotics are classified as prescription medicines in the UAE and legally according to the UAE Medicine Regulations require a prescription to be dispensed.…”

Antibiotic Abuse in Developing Countries

“…The conditions are worsened with inappropriate self medication of antibiotics. It has been reported that with lack of supervision from healthcare professionals, people in Jordan [6] and Laos [7] consumed non -prescribed antibiotics for treating common cold. This will lead to the increase of microbial resistance, an undesirable effect that causes antibiotic ineffectiveness and not only harmful to the patient but also to the society.…”