Knowledge, practices and attitudes on antibiotics use in Cameroon: Self-medication and prescription survey among children, adolescents and adults in private pharmacies

Abstract

Benefits of antibiotics are threatened by the self-medication, people’s lack of knowledge and inappropriate use of antibiotics, especially in developing countries. This study was designed to determine knowledge; attitudes and practices toward antibiotics use in an urban community, and evaluate the factors that are associated with antibiotic use. Between January and March 2015, a cross sectional and prospective study was conducted in all pharmacies within the Douala IV health district, Cameroon. Anonymous interviews including both open and closed ended questions were conducted in participants selected by convenience sampling Descriptive and logistic regression analysis were performed using StataSE11 software (version 11 SE) and R software (version 3.1.1) in data analysis. Overall 402 (33.7%) of 1,192 customers purchased antibiotics and of these, 47% bought antibiotics without a prescription. 60.7% of purchased antibiotics was for adult ‘patients and around 60% of parents carried out self-medication on their children. The vast majority reported that all microbes can be treated with antibiotics (88.3%). The belief that antibiotics are appropriate for bacterial infections was more common among those with a higher level education (OR = 4.03, 95%CI:1.89–8.57, p<0.0001) and among public/private servants (OR = 2.47, 95%CI:1.21–5.08, p = 0.013). Physicians provide less explanations about antibiotics are and their potential side effects than the pharmacy auxiliaries (OR = 0.205, 95%CI = 0.09–0.46, p<0.0001), but more than pharmacists (OR = 3.692, 95%CI:1.44–9.25, p = 0.005). Indications on antibiotics use were 7 times more given to customers with a prescription compared to those without a prescription (OR = 7.37, 95% CI = 2.13–25.43, p = 0.002). Adult male (OR = 2.32, 95%CI:1.24–4.34, p = 0.009) and higher education (OR = 2.05, 95%CI:1.08–3.89, p = 0.027) were significantly associated with self-medication. Misuse, little "practical knowledge" and high self-medication confirm the unsatisfactory prescription and dispensing practices of the antibiotics in our country. These results highlight the important of the development and implementation appropriate guidelines for the responsible use of antibiotics for health care providers and health education targeting community members themselves.

Knowledge, Attitude, and Practices of Antibiotics and Antibiotic Resistance Among Chinese Pharmacy Customers: A Multicenter Survey Study

“…The present study illustrated that the habits of antibiotics usage were not good enough as 85.0% of respondents keep leftover antibiotics at home in case of future need, which could trigger the self-medication of antibiotics, thereby impacting the AMR burden [47]. The rate of antibiotic self-medication was 20.8%, which is in line with a study conducted in Cameroon [48]. However, the rate of self-medication in our study was lower than the previous Chinese study, which reported self-medication among 29.4% enrolled participants [49].…”

Use of antibacterials in the management of symptoms of acute respiratory tract infections among children under five years in Gulu, northern Uganda: Prevalence and determinants

“…The high antibacterial resistance selection pressure created by high antibacterial use is a potential driver of resistance emergence and spread (20), further diminishing the already limited choices of antibacterial therapy for infectious diseases especially in LMICs (10). The high prevalence of antibacterial use reported in this study is similar to reports of previous studies done in LMICs [3,[7][8][9][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. A household survey in Kampala, Uganda, reported lower prevalence (43%) of antibacterial use in treating children under five years compared to the current study [7].…”

Sale of WHO AWaRe groups antibiotics without a prescription in Pakistan: a simulated client study

“…Firstly, there is a need to educate patients that most infections seen in ambulatory care such as upper respiratory tract infections are viral in origin and will typically resolve without an antibiotic [ 76 – 80 ]. This can be via general awareness and other campaigns [ 54 , 81 – 83 ]. Secondly, there is a need to educate pharmacists and their assistants about the appropriate management of infections typically seen in ambulatory care given concerns with their knowledge in a number of countries including Pakistan [ 32 , 50 , 53 , 55 , 84 , 85 ].…”

“…In addition, assess the quality of pharmacy services provided to patients in both small- and large-scale pharmacies and medical stores to provide future guidance to the authorities in Pakistan as they develop additional programs to combat AMR as part of the recently developed National Action Plan in Pakistan [ 17 ]. Community pharmacists are a key stakeholder with reducing inappropriate dispensing of antibiotics without prescriptions as they are often the first healthcare professionals that patients consult with especially in LMICs where affordability is a key issue with often insufficient financial means to see both a physician and purchase medicines [ 50 , 54 – 56 ].…”