PS-004 The prevalence, possible causes and outcomes of self-medication with antibiotics in middle eastern countries

Abstract

BackgroundAntibiotic resistance is a growing problem worldwide. It has considerable implications on societies’ health and resources. However, there has been no systematic review on non-prescription antibiotics in Middle Eastern (ME) countries.PurposeTo review relevant studies published in ME countries to establish the prevalence, possible causes and clinical outcomes of self-medication with antibiotics (SMA) and identify recommendations to reduce irrational use of antibiotics.Material and methodsDatabases (PubMed, Scopus, ProQuest, Web of Science) were searched for peer reviewed research published between January 2000 and June 2016 on SMA among adults aged ≥18 years living in the ME. A hand search for relevant citations and key journals was also performed. Articles were scrutinised for country of origin, sample size, recall period, prevalence rate, determinants and possible causes of SMA, type of antibiotic, source of supply, indication for SMA, inappropriate use, source of drug information, clinical outcomes and recommendations to address the problem where possible.Results22 studies were found. The prevalence of SMA ranged from 19% to 82%. Age, gender, educational and income levels were the main determinants of SMA. The reasons for SMA varied across studies. Sociocultural, economic and regulatory factors were the most commonly cited reasons for SMA. Penicillins were the antibiotics most commonly used; the antibiotics were obtained mainly via stored leftover drugs at home, pharmacies/drug stores without prescriptions and friends/relatives. SMA was mainly for sore throat, fever and respiratory problems, such as cold/flu and cough. The primary sources of drug information and recommendations included relatives/friends and previous successful experience with the same antibiotic. Inappropriate drug use such as incorrect indication, short and long duration of treatment, exchange/sharing of antibiotics, and storing antibiotics at home for use at a later time were reported. Negative and positive outcomes of SMA were identified. Some recommendations were made based on the problems that were found, but these were not evaluated.ConclusionThe prevalence of SMA is high in ME countries. Thus we have to understand the links between different factors promoting SMA and assess the changing trend in order to help us derive strategies aimed at reducing drug related health risks among the ME population.No conflict of interest

COVID -19 Pandemic Diseases Effect on Self-Medication Practices Among Community of Bedelle City and Its Surrounding, Buno Bedelle Zone, South West of Oromia, Ethiopia

“…The most common class of pharmaceuticals used in our study was analgesics and respondents older than 18 years, those who had already contracted COVID-19, and those who reported symptoms of headache, fever, and cold significantly employed self-medication practices as the finding indicating. Results from Saudi Arabian nursing undergraduate students are consistent with the high use of analgesic medicines like paracetamol (17) and from the Peru adult population (16) where it was also the most consumed drug for treatment of Covid-19 pandemic diseases. From pharmacology concept, Paracetamol is known analgesic medication with a very weak anti-inflammatory effect (28) and it can be used to treat minor COVID-19 symptoms when treating patients at home, according to guidelines given during the early months of the pandemic (29) or to treat oneself, particularly for fever or headache (30).…”

“…The most frequently self-prescribed medications for Covid-19 pandemic diseases are analgesics, antipyretics, antitussives, antidiarrheal, calcium and vitamin supplements, anabolic steroids, sedatives, certain antibiotics, and many herbal and homeopathic remedies and a portion of global health practices lack control over self-treatment with prescription medicines [15]. Antibiotic resistance is the most major problem of self-medication with antibiotics (SMA), which has also been linked to negative side effects, unsuccessful treatment, and other issues [16][17][18]. Factors like age, sex, economic level, and educational attainment are only a few of the characteristics linked to SMA in the community as most scholars stated in the previous literature and additionally, people's irrational usage of antibiotics was caused by a lack of accurate knowledge regarding their function in treatment [16].…”

“…Antibiotic resistance is the most major problem of self-medication with antibiotics (SMA), which has also been linked to negative side effects, unsuccessful treatment, and other issues [16][17][18]. Factors like age, sex, economic level, and educational attainment are only a few of the characteristics linked to SMA in the community as most scholars stated in the previous literature and additionally, people's irrational usage of antibiotics was caused by a lack of accurate knowledge regarding their function in treatment [16]. This resulted in ineffective practices such as shorter treatment durations, incorrect dosages, and drug consumption for the wrong indication, such as the use of antibiotics to treat viral illnesses [19].…”

Dispensing Antibiotics Without Prescription in the Arab World: A Narrative Review of the Prevalence, Appropriateness, Facilitators and Preventive Interventions

“…The contribution of such practices to AMR is well documented 7 , and higher AMR rates (>50%) against antibiotics commonly used in community as compared to those used only in hospitals (resistance rates < 25%), were reported 8 . The prevalence of self-medication with antibiotics in the middle east ranges from 19 to 82% as reported in a systematic review of 22 studies 9 . The antibiotics were most commonly obtained from community pharmacies without prescription, though other sources were reported including stored leftover antibiotics and family members/friends [10][11][12] .…”

Chitosan with pendant (E)-5-((4-acetylphenyl)diazenyl)-6-aminouracil groups as synergetic antimicrobial agents

“…1 This resistance is brought on in part by indiscriminate/inappropriate use of broad-spectrum antibiotics and self-medication; a crime carried out by a significant portion of the world's population, more so in developing countries. [2][3][4][5] The discovery of antibiotics like penicillin found short-lived efficacy, with organisms such as Staphylococcus aureus and Escherichia coli becoming resistant within 12 years of antibiotic discovery. 6 Sulfonamides, on introduction, enjoyed less than 5 years before organisms became drug-resistant.…”