Restriction on antimicrobial dispensing without prescription on a national level: Impact on the overall antimicrobial utilization in the community pharmacies in Saudi Arabia

Al‐Jedai, Ahmed; Almogbel, Yasser; Eljaaly, Khalid; Alqahtani, Nasser M.; Almudaiheem, Hajer; Awad, Nancy; Alissa, Dema A.; Assiri, Abdullah; Alaama, Tareef

doi:10.1371/journal.pone.0271188

Cited by 8 publications

(7 citation statements)

References 28 publications

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“…A recent study in Saudi Arabia evaluated the antibiotic consumption after the adoption of a new prescription-only antimicrobial dispensing policy in community pharmacies. Generally, non-prescription antimicrobial use has dropped slightly ( 5 ). Although effective prescription limitations must be implemented, community-based activities are deemed essential.…”

Section: Discussionmentioning

confidence: 99%

“…Because of the country’s high rates of antimicrobial administration without a prescription, antimicrobial abuse and misuse have reached pandemic proportions in Saudi Arabia. Implementation of the regulation in Saudi Arabia’s public pharmacies led to a slight decrease in the use of antimicrobials without prescriptions ( 5 ). Most antibiotics are misused or overused in Saudi Arabia for the treatment of upper respiratory tract infections (URTIs), which are predominantly viral infections ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of antibiotic misuse in cases of pneumonia and diarrhea in Saudi Arabia

ALmughais,

Alreshidi,

Ahmed

2023

dti

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Background: Antibiotic misuse is a major public health issue with long-term repercussions. Objective: The purpose of this investigation was to evaluate the effects of pneumonia and diarrhea, with an emphasis on antibiotic misuse. Methodology: This study included 410 participants (217 fathers and 193 mothers), of whom 239 purchased antibiotics for their children without a prescription, whereas 171 had a prescription or were unsure if one was required. Results: Antibiotics were used incorrectly by 58.1% of respondents. About 51.2% of participants said they were taking two antibiotics at the same time. Around 30% of people admitted to using antibiotics inefficiently. The most prevalent reason for use was “viral and bacterial,” followed by “viral,” and then “bacterial,” with 35%, 21%, and 20%, respectively. In addition, 22.4% of patients have used antibiotics for an unknown reason. Conclusion: Saudi parents of children with pneumonia and diarrhea abuse antibiotics. Saudi legislation banning medications without a prescription has helped reduce antibiotic abuse, but more community-based education and awareness are needed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of antibiotic misuse in cases of pneumonia and diarrhea in Saudi Arabia

ALmughais,

Alreshidi,

Ahmed

2023

dti

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“…Unfortunately, the effectiveness of governmental interventions to enhance antibiotic use in Saudi Arabia has not been thoroughly investigated in Saudi Arabia. One recent study conducted by Al-Jedai et al (2022) , conducted from May 2017 to May 2019, showed that MOH policy enforcement has only an immediate and temporary effect on reducing antimicrobial use in community pharmacies across Saudi Arabia. Given the study’s limited timeframe—covering 1 year before and 1 year after MOH policy implementation—the assessment of the policy’s effectiveness and sustainability may be questioned.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the effectiveness of the Ministry of Health restriction policy on seasonal antibiotic consumption trends in Saudi Arabia, 2016–2020

Alzahrani,

Alshahrani,

Alajel

2023

Front. Pharmacol.

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Background: Understanding antibiotic consumption patterns over time is essential to optimize prescribing practices and minimizing antimicrobial resistance. This study aimed to determine whether the antibiotics restriction policy launched by the Saudi Ministry of Health in April 2018 has impacted antibiotic use by assessing changes and seasonal variations following policy enforcement.Methods: Quarterly sales data of J01 antibacterial for systemic use in standard units were obtained from the IQVIA-MIDAS database, spanning from the first quarter of 2016 to the last quarter of 2020. Antibiotics consumption was measured in defined daily doses per 1,000 inhabitant per day- in a quarter (DDDdq). A comparative analysis of antibiotic consumption pre- and post-policy periods introduction was conducted by computing the average consumption values for each period. Statistical comparison of the mean differences between the two periods were then made using independent samples t-test, Mann-Whitney U Test where needed. Time series analysis was employed to estimate the projected antibiotic consumption in the post-policy period if the restriction policy had not been implemented, which was then compared to actual consumption values to evaluate the effectiveness of the restriction policy.Results: During the pre-policy, there were seasonal trends of the total and oral antibiotic consumption through quarters, with higher consumption observed in the first and fourth quarters. In contrast, parenteral antibiotic consumption did not appear to follow a clear seasonal pattern. Following the restriction policy, there was a significant reduction in total and oral antibiotic use, with mean reductions of −96.9 DDDdq (p-value = 0.002) and −98 DDDdq (p-value = 0.002), respectively. Conversely, a significant increase in parenteral antibiotic consumption was observed with a mean increase of +1.4 DDDdq (p-value < 0.0001). The comparison between the forecasted and actual models showed that the actual antibiotics consumption for total, oral, and parenteral were lower than the corresponding forecasted values by 30%, 31%, and 34%, respectively.Conclusion: Overall, our analysis of antibiotics consumption from 2016 to 2020 displays great success for the policy implemented by the Saudi Ministry of Health in significantly reducing the total and oral use of antibiotics. However, future studies are needed to explore the increased consumption of the parenteral antibiotics as well as the persistent high consumption patterns during the fall and winter months even after the implementation of the restriction policy.

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“…This policy targets antimicrobial management and aims to lower the prevalence of self-medication and compels patients to seek advice from healthcare professionals. However, a study done by Al-Jedai et al revealed that the new policy has had no long-term impact, possibly due to easy access to healthcare facilities in the KSA and the ability to obtain antibiotics for free at healthcare facilities if prescribed by physicians [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic-Prescribing Patterns Among Patients With Respiratory Symptoms in the Eastern Province, Kingdom of Saudi Arabia

Al-baghli,

Al Saif,

Al Dorazi

et al. 2023

Cureus

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Background Upper respiratory tract infections (URTIs) represent the most common diagnosis in ambulatory care settings. Some of these infections are properly treated with antibiotics, but evidence points to an inappropriate overuse of antibiotics in URTI management. This overuse is linked to antibiotic resistance, drug-related adverse effects, and increased costs. Objective This study evaluated the prevalence and predictors of antibiotic prescription for patients with URTI symptoms at the primary healthcare centers (PHCCs) and pediatric emergency department (ED) of the Maternity and Children Hospital (MCH) in Dammam, Saudi Arabia. Methods A prospective study was conducted in the PHCCs and pediatric ED of MCH. Trained physicians collected data on patients with URTI symptoms aged three years and older. Scores based on modified Centor criteria were calculated, and rapid antigen detection tests (RADTs) were conducted for all study participants. Results Out of 469 patients with a URTI, 141 (30.1%) received a prescription for an antibiotic, with a smaller proportion in the PHCCs (n=85; 24.4%) than in the pediatric ED (n=56; 46.3%). The main significant predictors of antibiotic prescription in terms of odds ratio (OR) and 95% confidence interval (95%CI) were a positive RADT result (OR=41.75, 95%CI=4.76-366.28), the presence of tonsillar exudate (OR=5.066, 95%CI=3.08-8.33), tender and/or swollen anterior cervical lymph nodes (OR=4.537, 95%CI=1.96-10.54), and fever (OR=3.519, 95%CI=2.33-5.31). A higher Centor score was also a predictor (2 to 5 vs. −1 to 1) (OR=2.72, 95%CI=1.8-4.12). The absence of a cough was not a significant predictor (OR=1.13, 95%CI=0.74-1.72). Conclusions Although a positive RADT increased the likelihood that a patient would be prescribed an antibiotic at the time of assessment, most antibiotic prescriptions were not justified. To control expenses, prevent adverse effects, and limit the spread of antibiotic resistance, efforts should be made to reduce unnecessarily high antibiotic usage.

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Restriction on antimicrobial dispensing without prescription on a national level: Impact on the overall antimicrobial utilization in the community pharmacies in Saudi Arabia

Cited by 8 publications

References 28 publications

Prevalence of antibiotic misuse in cases of pneumonia and diarrhea in Saudi Arabia

Prevalence of antibiotic misuse in cases of pneumonia and diarrhea in Saudi Arabia

Evaluating the effectiveness of the Ministry of Health restriction policy on seasonal antibiotic consumption trends in Saudi Arabia, 2016–2020

Antibiotic-Prescribing Patterns Among Patients With Respiratory Symptoms in the Eastern Province, Kingdom of Saudi Arabia

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