The Irrational Use of Antibiotics Among Doctors, Pharmacists and the Public in River Nile State, Sudan

Abstract

Background: Inappropriate antibiotic prescription, dispensing and self-medication are alarmingly high worldwide. The problem is more so in developing countries, including Sudan, where resistance to life-saving drugs is emerging. Objective: to assess the prevalence of irrational use of antibiotics among doctors, pharmacists and the public in River Nile State (RNS), Sudan. Methodology: a descriptive cross-sectional study was conducted, in March 2014 through April 2014. The study population was 278 individuals, composed of 100 doctors, 78 pharmacists selected randomly from hospitals, pharmacies and health centers, besides 100 adults from the community. Three different intervieweradministered standardized pre-tested questionnaires were used for data collection. Results:antibiotic misuse is common practice among both medicals as well as the public in RNS. This was evidenced by the facts that 92% of doctors prescribed antibiotics without culture and sensitivity results, more than 93% of pharmacists dispensed antibiotics as over the counter medications and that 89% of participants used antibiotics without consulting a doctor. More than 90% of the misused antibiotics werebeta-lactams and macrolides and the most common indication for their use was cough and common cold. Conclusion: Irrational use of antibiotics is a widespread practice in RNS among all stakeholders. Therefore, health care policy makers and care providers should have antibiotic policy and clear to follow obligatory guidelines and to ensure that the public and every prescriber/dispenser conforms to that policy. Moreover, increasing awareness about the appropriate antibiotic use among all stakeholders is of paramount importance.

Irrational use of antibiotics with representation of antimicrobial resistance patterns in Sudan: a narrative review

“…Prevalence of irrational use of antibiotics in different Prevalence of irrational use of antibiotics in different levels of the community levels of the community Despite the few numbers of data published in Sudan, the results shown were surprising and indicate an upcoming crisis in Sudan. However, the irrational use of antibiotics is practiced by doctors, pharmacists, and community members as shown in the study done by (Sara H Oleim et al, 2019) in River Nile State (RNS) in Sudan (2). Accordingly, patterns of antibiotics misuse in this study showed that 92.0% of doctors are prescribing antibiotics without culture and sensitivity tests while less than 10.0% depend on culture and sensitivity tests.…”

“…At the time of writing, there were few published papers conducted on irrational use of antibiotics and antimicrobial resistance in Sudan (2). Nonetheless, the absence of an antibiotic stewardship program that is applied and activated in Sudan's healthcare system is an alarming concern in regards to the issue of antibiotics resistance.…”

“…Antibiotics have a wide range of uses; from treating serious infections, to preventing surgical wound infections, and as a prophylaxis for immunocompromised individuals (2). Inappropriate uses include multiple drug prescriptions (polypharmacy), over prescribing and over use of antibiotics, and irrational use of antimicrobials for infections that are viral in nature (3).…”

“…The lenient behavior of community pharmacies in regards to dispensing antibiotics together with the expendable prescribing of antibiotics by physicians' results in unrestrained and excessive use that, in turn, raises the resistance of the human pathogens (4). Collective antibiotics consumption worldwide, essentially in developing countries, maximizes the antimicrobial resistance of the pathogen as the choices of effective antibiotics that are readily used to treat serious infections are narrowing (2). It is estimated that in some developing countries, 20.0% of antibiotics are used in hospitals and health care facilities while 80.0% are used in the community via prescription by a health care provider or an over the counter purchase (2).…”

“…Collective antibiotics consumption worldwide, essentially in developing countries, maximizes the antimicrobial resistance of the pathogen as the choices of effective antibiotics that are readily used to treat serious infections are narrowing (2). It is estimated that in some developing countries, 20.0% of antibiotics are used in hospitals and health care facilities while 80.0% are used in the community via prescription by a health care provider or an over the counter purchase (2). In Spain for example, outpatient prescriptions accounting for antibiotics alone are an alarming 92.0% whereas at an international scale it is a whopping 80.0% (5).…”