The Irrational Use of Antibiotics Among Doctors, Pharmacists and the Public in River Nile State, Sudan
DOI:
https://doi.org/10.52981/sjms.v14i4.1506Abstract
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 interviewer administered 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.
References
[2] Faryna A, Gilbert L, Wergowske, Kim G: Impact of therapeutic guidelines on antibioticuse by residents in primary care clinics.J Gen Intern Med 1987;2:102–7.
[3] Chambers HF:General Principles of antimicrobial therapy.In Goodman and GillmansvThe pharmacological basis of therapeutics.11th edition. Edited by Brunton LL, LazoJS, Parker KL. New York: Mc Graw-Hill Press; 2006:1095–110.
[4] Kotwani, A, Holloway K. Trends in Antibiotic Use Among Outpatients in New Delhi, India. BMC Infectious Diseases, 2011;11(1):99. doi:10.1186/1471-2334-11-99.
[5] Shankar RP, Partha P, Shenoy NK, Easow JM, Brahmadathan KN:Prescribing patterns of antibiotics and sensitivity patterns of common microorganismsin the Internal Medicine ward of a teaching hospital in Western Nepal: A prospective study.Ann ClinMicrobiolAntimicrob 2003;2:7
[6] World health organization, 1987, The Rational Use of Drugs – Report of the conference of Experts, Nairobi 25-29 November 1985, World health organization, Geneva.
[7] Awad, A, Eltayeb I, Matowe L, Thalib L. Self-medication with antibiotics and antimalarials in the community of Khartoum State, Sudan. J. Pharm Pharm. Sci. 2005; 8: 326–31.
[8] Elsidi H. Irrational use of antibiotics among people residing in Almamoura, , Sudanese journal of public health, 2009; 5(1):50-3
[9] Biswas M, Roy D,Tajmim A, Rajib S, Hossain M, Fahamida Farzana F, Yasmen N. Prescription antibiotics for outpatients in Bangladesh: a cross-sectional health survey conducted in three cities. Ann ClinMicrobiolAntimicrob. 2014; 13: 15.
[10] Nga DT, Chuc NT, Hoa N, Nguyen NT, Loan H, et al. Antibiotic sales in rural and urban pharmacies in northern Vietnam: an observational study . BMC PharmacolToxicol.2014;15:6.
[11] Australian Commission on Safety and Quality in Health Care. Antimicrobial Stewardship Clinical Care Standard. Sydney: ACSQHC, 2014.
[12] Kontarakis N, Tsiligianni IG, Papadokostakis P, Giannopoulou E, Tsironis L,MoustakisV.Antibiotic prescriptions in primary health care in a rural population in Crete, Greece. BMC research notes 2011; 4(1): 38.
[13] Karabay O, Özdemir D, Güçlü E, Y Ild????r????m M, ?nce N, Küçükbayrak A, Çak????rS,GülençM, ?nce M, Demirli K. Attitudes and behaviors of Family Physicians regarding use ofantibiotics. J Microbiol Infect Dis 2011;1(2):53–7.
[14] Salunkhe SD, Pandit VA, Dawane JS, Sarda KD, More CS: Study of over the countersale of antimicrobials in pharmacy outlets in Pune, India: a cross sectional study.Int J Pharm Bio Sci 2013, 4(2):616–22.
[15] Nyazema N, Viberg N, Khoza S, Vyas S, Kumaranayake L, Tomson G,Lundborg CS: Low sale of antibiotics without prescription: a cross-sectional study in Zimbabwean private pharmacies. J AntimicrobChemother2007;59(4):718–26.
[16] Bin Abdulhak AA, Altannir MA, Almansor MA, Almohaya MS, Onazi AS, Marei MAet al. Nonprescribed sale of antibiotics in Riyadh. Saudi Arabia: a cross sectionalstudy. BMC Public Health 2011;11:538.
[17] Al-Faham Z, Habboub G, Takriti F. The sale of antibiotics without prescription inpharmacies in Damascus. Syria. J Infect DevCtries 2011,5(5):396–9.
[18] Ez-Elarab HS, Eltony MA, Swillam S. Appropriateness of antibiotic use at two university hospitals in Egypt, The Egyptian Journal of Community Medicine2009; 27.
[19] Väänänen M H, Pietilä K, Airaksinen M. Self-medication with antibiotics—Does it really happen in Europe? Health Policy 2006; 77: 166–71.
[20] Muras M, Krajewski J, Nocun M, Godycki-Cwirko M. A survey of patient behaviours and beliefs regarding antibiotic self-medication for respiratory tract infections in Poland. Arch. Med. Sci. 2013; 9;854–7.
[21] Skliros E,MerkourisP, Papazafiropoulou A, Gikas A,MatzouranisG, Papafragos C et al.Self-medication with antibiotics in rural population in Greece: A cross-sectional multicenter study. BMC Fam. Pract. 2010; 11. doi:10.1186/1471-2296-11-58.
[22] Al-AzzamSI , Al-HuseinBA, Alzoubi F, Masadeh MM, Al-HoraniMAS. Self-medication with antibiotics in Jordanian population. Int. J. Occup. Med. Environ. Health2007; 20: 373–80.
[23] Widayati A, Suryawati S, de Crespigny C, Hiller J.E. Self medication with antibiotics in Yogyakarta City Indonesia: A cross sectional population-based survey. BMC Res. Notes 2011:4, doi:10.1186/1756-0500-4-491.
[24] Bi P, Tong SL, Parton KA: Family self-medication and antibiotics abuse for children and juveniles in a Chinese city. SocSci Med 2000,50:1445–50.
[25] Remesh A, Samna Salim AM, Gayathri UN, Retnavally KG. Antibiotics prescribingpattern in the in-patient departments of a tertiary care hospital. PharmaPract 2013,4:71–6.
[26] Okumura J, Wakai S, Umenai T. Drug utilisation and self-medication in ruralcommunities in Vietnam. SocSci Med2002;54:1875–86.
[27] Murphy MC, Bradley C, Byrne S.Antibiotic prescribing in primary care, adherence toguidelines and unnecessary prescribing-an Irish perspective, BMC family practice2012; 13(1): 43.
[28] Muhammad S, Muhammad F, Mariah I, Amjad H. Evaluation of antibiotic use behavior in cold and flu amongst the students of BahauddinZakariya University MultanPakistan.Pak J Pharm 20-23 (1&2) 15-2, 2007-2010
[29] Sun Q, Dyar O, Zhao L, Tomson G, Nilsson L,Grape M et al. Overuse of antibiotics for the common cold – attitudes and behaviors among doctors in rural areas of handong Province, China. BMC PharmacolToxicol 2015; 16: 6.
