Abstract

Inappropriate use of antibiotics has resulted in a dramatic increase of antimicrobial resistance in developing countries. We examined knowledge, attitudes, and practices of antibiotic use in three Asian countries. A nationwide cross-sectional study of teachers in large cities of Yemen, Saudi Arabia, and Uzbekistan was conducted. A random sample of 1,200 teachers was selected in each country. Data were collected through a questionnaire-based survey and then analyzed using descriptive and multivariate statistical methods. The prevalence of non-prescription antibiotic use ranged from 48% in Saudi Arabia to 78% in Yemen and Uzbekistan. Pharmacies were the main source of non-prescribed antibiotics. The most common reasons for antibiotic use were cough (40%) and influenza (34%). Forty-nine percent of respondents discontinued antibiotics when they felt better. Although awareness of the dangers of antibiotic use correlated inversely with self-medication, understanding of the appropriate use of antibiotics was limited. The prevalence of antibiotic self-medication in the educated adult population in the studied countries was found to be alarmingly high. Effective strategies involving regulatory enforcement prohibiting sales of antibiotics without prescription should be implemented along with educational interventions for health professionals and the public.

Highlights

  • Inappropriate use of antibiotics has resulted in a dramatic increase of antimicrobial resistance in developing countries

  • The prevalence of non-prescription antibiotic use ranged from 48% in Saudi Arabia to 78% in Yemen and Uzbekistan

  • Pharmacies were the main source of non-prescribed antibiotics

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Summary

Introduction

Inappropriate use of antibiotics has resulted in a dramatic increase of antimicrobial resistance in developing countries. Antimicrobial resistance is dramatically increasing worldwide in response to inappropriate antibiotic use [1]. Antimicrobial resistance to most common pathogens has reached alarming levels in developing countries, and trends show further increase. It is estimated that approximately two-thirds of all oral antibiotics used worldwide are obtained without a prescription and are inappropriately used for diseases such as tuberculosis, malaria, pneumonia, and for mild childhood infections [3]. Antibiotic consumption appears to be increasing steadily due to expanded population, rising incomes, and improved access to health care. In contrast with developed countries, where outpatient antimicrobials are largely restricted to prescription-only use, nonprescription access to antimicrobials is common in less affluent countries, resulting in uncontrolled use and self-medication [2,4,5]

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