Abstract
Most current guidelines recommend prescribing second-generation antihistamines (SGAs) over first-generation antihistamines because SGAs are less likely to cause sedation and impairment of heavy work performance. However, common residents who use these antihistamines as over-the-counter (OTC) medicines are less likely to know that. So, this study was designed to compare the over-the-counter use of antihistamines by common residents with the prescribing preferences of physicians residing at Dhaka City, Bangladesh. Between June and August of 2017, a total of 100 Physicians from some of the top medical institutions of the city and 350 randomly selected common residents were directly interviewed with two separate semistructured questionnaires specifically designed for each population. Data was statistically analyzed using Fischer’s exact test, Spearman’s rank correlation test and Kendall’s tau rank correlation test. The data shows that physicians prefer second-generation antihistamines with fexofenadine (48.09% of the total responses), desloratadine (16.03%), and rupatadine (13.74%) taking the top spots. Cetirizine (29.46% of total responses), desloratadine (14.73%), and chlorpheniramine (14.52%) were the most used OTC antihistamines by the common residents. Statistical analysis with Fischer’s exact test revealed that the difference in preference of first-generation antihistamines between physicians and common residents were extremely significant (p<0.0001). Furthermore, cetirizine (which is known to have some degree of sedating activity) and chlorpheniramine are more preferred among common residents than among physicians (extremely significant difference, p<0.0001 in both cases). The study concludes that physicians of Dhaka City are complying with practice guidelines, but sedating antihistamines still retain some popularity among the common residents. Hence, a more engaging community pharmacy is needed to minimize adverse effects that can arise from OTC use of sedating antihistamines.
Highlights
Bangladesh is a developing country with a very high population density
Antihistamines are a class of drugs which are commonly taken by the common residents as over-the-counter (OTC) medicine. ese drugs are frequently prescribed by physicians for colds and various types of allergic conditions
Survey questionnaire had to be prepared to collect data from two distinct populations namely the common people living in Dhaka City and the physicians who practice at the city
Summary
Bangladesh is a developing country with a very high population density. Is has created another problem, as the wide availability of medicines has prompted the common people and sometimes the physicians to unnecessarily resort to certain medicines [2, 3]. Regulations have been developed to battle the indiscriminate use of medicines, but they are yet to be enforced e ectively [4]. Antihistamines are a class of drugs which are commonly taken by the common residents as over-the-counter (OTC) medicine. Among the two classes ( rst-generation and Advances in Public Health second-generation) of antihistamines available in the market, the first-generation antihistamines (FGAs) can possess some risks to the patients due to their sedative property
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