Abstract
In Haiti, where all drugs are available over the counter, self-medication with antibiotics appears as a common practice. Inappropriate use of beta-lactams and macrolides is likely to contribute to the development of antimicrobial resistance. This study aimed to (i) assess the extent of self-medication with antibiotics, (ii) explore the contributing factors (age, gender and educational background) and (iii) identify specific antibiotic drug classes used among patients attending the outpatient clinic of the State University Hospital of Port-au-Prince. A cross-sectional survey among 200 outpatients of the State University Hospital of Port-au-Prince was conducted in December 2014. Face-to-face interviews were conducted using a standardized questionnaire. Parents of pediatric patients were allowed to answer to questions on their behalf. Among the study sample, 45.5% practiced self-medication with antibiotics. It was less prevalent among patients with the highest education level (23.1%; OR: 0.89 (0.5-1.75), p = 0.001). Mild symptoms (28.6%) and vaginal itching (44.4%) were the main reasons for self-medication with antibiotics. Self-medication using amoxicillin was reported by 67.0%. Self-medication with antibiotics is a common practice among Haitian patients and is more common among the less educated. Amoxicillin for urinary tract infections is the most commonly used medication. It is crucial to raise awareness on the dangers of the practice in the population and inforce the current law regarding the use of over the counter antibiotics.
Highlights
Self-medication, which can be defined as the practice of treating one's own symptoms or disease without the advice or prescription from a medical provider other than a pharmacist [1, 2], is a common practice around the world [3], in developing countries [4, 5]
Antibiotics self-medication is a common practice among Haitian patients
Public health authorities should implement health education programs nationwide regarding the use of antibiotics
Summary
Self-medication, which can be defined as the practice of treating one's own symptoms or disease without the advice or prescription from a medical provider other than a pharmacist [1, 2], is a common practice around the world [3], in developing countries [4, 5]. Prevalence of self-medication is likely to be influenced by the health system organization, including the availability of physicians who are able to prescribe and the health literacy of the population [8]. A parallel market of contraband pharmaceuticals has developed It is common in Haiti for antibiotics to be sold illegally over the counter (OTC), by street vendors, by "marketing agents," which are itinerant promoters and vendors of pharmaceutical products and in unlicensed pharmacies. Our goals were to 1) estimate the prevalence of antibiotic use among an outpatient population in Haiti, 2) explore reasons for self-medication vs. seeking prescriptions for antibiotics and 3) determine which antibiotics are most commonly bought without a prescription
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