Irrational use of antibiotics in the Moshi Municipality Northern Tanzania: a cross sectional study.

Erick Alexander Mboya,Leah Anku Sanga,James Samwel Ngocho

doi:10.11604/pamj.2018.31.165.15991

Abstract

IntroductionIrrational use of antibiotics includes prescription of incorrect doses, self-medication and treatment of non-bacterial illness. As a direct consequence of irrational antibiotic use, resistance to the commonly available antibiotics has been increasing rapidly. This phenomenon is associated with poorer health outcomes, longer hospitalization, increased cost to both the patient and government, and increased mortality. The aim of this study was to determine the prevalence of, and examine factors associated with, irrational use of antibiotics in the Moshi municipality, Northern Tanzania.MethodsWe conducted a cross-sectional descriptive study between April and May 2017 in the Moshi municipality. Twelve drug outlets, of which five were pharmacies and seven accredited drug dispensing outlets (ADDOs), were selected at random. On exiting these outlets, all adults who had purchased antibiotics were interviewed using structured questionnaires.ResultsA total of 152 adults were enrolled in this study. The median (QR) age was 31 years (25-42). The majority, 94 (61.8%), of the participants were female. ADDOs contributed 81 (53.3%) and pharmacies contributed 71 (46.7%) of all participants. Overall, 135 (88.8%) of antibiotic purchases were irrational. The most prevalent form of irrational antibiotic use was non-prescription usage; 116 of the 152 (76.3%) purchases fell in this category. Purchases of the incomplete dosage and purchases for non-bacterial illness were also widespread. Poor knowledge about the use of antibiotics had a significant association with irrational use of antibiotics (aOR=5.1, 95% CI: 1.80-15.15).ConclusionIrrational use of antibiotics is highly prevalent in this population. Non-prescription use of antibiotics is the most prevalent form. Poor knowledge about antibiotic use plays a significant role in irrational antibiotic use. There is a need to review the accessibility of antibiotics in drug outlets.

Highlights

Antibacterial resistance is a natural phenomenon, human factors exacerbate its emergence and spread [1]
The aims of this study are to determine the prevalence of the irrational use of antibiotics obtained from pharmacies and other drug outlets in the Moshi municipality, Northern Tanzania, and to examine the factors associated with the irrational use of antibiotics
The results of this study show that the irrational use of antibiotics in the Moshi municipality is 88.8%, with non-prescription usage being the most prevalent form

Summary

Introduction

Antibacterial resistance is a natural phenomenon, human factors exacerbate its emergence and spread [1]. Irrational use of antibiotics can take many forms, including the use of too many medicines per patient (polypharmacy), the inappropriate use of self-medication (often with prescription-only medicines), in non-bacterial infections, outside clinical guidelines, or with inadequate dosage or inappropriate route of administration such as overuse of injections when oral formulations would be more appropriate [2, 4] All these factors expose bacteria to sub-optimal levels of antibiotics, which is therapeutically ineffective and facilitates the formation of resistance against the drug by the bacteria [1]. Studies in Ethiopia and Zambia have shown that irrational use of antibiotics ranges from 75% to 100% [12, 16, 17] As a consequence of irrational antibiotic use, resistance to the commonly available antibiotics has been increasing rapidly This phenomenon is associated with poorer health outcomes, longer hospitalization, increased cost to both the patient and government, and increased mortality [18, 19]. The aims of this study are to determine the prevalence of the irrational use of antibiotics obtained from pharmacies and other drug outlets in the Moshi municipality, Northern Tanzania, and to examine the factors associated with the irrational use of antibiotics

Objectives

Methods

Results

Conclusion