Practices About Antibiotic Use Among Urban Residents: A Cross-Sectional Survey in Rufisque, Senegal

Oumar Bassoum

doi:10.11648/j.cajph.20190501.11

Abstract

Antibiotics have saved millions of lives around the world. However, their effectiveness is compromised by the emergence and spread of antibiotic resistance. The latter is a threat to global health. Under the International Health Regulations, a national self-assessment was conducted in Senegal to assess the country's capacity to cope with this scourge. It is followed by the joint external evaluation of the World Health Organization. One of the main recommendations is raising public awareness about the rational use of antibiotics. The goal of this study was to evaluate the general public's practices regarding antibiotics and the determinants of antibiotic use without a medical prescription. The study was cross-sectional. It was conducted at the Rufisque bus station. Rufisque is a city located in the region of Dakar, capital of Senegal. We estimated the sample size using Raosoft. Participants were selected according to a convenience sampling. A questionnaire was administered in an individual interview. Logistic regression was used to identify the determinants of antibiotic use without a prescription. A total of 400 people were included. Among them, 75% (300/400) said they had taken antibiotics during the last twelve months. The sources of supply were the community pharmacy (81%), the entourage (12%), the remaining antibiotics (5%) and the illicit drugs market (2%). The use of antibiotics without a prescription was reported by 75% of participants (225/300). It was more common among the uneducated people (OR = 2.7, P =.002). In addition, 16.8% (67/400) said they had shared their antibiotic treatment with their relatives or friends. Shortening the duration and frequency of antibiotic treatment was found in 65.8% (263/400) and 29.3% (117/400) of respondents, respectively. About 7% (29/400) said they sometimes demand antibiotics to prescribers. Almost all (98.8%, 395/400) stated that they had never returned unwanted medicines to pharmacies or health facilities while 37.8% (151/400) said they had never checked the expiry dates of medicines. This study, conducted in an urban setting, showed that respondents have recourse to inadequate practices toward antibiotics. We recommend the sensitization of populations especially those who are not educated. Other studies should be conducted mainly in rural areas to identify the most commonly used antibiotics and the extent of inappropriate practices and their determinants.

Highlights

An antibiotic is a chemical substance, produced by microorganisms, that has the ability to prevent growth of and to even destroy bacteria and other microorganisms [1]
The situation is worrying since the development of new antibiotics has significantly declined since the 1970s [1]
The absence of a significant relationship between distance from participants’ home to a health facility or a community pharmacy and use of antibiotics without a prescription (UAWP) assumes that populations practice self-medication using leftover antibiotics or those received from their entourage. These results show that sensitization campaigns on the rational use of antibiotics should target the uneducated people or those with a low level of education

Summary

Introduction

An antibiotic is a chemical substance, produced by microorganisms, that has the ability to prevent growth of and to even destroy bacteria and other microorganisms [1]. The period 1940-1970 represents the golden age of antibiotics with the development of new antibacterial agents [1]. These include, among others, tetracycline, erythromycin, methicillin and gentamicin [2]. Bacterial resistance has occurred in parallel with the discovery of antibiotics [2] This situation was already predicted by Sir Alexander Fleming who claimed that one day the world would face bacterial resistance [3]. According to the Director of the WHO Antimicrobial Resistance Secretariat, Dr Marc Sprenger, there is little hope of developing new antibiotics. He estimates that one or two new antibiotics are expected in the seven years [6]

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