Antibiotics In Pharmacies Research Articles

The hidden dangers lurking at home: Unveiling the prevalence of leftover antibiotics and its associated factors among Lebanese households

BackgroundAntimicrobial Resistance (AMR) is a major global concern. Irrational use of antibiotics including self-medication (SM) with leftovers without a medical prescription can be a leading cause. This study aimed to investigate the prevalence and related factors of leftover antibiotics (LA) in Lebanese households. Study designA cross-sectional study of the Lebanese population was conducted between March and October 2022. MethodsThrough random proportional stratified sampling, a total of 494 families participated in this study. Data collection was carried out through phone calls using a comprehensive and reviewed questionnaire. The data was then analyzed using SPSS version 26. Logistic regression was utilized to identify the factors associated with LA, with the presence of LA in households as the dependent variable and other factors such as age, region of residence, and presence of elderly individuals at home as the independent variables. ResultsAmong selected households, 118 households (23.89%) had LA. The most common type of antibiotic found was penicillin (59.84%). Most of the LA were in the form of tablets and capsules (94%) with valid expiration dates (87%). Antibiotics were mainly prescribed by doctors (61%), and the main reason for prescribing was acute respiratory tract infections (47.46%). SM was reported by 42.37% of the families with LA. A family with elderly patients (p = 0.002; OR = 2.23; 95% CI = 1.33–3.73) and those residing in Mount Lebanon (p = 0.019; OR = 2.28; 95% CI = 1.14–4.56) had significantly higher odds of having LA. ConclusionLeftover antibiotics were found in nearly a quarter of the addressed Lebanese families. Therefore, public educational campaigns should be launched to limit injudicious antibiotic use including SM, and to promote proper disposal of any leftovers. It is also crucial to adopt the One Health approach by developing national programs for the safe disposal of LA and implementing regulations to restrict the distribution of antibiotics in pharmacies without a prescription.

The Antibiotic Knowledge, Attitudes, and Behaviors of Patients Purchasing Antibiotics without Prescription: Results of National Survey

Background. The inappropriate and overuse of antimicrobials is a problem worldwide. To target future interventions, a thorough understanding of current behavior reasons is needed. The aim of the study was to explore antibiotic knowledge, attitudes, and behaviors among patients residing in Russia. Methods. In total, 149 semistructured interviews were carried out with respondents using antibiotics without prescriptions. Interviews were used to assess participants’ practices to treat symptoms of a confirmed/suspected infectious disease and their behaviors, knowledge, and attitudes toward the use of antimicrobials. A directed content analysis was applied. Results. Despite regulation, inappropriate use of antibiotics is a common practice. Knowledge on the mechanism of action and indications for the use of antibiotics was generally low. However, self-diagnosis, self-treatment with antimicrobials, and attempts to purchase antibiotics in pharmacies with no prescription were quite common. Family members and friends were involved in decisions about treatment strategy. Time spent for the doctor’s visit, fear to be exposed to additional infections in outpatient clinics/hospitals, previous experience with antimicrobial self-treatment, and “loyal” policy of selling antibiotics influenced the respondents’ decisions of not going to the doctor. COVID-19 made an impact on antimicrobial self-treatment: there was a substantial complexity in contacting a medical healthcare provider. Most of the respondents did not pay much attention or even noticed informational materials on the proper use of antibiotics. Conclusion. Self-treatment with antibiotics in Russia exists. Conducted information campaigns were not effective enough as the low level of knowledge about antimicrobials and antimicrobial resistance was revealed by the present study.

Knowledge, Attitudes, and Practices Regarding Antibiotic Sales in Pharmacies in Medellín, Colombia 2023.

Describe the knowledge, attitudes, and practices regarding the sale of antibiotics in pharmacies in Medellín, Colombia. A cross-sectional descriptive study was conducted in 277 selected pharmacies using a stratified sampling method with proportional allocation to represent all areas of the city. Knowledge, attitudes, and practices (KAPs) were assessed using a scale, analyzed with absolute and relative frequencies for each item, and represented in a global score ranging from 0 to 100, with a higher score indicating better KAPs. Data were analyzed using relative frequencies with 95% confidence intervals, the Mann-Whitney U test, the Kruskal-Wallis test, and linear regression. Of the included pharmacies, 52.6% were chain pharmacies, 48.4% were attended by pharmacy assistants, and 59% of pharmacists had more than 5 years of experience. The median knowledge score was 70.8 (IQR 58.3-87.5), with 35.3% of pharmacists believing that antibiotics are effective in treating the common cold, 35.2% for treating COVID-19, and 29.4% considering them available for sale without a medical prescription. The attitude score was 53.3 (40.0-66.7), with 60.9% agreeing that prohibiting the sale of antibiotics without a prescription would decrease their sales. The practice score was 62.5 (40.0-79.2), with 65.4% of pharmacists stating that they sometimes sell antibiotics without a prescription due to patients struggling to obtain a medical consultation, 61.3% admitting to selling antibiotics without a prescription for urinary tract infections, and 41.3% for upper respiratory tract infections. Practices were predominantly influenced by pharmacy type (chain or independent) and, to a lesser extent, by knowledge and attitudes. Pharmacists in Medellín exhibit inadequate knowledge, attitudes, and practices regarding the use and sale of antibiotics without a medical prescription. These findings align with international evidence highlighting the need for educational and regulatory strategies promoting rational antibiotic use in pharmacies.

Evaluation of Attitudes and Practices of mothers on Antibiotic Use in Children under five years old Referred to Shahid Sadoughi Hospital in Yazd, 2019-2020

Introduction: Microbial resistance due to antibiotics overuse can endanger the general health of society. Various factors play a role in mothers' overuse of antibiotics for their children. This study aimed to investigate mothers' attitude and behavior about the use of antibiotics in children under five years old in Yazd City.
 Methods: In this cross-sectional descriptive study, 302 mothers with children under five years old were included in 2019-2020; a questionnaire of mothers' attitudes and practices regarding antibiotic use was completed. Then, the obtained data were analyzed by SPSS software version 16 and P-value less than 0.05 was considered statistically significant.
 Results: The mothers' attitude level was poor, moderate, and good in 60 (20%), 180 (59.5%), and 62 patients (20.5%), respectively. Furthermore, mothers' practice level was poor in 55 (18.2%), moderate in 210 (69.5%) and good in 37 (12.3%). The level of attitude (P = 0.000) and practice (P = 0.007) in mothers with a higher level of education was significantly higher. With increasing the number of children, mothers' attitude (P = 0.03) and practice (P = 0.02) were significantly lower.
 Conclusion: The study results showed that most mothers have a moderate level of attitude and practice in using antibiotics in their children. A significant number of them also mentioned antibiotic use without a prescription. Therefore, to reduce the improper use of antibiotics, it is recommended to pay attention to educational programs with proper planning by the public media. It makes sense to train physicians, monitor their performance and closely monitor the sale of antibiotics in pharmacies to reduce their use without a doctor's prescription.

POSC218 Study of Antibiotic Consumption Trends in Public Pharmacies during the COVID-19 Pandemic in Ukraine

European studies showed, up to 70% of patients with COVID-19 received antibiotics. In Ukraine, due to the Order of MoH of Ukraine dated 31.12.2020 3094 there is a requirement that antibiotics are contraindicated, they can prescribe only in the presence of laboratory-confirmed bacterial infection or with reasonable suspicion. The study aim was to assess current trends in the consumption of antibiotics in pharmacies during COVID-19 pandemic.

Potency of commonly retailed antibiotics in pharmacies found in Adama, Oromia regional state, Ethiopia.

Antibiotics are commonly used for the treatment and prevention of bacterial infections. The potency of antibiotics can be affected by factors such as temperature, light, moisture, and storage conditions. Inappropriate storage and transportation of antibiotics may lead to loss of potency earlier than the expiry date. The aim of this study was to determine the potency and associated factors of commonly retailed antibiotics. Institution-based cross-sectional study was conducted on commonly retailed antibiotics in pharmacies that are available in Adama, Ethiopia from March 2018 to June 2018. This study focused on commonly ordered antibiotics such as amoxicillin, azithromycin, ciprofloxacin, and ceftriaxone. Antibiotics to be tested were selected by using a simple random sampling technique. Socio-demographic and related data were collected using a semi-structured questionnaire. Antibiotic susceptibility testing was performed using the disc diffusion method as described in the Clinical Laboratory Standard Institute guideline. Mean inhibition zones of amoxicillin, ciprofloxacin, azithromycin, and ceftriaxone were 14.2 ± 4 mm, 30.9 ± 4.2 mm, 17.47 ± 3.83 mm, and 32.7±1.8 respectively. Out of 164 antibiotics tested, 61% passed the potency test. The potency of antibiotics varies across different countries in which 53.7% and 54.6 of antibiotics from India and Ethiopia passed the potency test. All ceftriaxone tested in this study passed the potency test. Factors such as air condition of pharmacy (X2 = 4.27; p = 0.039), source of all antibiotics (X2 = 5.41; p = 0.02), and source of amoxicillin (X2 = 4.73; p = 0.03) were significantly associated with potency of antibiotics. About 40% of antibiotics tested in the current study did not pass the potency test; this warrants further investigation to identify the magnitude of the problem and its causes at a large scale.

Hubungan Tingkat Pendidikan Masyarakat Terhadap Pengetahuan dalam Penggunaan Antibiotik Oral di Apotek Kecamatan Koto Tangah Padang

Antibiotics are drugs that are widely used for therapeutic treatment of infections, but now the purchase of antibiotics without a doctor's prescription at pharmacies has become a global problem, especially in developing countries. This study aims to determine the relationship of community education level to knowledge in the use of oral antibiotics in pharmacies in Koto Tangah District, Padang. The method used is descriptive correlative with cross-sectional approach. The population in this study were all people who visited the pharmacy in Koto Tangah District. The sampling technique uses non-random sampling technique that is purposive sampling of 100 respondents who have met the inclusion and exclusion criteria. Measuring instruments in this study used a questionnaire about knowledge in the use of oral antibiotics. Based on the results of the chi-square statistical test between the level of knowledge and the level of education obtained p = 0,000. This shows the p value is not greater than 0.05, and the relationship between the level of public education with knowledge in the use of Oral Antibiotics with the Spearman correlation test is 0.53, so it can be concluded that there is a relationship between the level of public knowledge and the level of public education in use of oral antibiotics.

Пандемия COVID-19: новый виток нарастания антибиотикорезистентности

In this article, we analyzed the problems associated with increasing antibiotic resistance, irrational use of antibiotics, and inadequate demand for them during the COVID-19 pandemic. Objective. Using the method of digital epidemiology, we analyzed the dynamics of the frequency of a specific request for antibiotics in pharmacies and hospitals. We used open data from Yandex (Wordstat.Yandex) and Google (Google Trends) collected on weekly basis for the Russian Federation. Results. The World Health Organization reports a growing problem of antibiotic misuse by some individuals and healthcare institutions during the COVID-19 pandemic. Extensive irrational use of antibiotics causes the development of antibiotic resistance by many microorganisms, including those circulating in hospitals (for example, ESKAPE group). Moreover, COVID-19 has led to an exponential increase in the use of biocides worldwide, potentially resulting in additional indirect pressure promoting the selection of antibiotic-resistant strains. The pandemic in Russia was marked by a significant increase in antibiotic sales in pharmacies (including systemic antibacterial agents) and purchases by healthcare institutions. Conclusion. Our findings demonstrate that the rapid spread of COVID-19 was associated with extensive consumption of antibiotics, which resulted in growing antibacterial resistance (number of circulating drug-resistant strains) and posed a threat to the national security. The COVID-19 necessitates the discovery of new effective treatments for this infection, as well as rational use of antimicrobial drugs. The implementation of surveillance of antibiotic consumption will help to identify changing trends in their use, combine efforts to solve problems related to antibiotics and drug resistance, and to ensure rational use of antimicrobials. Key words: antibiotics, antibiotic resistance, pandemic, COVID-19, digital epidemiology

ANTIBIOTIC SENSITIVITY OF CLINICAL ISOLATES AT OUTPATIENT UNITIN TVER, RUSSIA: A COMPARATIVES

Background Discovery of antibiotics opened a new era in the treatment of bacterial diseases. However, the microorganisms are able to adapt and resist the effects of the drugs. Objective Our study is aimed to investigate the sensitivity of clinical specimens to antibiotics. Methods Clinical samples of 280 case record forms were collected at departments of surgery, urology and otorhinolaryngology in an ambulatory clinic (Tver, Russia) during 2019. The results of microbiologically assessed isolates from pharynx, nose, ears, eyes, wounds, sputum and urine underwent statistical analysis. Results The outcomes confirmed a general trend of reduced susceptibility of bacteria to antibiotics. The worst result was shown by protected Amoxicillin; practically no microorganisms were sensitive to it. Protected Cephalosporins Cephalosporins of IV generation and Imipenem were among the best, although not highly sensitive to all the pathogens. Conclusion United efforts of all states are required to combat the growing antibiotic resistance. It is necessary to adhere to strict regulations on dispense of antibiotics in pharmacies and the use of antibiotics therapy

Community pharmacy staff\u2019s response to symptoms of common infections: a pseudo-patient study

BackgroundInappropriate over-the-counter supply of antibiotics in pharmacies for common infections is recognised as a source of antibiotic misuse that can worsen the global burden of antibiotic resistance.ObjectivesTo assess responses of community pharmacy staff to pseudo-patients presenting with symptoms of common infections and factors associated with such behaviour.MethodsA cross-sectional pseudo-patient study was conducted from Jan-Sept 2017 among 242 community pharmacies in Sri Lanka. Each pharmacy was visited by one trained pseudo-patient who pretended to have a relative with clinical symptoms of one of four randomly selected clinical scenarios of common infections (three viral infections: acute sore throat, common cold, acute diarrhoea) and a bacterial uncomplicated urinary tract infection. Pseudo-patients requested an unspecified medicine for their condition. Interactions between the attending pharmacy staff and the pseudo-patients were audio recorded (with prior permission). Interaction data were also entered into a data collection form immediately after each visit.ResultsIn 41% (99/242) of the interactions, an antibiotic was supplied illegally without a prescription. Of these, 66% (n = 65) were inappropriately given for the viral infections. Antibiotics were provided for 55% of the urinary tract infections, 50% of the acute diarrhoea, 42% of the sore throat and 15% of the common cold cases. Patient history was obtained in less than a quarter of the interactions. In 18% (44/242) of the interactions staff recommended the pseudo-patient to visit a physician, however, in 25% (11/44) of these interactions an antibiotic was still dispensed. Pharmacy staff advised the pseudo-patient on how to take (in 60% of the interactions where an antibiotic was supplied), when to take (47%) and when to stop (22%) the antibiotics supplied. Availability of a pharmacist reduced the likelihood of unlawful antibiotic supply (OR = 0.53, 95% CI: 0.31–0.89; P = 0.016) but not appropriate practice.ConclusionsIllegal and inappropriate dispensing of antibiotics was evident in the participating community pharmacies. This may be a public health threat to Sri Lanka and beyond. Strategies to improve the appropriate dispensing practice of antibiotics among community pharmacies should be considered seriously.

Contribution of storage conditions of antibiotics in pharmacies on efficacy loss of Amoxicillin and Tetracycline against strains of Escherichia coli and Staphylococcus aureus in the city of Lome.

Background The resistance of bacteria to antibiotics is now a public health issue. The causes of such resistance are multiple and some are related to non-compliance with recommended doses of antibiotics. The storage conditions of antibiotics can have an impact on their effectiveness. Indeed, at a temperature above 30 ° C and a relative humidity above 60%, pharmaceutical presentations of antibiotics may lose their doses. The goal of our study was to evaluate the existence of a correlation between failures of antibiotic therapy and poor conservation of marketed antibiotics in the city of Lome. Methods We had prospected 5 pharmacies in the city of Lome and have collected in each 4 pharmaceutical presentations of antibiotics.These antibiotics are Amoxicillin, Ciprofloxacin, Tetracycline and Chloramphenicol. Also, we isolated in two private laboratories in the city of Lome, 5 hospital strains of these following bacteria: Escherichia coli, Escherichia coli Alkalescens-Dispar, Klebsiella pneumonia and two strains of Staphylococcus aureus. Reference strains of Klebsiella pneumoniae ATCC 13883, Escherichia coli ATCC 25922, Staphylococcus aureus ATCC 29213, Staphylococcus aureus ATCC 25923 and Pseudomonas aeruginosa ATCC 27853 were used for analysis control.We carried out a prospective investigation and an analysis of the effectiveness of the antibiotics by the method of diffusion in agar medium. Results The survey results showed that all pharmacies surveyed had an ambient temperature above what is recommended. In vitro analysis of the efficacy of Amoxicillin on hospital strains of Escherichia coli revealed some resistances. Also, the in - vitro analysis of the Tetracycline on reference strains of Staphylococcus aureus ATCC 29213 and Staphylococcus aureus ATCC 25923 was found to be ineffective. Conclusion The storage conditions of these antibiotics, especially the temperature of their conservation, could be responsible of the loss of their effectiveness. It is possible that, in the city of Lome, some resistances of bacteria to marketed antibiotics are due to inappropriate conservation conditions of these products.

Decrease in Antibiotic Sales in Brazil After New Control Legislation

Abstract Background Brazil, like many Latin American countries, has struggled with the inappropriate use of antibiotics in the community without a prescription form a physician. Since November 2010, The Brazilian Health Surveillance Agency has established stricter control of antibiotic sales, which requires that a copy of antibiotic prescriptions be retained by the pharmacy for audit. Pharmacists now also have more severe civil and criminal liability if they allow the sale of antibiotics without a prescription. The aim of this study was to analyze the impact of the new legislation preventing the sale of antibiotics in pharmacies without a prescription. Methods The data for antibiotic usage in units was collected from electronic monitoring of pharmacy members of the Brazilian Federation of Pharmacies (FEBRAFAR), which tracked information about the antibiotics sold in approximately 3,000 pharmacies from 1,500 municipalities across Brazil. We compared the sale of antibiotics during two time periods: 12 months prior to the new legislation and 12 months after. Results We observed a reduction in pharmacy sales of each class of antibiotics included in this study following the implementation of the new legislation. Pharmacy sales for 27 (84.4%) of the 32 antibiotics included in the study were reduced in response to the new legislation, whereas sales of five antibiotics were increased. Overall, tetracycline (−57.8%), co-trimoxazole (−28.8%), and amoxicillin (−29.1%) showed the largest reduction of all agents. With month to month analysis, the greatest reduction in units sold/month was observed for the following therapeutic classes: tetracyclines (30.5%), sulfonamides (28.5%), macrolides (25.0%), and penicillins (20.5%). Yearly trend analysis showed a significant reduction in antibiotics during the winter months (average monthly difference: −31.5%, P < 0.05) Conclusion The reduction in the number of antibiotic units sold by pharmacies after the implementation of legislation designed to regulate antibiotic use in Brazil suggests that the policy is successful and will contribute to rational use of antibiotics in Brazil. Disclosures All authors: No reported disclosures.

Association between public knowledge regarding antibiotics and self-medication with antibiotics in Teling Atas Community Health Center, East Indonesia

Background: Self-medication with antibiotics increases the risk of resistance, which leads to higher morbidity and mortality. The community plays an important role in preventing and controlling the spread of antibiotic resistance. This study aims to determine factors associated with antibiotics self-medication practices in the community, which are the key to developing effective intervention programs.Methods: This cross-sectional study was conducted between September and October 2015 at Teling Atas Community Health Center in Wanea, a sub-district of East Indonesia region. Data was collected by a questionnaire-guided interview. There were 35 questions which cover respondent demographics, antibiotic use, and respondents’ knowledge about antibiotics. Logistic regression was used to analyze the association between self-medication with antibiotics and respondents’ level of knowledge as well as other factors.Results: Among 400 respondents, there were 240 (60%) who had used antibiotics within 6 months prior to the interview and 180 (45.0%) who had self-medicated. Wounds or skin diseases (32.2%) were main reasons for self-medication. The majority of respondents self-medicated on their own initiatives (70.6%) and purchased antibiotics in pharmacies (52.2%). The mean score for respondent knowledge about antibiotic was categorized as “moderate” (score 7.14±2.49). Respondents with lower knowledge scores had higher probabilities to self-medicate with antibiotics than those with higher scores (OR= 16.86; 95% CI= 4.25–66.83).Conclusion: Self-medication practices with antibiotics in this study are associated with age, family income, and knowledge. Since poorer knowledge about antibiotics is associated with a higher probability of self-medication with antibiotics, education programs to improve public awareness are needed.

Non-prescription sale of antibiotics in pharmacies across Puducherry, India

Background: Despite being illegal, non-prescription sales of antibiotics in India continue to be a major contributor to antibiotic abuse, which fosters antibiotic resistance. Methods: Two trained actors simulated symptoms of acute gastroenteritis (AGE) and upper respiratory tract infections (URTI) in 60 pharmacies each randomly selected in the Union Territory of Pondicherry, India. The ease of obtaining antibiotics, any additional enquiries made by the pharmacies, and any additional advise given were noted. Results: Only 33/120 pharmacies (27.5%) declined to dispense antibiotics without prescription; all 33 were attached to a hospital or nursing home. The most frequently dispensed antibiotics for AGE and URTI were ciprofloxacin (41.4%) and coamoxiclav (41.3%) respectively. Out of the 87 pharmacies which dispensed antibiotics without prescription, the presence of additional symptoms and previous drug allergy were enquired by 20 (22.9%) and 9 (10.3%) pharmacies respectively. While over half of the pharmacies gave instructions regarding dose, duration and frequency of antibiotic consumption, none of the pharmacies provided information regarding adverse reaction profile of antibiotics. Non-pharmacological measures for symptomatic improvement were advised by 24/120 pharmacies (20%). Conclusions: Non-prescription sales of antibiotics are unacceptably high in Pondicherry. Stricter implementation of the law and public awareness of the perils of inappropriate antibiotic usage are the need of the hour.

Analysis of Primary Care Medicines Expenditure In Relation To Measures of Deprivation In Wales Uk

e144 Volume 37 Number 8S (with antibiotic leftovers or by acquiring antibiotics directly in the pharmacy without a prescription), are behaviours directly related with this misuse, revealing the necessity of interventions directed to health professionals. The aim of this study is to improve the consumption of antibiotics through an educational intervention directed to community pharmacists and primary care physicians. Material and Methods: A cluster randomized trial in the region center of Portugal. Of the 8 clusters, 4 clusters received an educational intervention and the other four clusters did not received any intervention and were included in the control group. Educational intervention consisted of group sessions with physicians and group sessions with pharmacists. In the sessions groups it was presented information about the problem of microbial resistances and each sessions was focused in the identified attitudes that influence the behaviour of physician during antibiotic prescription or the behaviour of pharmacist during the dispensation of antibiotics in pharmacies. At the end of each group session, were distributed flyers and poster about the importance of the adequate use of antibiotics to be divulgated to the patients. The data of antibiotics consumption was compared between the intervention group and the control group. Results: The intervention was well received for the pharmacists and for the physicians included in the study. Comparing the consumption of antibiotics between the two groups, it was observed a decrease in the total consumption of antibiotics in the intervention group during 12 months of the follow-up period after the intervention was made. Conclusions: It was possible decrease the consumption of antibiotics through an educational intervention directed to community pharmacists and primary care physicians.

Legislation Alone is Enough to Combat Antibiotic Misuse? Certainly Not!

Sir There is no doubt that increasing bacterial resistance against antibioticsisbecomingamajorworld‑widehealthchallenge� and the cooperation of comprehensive and well-defined measures is imperative to tackle the possible devastating outcomes. Antibiotic misuse is an important risk factor that is participating in bacterial resistance. In developed countries, interventions designed to target antibiotic abuse are established and successfully employed. In contrast, given the lack of research and strategies implemented in developing countries, the knowledge about antibiotic misuse is still scarce and the number of individuals consuming antibiotics improperly is rising. We believe that newly enacted laws for rational use of antibiotics as the proposed Schedule H1 in India should not only focus on prohibiting the sale of antibiotics without prescriptions and implementing punishments on those who violate the recommendations. These laws will be meaningless if high level of misconceptions and poor knowledge in societies still exists since individuals will continue to put pressure on physicians to prescribe antibiotics even when there is no medically-proved need for such actions. As an example of a developing country, legislation was developed by the Syrian Ministry of Health to prevent selling antibiotics in pharmacies without medical prescription. (1) Unfortunately, and due to the lack of educational interventions delivered to the community, the accurateness that health-care professionals follow these laws is questionable. Therefore, the conception of laws regulating antibiotic consumption should be accompanied by research aiming to understand why individuals in such communities still put a lot of effort to swindle antibiotic-regulating laws, and to identify the demographic groups that are mostly endorsing such attitudes. Subsequently, educational programs should be implemented in the community, with a focus on the effectiveness and the correct use of antimicrobial drugs, aiming to discourage self-medication, and improve the communication about antibiotic appropriateness between health professionals and patients, simultaneously with anactiveandfirmimplementationofthelawsrelated.�The� efficiencyofsuchcampaignsandchangesinknowledgeand� antibiotic use should be evaluated and monitored to help to inform policy and future practice.

Assessment of self-medication in population buying antibiotics in pharmacies: a pilot study from Beirut and its suburbs

This study was performed to assess self-medication with antibiotics (ATB) in the general population and its associated factors. Face to face interviews using a structured questionnaire were conducted to collect data from ATB buyers in pharmacies in Beirut area. Data were analyzed using descriptive statistics and Chi-square test. A multivariate logistic regression was performed to predict self-medication. 42 % of 319 participants were buying ATB without prescription and the pharmacists were the main helpers (18.8 %). Saving time was the most common cited reason for self-medication with ATB (39.7 %). The logistic regression showed that self-medication with ATB was significantly increased among men [OR = 3.03; IC 95 % (2-5)]; it was associated with sore throat symptoms [OR = 2.38; IC 95 % (1.40-4.03)] and the ignorance of ATB use dangers [OR = 3.33; IC 95 % (1.96-5.55)]. In addition, it was prominent with amoxicillin [OR = 1.93; IC 95 % (0.17-1.34)], and inversely related to quinolone [OR = 0.44; IC 95 % (0.18-1.03)] and cephalosporin families [OR = 0.28; IC 95 % (0.11-1.68)] or other ATB classes [OR = 0.96; IC 95 % (0.41-2.22)]. Self-medication with antibiotics is a relatively frequent problem in Beirut area. Interventions are required to reduce antibiotic misuse.

A survey of public knowledge and behavior related to antibiotic use and resistance in community pharmacies in Khartoum state

Antibiotic use is reviewed as a key driver for increase and spread of antibiotic resistance. The public play a key role in the emergency and spread of bacterial resistance. Patients' behavior, associated to their knowledge, attitudes and beliefs, may influence antibiotic prescribing. This survey explores knowledge, behavior and expectations of Sudanese general public with respect to antibiotic use and resistance. Method: A quantitative, cross-sectional survey based on a structured questionnaire include a sample of 300 participants represents the general public from Khartoum State interviewed during a 2- month period, from the 1st February to 31th of March in 2012. Statements on behavior and attitudes indicated that (70.0%) of respondents use antibiotics to get rid of the cold. (34.0%) of them agreed to stop taking antibiotics when feel better and (54.0%) left over antibiotics. Over half of the respondents (64.0%) had correct knowledge that antibiotics are effective against bacteria, but (40.0%) believe that antibiotics are effective against viruses. (82.0%) knew that bacteria can be resistant to antibiotics, and (72.0%) acknowledged that the use of antibiotics can increase the bacterial resistance. Most of the respondents (78.0%) obtained their information on antibiotic use from pharmacy personnel. Non-affordability of doctors’ fees is the main reason for the patients surveyed (30.0%) to seek antibiotics in pharmacies. Our findings highlight the need to devise effective interventions to deal with self-medication with antibiotics in Sudan.