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Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

“Antibiotics kill things very quickly” - consumers’ perspectives on non-prescribed antibiotic use in Saudi Arabia

Authors: Faten Alhomoud, Zainab Aljamea, Lama Basalelah

Published in: BMC Public Health | Issue 1/2018

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Abstract

Background

In recent decades, the Kingdom of Saudi Arabia has seen an exponentially growing antibiotic resistance, which is exacerbated by the use of antibiotics without a prescription and other various factors. However, no published data are available on factors influencing non-prescription use of antibiotics among the general public in Saudi Arabia using an in-depth interview technique.

Methods

Semi-structured interviews were carried out with 40 Saudi participants from the Eastern Province of Saudi Arabia, selected via snowball sampling technique. Participants were enrolled based on the following inclusion criteria: 18 years of age or older and had self-medicated themselves with antibiotics in the past two years. Data collection was continued until data saturation was attained. Interviews were audiotaped, transcribed verbatim and analysed using NVivo 10 software.

Results

Participants (80% female) had a mean (SD) age of 30 years (10.2). Self-medication with antibiotics was associated with various inappropriate antibiotic use behaviours and negative outcomes such as antibiotic resistance, treatment failures and adverse events. Interviews revealed that different reasons contribute to the rise of self-medication with antibiotics, ranging from difficulty accessing healthcare services, participant’s cultural beliefs and practices, lack of knowledge about antibiotics and antibiotic resistance, and weak regulatory enforcement.

Conclusions

The findings of the present study will aid in generating data that may provide an insight when designing future interventions to promote public health awareness regarding safe and effective use of antibiotics.
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Literature
1.
go back to reference Goossens H, Ferech M, Vander Stichele R, Elseviers M. ESAC project group. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet. 2005;365(9459):579–87.CrossRef Goossens H, Ferech M, Vander Stichele R, Elseviers M. ESAC project group. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet. 2005;365(9459):579–87.CrossRef
2.
go back to reference Bronzwaer SL, Cars O, Buchholz U, Mölstad S, Goettsch W, Veldhuijzen IK. European antimicrobial resistance surveillance system. A European study on the relationship between antimicrobial use and antimicrobial resistance. Emerg Infect Dis. 2002;8(3):278–82.CrossRef Bronzwaer SL, Cars O, Buchholz U, Mölstad S, Goettsch W, Veldhuijzen IK. European antimicrobial resistance surveillance system. A European study on the relationship between antimicrobial use and antimicrobial resistance. Emerg Infect Dis. 2002;8(3):278–82.CrossRef
5.
go back to reference Nafisaha S, Nafesa S, Alamery A, Alhumaidb M, AlMuhaidib H, Al-Eidan F. Over-the-counter antibiotics in Saudi Arabia, an urgent call for policy makers. J Infect Public Health. 2017;10(5):522–6.CrossRef Nafisaha S, Nafesa S, Alamery A, Alhumaidb M, AlMuhaidib H, Al-Eidan F. Over-the-counter antibiotics in Saudi Arabia, an urgent call for policy makers. J Infect Public Health. 2017;10(5):522–6.CrossRef
7.
go back to reference Anghel IB, Craciun C. Self-medication with over-the-counter drugs and antibiotics in Romanian consumers: a qualitative study. Cogn Brain Behav. 2013;17(3):215–35. Anghel IB, Craciun C. Self-medication with over-the-counter drugs and antibiotics in Romanian consumers: a qualitative study. Cogn Brain Behav. 2013;17(3):215–35.
8.
go back to reference Centers for Disease Control and Prevention (CDC) [internet]. About antimicrobial resistance. Atlanta, Georgia: US Department of Health and Human Services, Centers for Disease Control and Prevention. 2013. www.cdc.gov/drugresistance/about.html. Accessed 29 September 2017. Centers for Disease Control and Prevention (CDC) [internet]. About antimicrobial resistance. Atlanta, Georgia: US Department of Health and Human Services, Centers for Disease Control and Prevention. 2013. www.​cdc.​gov/​drugresistance/​about.​html. Accessed 29 September 2017.
9.
go back to reference Ocan M, Obuku EA, Bwanga F, Akena D, Richard S, Ogwal-Okeng J, et al. Household antimicrobial self-medication: a systematic review and meta-analysis of the burden, risk factors and outcomes in developing countries. BMC Public Health. 2015;15(742). https://doi.org/10.1186/s12889-015-2109-3. Ocan M, Obuku EA, Bwanga F, Akena D, Richard S, Ogwal-Okeng J, et al. Household antimicrobial self-medication: a systematic review and meta-analysis of the burden, risk factors and outcomes in developing countries. BMC Public Health. 2015;15(742). https://​doi.​org/​10.​1186/​s12889-015-2109-3.
11.
go back to reference Balkhy H, Assiri A, AlMousa H, Al-Abri S, Al-Katheeri H, Alansari H, et al. The strategic plan for combating antimicrobial resistance in gulf cooperation council states. J Infect Public Health. 2016;9(4):375–85.CrossRef Balkhy H, Assiri A, AlMousa H, Al-Abri S, Al-Katheeri H, Alansari H, et al. The strategic plan for combating antimicrobial resistance in gulf cooperation council states. J Infect Public Health. 2016;9(4):375–85.CrossRef
13.
14.
go back to reference Behling O, Law K. Translating questionnaires and other research instruments: problems and solutions. London: Sage Publication; 2000. ISBN 9780761918240CrossRef Behling O, Law K. Translating questionnaires and other research instruments: problems and solutions. London: Sage Publication; 2000. ISBN 9780761918240CrossRef
15.
go back to reference Belkina T, Alwarafi A, Hussein Eltom E, Tadjieva N, Kubena A, Vlcek J. Antibiotic use and knowledge in the community of Yemen, Saudi Arabia, and Uzbekistan. J Infect Dev Ctries. 2014;8(4):424–9.CrossRef Belkina T, Alwarafi A, Hussein Eltom E, Tadjieva N, Kubena A, Vlcek J. Antibiotic use and knowledge in the community of Yemen, Saudi Arabia, and Uzbekistan. J Infect Dev Ctries. 2014;8(4):424–9.CrossRef
16.
go back to reference Emeka PM, Al-Omar M, Khan TM. Public attitude and justification to purchase antibiotics in the eastern region Al Ahsa of Saudi Arabia. Saudi Pharm J. 2014;22(6):550–4.CrossRef Emeka PM, Al-Omar M, Khan TM. Public attitude and justification to purchase antibiotics in the eastern region Al Ahsa of Saudi Arabia. Saudi Pharm J. 2014;22(6):550–4.CrossRef
22.
go back to reference Klepser DG, Bisanz SE, Klepser ME. Cost-effectiveness of pharmacist-provided treatment of adult pharyngitis. Am J Manag Care. 2012;18(4):e145–54.PubMed Klepser DG, Bisanz SE, Klepser ME. Cost-effectiveness of pharmacist-provided treatment of adult pharyngitis. Am J Manag Care. 2012;18(4):e145–54.PubMed
23.
go back to reference Van I, Stolk RP, Krans HM, Grobbee DE, Schrijvers AJ. Management of type 2 diabetes: a challenge for patient and physician. Patient Educ Couns. 2000;40(2):187–94.CrossRef Van I, Stolk RP, Krans HM, Grobbee DE, Schrijvers AJ. Management of type 2 diabetes: a challenge for patient and physician. Patient Educ Couns. 2000;40(2):187–94.CrossRef
24.
go back to reference Ashiru-Oredope D. Community pharmacist must help conserve antibiotics. Pharm J. 2014;24:896–900. Ashiru-Oredope D. Community pharmacist must help conserve antibiotics. Pharm J. 2014;24:896–900.
25.
go back to reference Earnshaw S, Monnet DL, Duncan B, O'Toole J, Ekdahl K, Goossens H. European antibiotic awareness day technical advisory committee; European antibiotic awareness day collaborative group. 2008 - the first Europe - wide public information campaign on prudent antibiotic use: methods and survey of activities in participating countries. Euro Surveill. 2009;14(30):19280.CrossRef Earnshaw S, Monnet DL, Duncan B, O'Toole J, Ekdahl K, Goossens H. European antibiotic awareness day technical advisory committee; European antibiotic awareness day collaborative group. 2008 - the first Europe - wide public information campaign on prudent antibiotic use: methods and survey of activities in participating countries. Euro Surveill. 2009;14(30):19280.CrossRef
26.
go back to reference Zarb P, Borg MA. Consumption of antibiotics within ambulatory care in Malta. Malta Med J. 2011;23(2):13–8. Zarb P, Borg MA. Consumption of antibiotics within ambulatory care in Malta. Malta Med J. 2011;23(2):13–8.
30.
go back to reference Stålsby Lundborg C, Tamhankar AJ. Understanding and changing human behaviour – antibiotic mainstreaming as an approach to facilitate modification of provider and consumer behaviour. Ups J Med Sci. 2014;119(2):125–33.CrossRef Stålsby Lundborg C, Tamhankar AJ. Understanding and changing human behaviour – antibiotic mainstreaming as an approach to facilitate modification of provider and consumer behaviour. Ups J Med Sci. 2014;119(2):125–33.CrossRef
31.
go back to reference Ajzen I. The theory of planned behaviour. Organ Behav Hum Decis Process. 1991;50(2):179–211.CrossRef Ajzen I. The theory of planned behaviour. Organ Behav Hum Decis Process. 1991;50(2):179–211.CrossRef
32.
go back to reference Prochaska JO, CC DC, Norcross JC. In search of how people change. Applications to addictive behaviours. Am Psychol. 1992;47(9):1102–14 39.CrossRef Prochaska JO, CC DC, Norcross JC. In search of how people change. Applications to addictive behaviours. Am Psychol. 1992;47(9):1102–14 39.CrossRef
33.
go back to reference Charani E, Edwards R, Sevdalis N, et al. Behaviour change strategies to influence antimicrobial prescribing in acute care: a systematic review. Clin Infect Dis. 2011;53(7):651–62.CrossRef Charani E, Edwards R, Sevdalis N, et al. Behaviour change strategies to influence antimicrobial prescribing in acute care: a systematic review. Clin Infect Dis. 2011;53(7):651–62.CrossRef
34.
go back to reference Prochaska JO, DiClemente C. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983;51(3):390–5.CrossRef Prochaska JO, DiClemente C. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983;51(3):390–5.CrossRef
35.
go back to reference Norcross JC, Krebs PM, Prochaska JO. Stages of change. J Clin Psychol. 2011;67(2):143–54.CrossRef Norcross JC, Krebs PM, Prochaska JO. Stages of change. J Clin Psychol. 2011;67(2):143–54.CrossRef
36.
go back to reference Jeragh-Alhaddad FB, Waheedi M, Barber ND, Brock TP. Barriers to medication taking among Kuwaiti patients with type 2 diabetes: a qualitative study. Patient Prefer Adherence. 2015;9:1491–503.CrossRef Jeragh-Alhaddad FB, Waheedi M, Barber ND, Brock TP. Barriers to medication taking among Kuwaiti patients with type 2 diabetes: a qualitative study. Patient Prefer Adherence. 2015;9:1491–503.CrossRef
37.
go back to reference Bavestrello L, Cabello A, Casanova D. Impact of regulatory measures in the trends of community consumption of antibiotics in Chile. Rev Med Chile. 2002;130(11):1265–72.CrossRef Bavestrello L, Cabello A, Casanova D. Impact of regulatory measures in the trends of community consumption of antibiotics in Chile. Rev Med Chile. 2002;130(11):1265–72.CrossRef
38.
go back to reference Cespedes A, Larson E. Knowledge, attitudes, and practices regarding antibiotic use among Latinos in the United States: review and recommendations. Am J Infect Control. 2006;34(8):495–502.CrossRef Cespedes A, Larson E. Knowledge, attitudes, and practices regarding antibiotic use among Latinos in the United States: review and recommendations. Am J Infect Control. 2006;34(8):495–502.CrossRef
Metadata
Title
“Antibiotics kill things very quickly” - consumers’ perspectives on non-prescribed antibiotic use in Saudi Arabia
Authors
Faten Alhomoud
Zainab Aljamea
Lama Basalelah
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-6088-z

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