Prevalence and determinants of self-medication with antibiotics among general population in Afghanistan,Expert Review of Anti-infective Therapy

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Prevalence and determinants of self-medication with antibiotics among general population in Afghanistan
Expert Review of Anti-infective Therapy ( IF 5.7 ) Pub Date : 2021-07-15 , DOI: 10.1080/14787210.2021.1951229
Rohullah Roien ₁ , Divya Bhandari ₂ , Sayed Mohammad Reza Hosseini ₃ , Sayed Hussain Mosawi ₃ , Mohammad Arif Ataie ₁ , Akihiko Ozaki _{2,

4} , Cecilia Acuti Martellucci ₅ , Yasuhiro Kotera ₆ , Mohammad Hossien Delshad _{7,

8} , Toyoaki Sawano ₉ , Shohra Qaderi _{1,

10} , Ranjit Sah ₁₁ , Tetsuya Tanimoto ₂ , Fatemeh Pourhaji _{7,

8} , Abbas Ali Ramoozi ₁ , Shamim Arif ₁ , Shamsullah Mehtarkhel ₁ , Shekiba Madadi ₁ , Sayed Hamid Mousavi ₁

Affiliation

Medical Research Center, Kateb University, Kabul, Afghanistan.
Medical Governance Research Institute, Tokyo, Japan.
Medical Sciences Research Center, Ghalib University, Kabul, Afghanistan.
Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan.
Department of Medical Sciences, University of Ferrara, Italy.
Human Sciences Research Centre, University of Derby, Derby, UK.
Department of Public Health Department, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan.
Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.

ABSTRACT

Objective

Self-medication with antibiotics (SMA) is a common cause of antibiotic resistance, a major public health problem. This research aimed to identify the prevalence of SMA and explore reasons for practicing SMA among people living in Kabul, Afghanistan.

Methods

A community-based cross-sectional study was conducted from May to November 2017 in 12 community pharmacies operating across Kabul, Afghanistan. Multivariable logistic regression was conducted to identify the factors associated with the use of SMA.

Results

Out of 385 participants, 282 (73.2%) practiced SMA during the last year. Overall, 241 (62.6%) were ‘very concerned’ about the use of SMA, and 156 (40.5%) highlighted it is bad to practice SMA. The top three antibiotics used for self-medication were penicillin (ATC class: J01C), metronidazole (ATC: P01AB01), and ceftriaxone (ATC: J01DD04). Economic problems, lack of time to visit doctors, and ease of use were cited as the main reasons for practicing SMA. Furthermore, female participants were less likely to practice SMA compared to male counterparts.

Conclusion

While efforts should be directed to enforce strict drug regulations system and awareness programs, priority should be given to provide accessible, affordable, and quality health care services to increase citizen’s compliance to appropriate drug prescriptions.

中文翻译：

阿富汗普通人群中抗生素自我用药的流行率和决定因素

摘要

客观的

使用抗生素进行自我用药 (SMA) 是抗生素耐药性的常见原因，这是一个重大的公共卫生问题。本研究旨在确定 SMA 的患病率，并探讨在阿富汗喀布尔生活的人们实施 SMA 的原因。

方法

2017 年 5 月至 2017 年 11 月，在阿富汗喀布尔的 12 家社区药房开展了一项基于社区的横断面研究。进行多变量逻辑回归以确定与使用 SMA 相关的因素。

结果

在 385 名参与者中，282 名（73.2%）在去年练习了 SMA。总体而言，241 人 (62.6%) 对 SMA 的使用“非常担心”，156 人 (40.5%) 强调练习 SMA 是不好的。用于自我用药的前三种抗生素是青霉素（ATC 分类：J01C）、甲硝唑（ATC：P01AB01）和头孢曲松（ATC：J01DD04）。经济问题、没有时间看医生和易用性被认为是实施 SMA 的主要原因。此外，与男性参与者相比，女性参与者不太可能练习 SMA。