RATIONALITY OF ANTIBIOTIC USE: A SURVEY REPORT Research article Safila Naveed 1, Fatima Qamar 1,Syeda Sarah Abbas 1,2, Syeda Zainab 2 Manahil Khalid 1, Javeria Idrees 1,Sadia Safdar 1, Haniyah Mansoor 1,Sana Sohail 1 1 Faculty of Pharmacy Jinnah University for women Karachi 2 Faculty of Pharamcy University of Karachi Corresponding Author: Email: safila117@yahoo.com, fatimamudassar2009@hotmail.com ABSTRACT Antibiotics are influential medicines that scrap bacterial infections. If used appropriately, antibiotics can save lives. They also execute bacteria or keep them from reproducing. Our study is based on the rationality of antibiotic use and awareness of antibiotic use among general population. A survey was conducted to find out whether the use of antibiotics is rational or irrational. Satisfactory results are obtained after a thorough research showing good awareness of antibiotic use among individuals and minimum irrational use of antibiotics. Our study reveals that 73% people complete the antibiotic therapy as prescribed by a doctor where as 27% people do not complete the antibiotic course. About 57% people continue the antibiotic therapy as prescribed by doctor, 32% people stop using antibiotics when they start feeling better and 11% people stop the antibiotic therapy when they finish the medication. KEY WORDS: Antibiotic, irrational use, resistance INTRODUCTION: Consumption of drugs without a physician advice to treat self-recognized illnesses or symptoms is referred to Self Medication (WHO Guidelines 2003). It is not only associated with OTC (over-the-counter) medications rather it is also associated with (POM) prescription-only medicines (Pereira FS et al., 2007). A community pharmacist may guide the patient on drug choice and the responsible use of approved OTC drugs and may give the concept of self-care (WHO 2013). Antibiotics are drugs used to treat bacterial infections, but their use can be harmful if not used properly (Mehrdad Askarian et al., 2012), even though the use of antimicrobial agents worldwide and their effectiveness is absolute (Ibeawuchi R et al., 2002). Their abuse is a worldwide dilemma in developed as well as developing countries that causes unnecessary expenditures, interactions, adverse drug reactions, and develops resistance. The undesirable effects of the irrational use of antibiotics include enteropathy, enduring illness, and high mortality rate. The main concern in modern medicine is selecting an appropriate antibiotic. The choice of drug is strongly dependent on the appropriate diagnosis of the disease and adequate knowledge of antimicrobial issues (Promise Madu Emeka et al., 2012). Without considering these factors the use of antibiotics can cause resistance against microorganisms so as to contribute to excessive costs in health care services (Sawair FA 2009).
Antibiotics are possibly the most frequently prescribed anti-infective agents by both public and private healthcare sectors with 9.55 defined daily dose/1,000 population/day. The most commonly used group is penicillin. In the year 2000, the World Health Organization (WHO) report 3 important issues for public participation in emergence of drug resistance to: 1- improving access to medical services; 2- reducing unnecessary use of antimicrobial drugs and taking a full course of treatment; and 3- not sharing medication with other people or keeping part of the course for another occasion. Antimicrobial agents plays a key role in developing resistance and this discriminating pressure comes from a combination of overuse world wide, chiefly for minor infections, maltreatment due to lack of access to appropriate treatment and underuse due to lack of financial support to complete treatment courses (WHO 2001). METHODOLOGY: A survey was conducted to determine irrational use of antibiotics among the public of Karachi Pakistan. A questionnaire was designed that contained seven questions. Out of seven, four questions were made to assess individual s knowledge about antibiotic use and three questions were for the assessment of rationality of antibiotic use. The sample size was one hundred and the questionnaire was distributed among general public. RESULT AND DISCUSSION: Antibiotics are the drugs used to treat bacterial infections but their misuse is a matter of concern. One of the most important problems associated with the use of antibiotics is drug resistance due to which an antibiotic becomes ineffective in treating an infection caused by the bacteria that has developed resistance against it. Therefore, it is very important to control irrational use of antibiotics all over the world. We have done these types of socioeconomic and preventable general health surveys before in our former research studies (Safila et al., 2015). Following are the results based on awareness of antibiotic use among general public: about 43% of the population knows that antibiotics are used to treat bacterial infections where as 57% population includes those individuals who think that an antibiotic can be used to treat many different conditions irrespective of the causative organism, and those who don t even know why antibiotics are used Figure 1. About 51% people think that an antibiotic can treat viral infections where as 49% people think that it cannot treat viral infections and it is only effective in the treatment of bacterial infections Figure 2. 35% people think that the same antibiotic will be effective in the treatment of the same infection in future where as 65% people think that the use of same antibiotic will be ineffective Figure 3. 77% people start antibiotic therapy on doctor s advice, 10% on pharmacist s advice and 13% on personal experience Figure 4. 73% people complete the antibiotic therapy as prescribed by a doctor where as 27% people do not complete the antibiotic course Figure 5. 57% people continue the antibiotic therapy as prescribed by doctor, 32% people stop using antibiotics when they start feeling better and 11% people stop the antibiotic therapy when they finish the medication Figure 6. CONCLUSION: Antibiotics are the drugs used to treat bacterial infections but their misuse is a matter of concern. One of the most important problems associated with the use of antibiotics is drug resistance due to which an antibiotic becomes ineffective in treating an infection caused by the bacteria that has developed resistance against it. Therefore, it is very important to control irrational use of antibiotics all over the world. Irrational use of antibiotics can be controlled by spreading awareness about antibiotics, by increasing patient s compliance to the antibiotic therapy and by stopping antibiotic self-medication. Results of this research show that most of the people are aware of antibiotics but still need to be educated about their use. Secondly, the results show minimum irrational use and maximum rational use of antibiotics.
Figure 1: Parentages showing Knowledge about the correct use of Antibiotics Figure 2: Knowledge about the Spectrum of Antibiotics
Figure 3: Knowledge about the effectiveness of Antibiotics for the future disease Fig; 4 People start antibiotic therapy on the advice of
Figure 5: Percentages of the Patients completing their antibiotic therapy Figure 6: when Patients stop their antibiotic therapy
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