Project description:Self-medication and antibiotic utilization without healthcare oversight may lead to delayed appropriate treatment, transmission of communicable infections, untoward adverse events, and contribute to antimicrobial resistance. Previous data suggest people obtain over-the-counter (OTC) animal antibiotics for their personal use. This study examined the availability of OTC fish antibiotics online and the documented intent for self-medication. The authors conducted a web-based cross-sectional study using Google search engine to identify vendor websites selling fish antibiotics in the United States. Vendor websites were included if product information, consumer reviews, and comments were publicly available. Nine fish antibiotics were chosen due to their possibility of having consequences to human misuse. The cost and availability of fish antibiotics was recorded. The proportion of reviews and comments related to human consumption was calculated. Consumer review traffic based on "likes" and "dislikes" received was compared between human- and non-human consumption-related reviews. Selected fish antibiotics were purchased and evaluated for physical appearance and compared to FDA-approved available equivalents. We found 24 website vendors with online ordering available for OTC fish antibiotics. Cost varied significantly by antibiotic and quantity ranging from USD $8.99 to $119.99. There were 2,288 reviews documented for the 9 selected antibiotics being sold. Among consumer reviews, 2.4% were potentially associated with human consumption. Human consumption-related reviews constituted 30.2% of all "likes" received and 37.5% of all "dislikes" received. Human consumption-related reviews received an average of 9.2 likes compared to 0.52 likes for non-human consumption-related reviews. The 8 fish antibiotics purchased were consistent with FDA-approved equivalents in physical appearance. Although infrequent, antibiotics intended for fish use are being purchased online without a prescription for self-medication to circumvent professional medical care. Reviews related to human consumption generate significant online traffic compared to reviews unrelated to human consumption.

Project description:IntroductionThe prevalence of self-medication of antibiotics has been revealed in various studies. The main aim of this work is to investigate the frequency of self-medication in children under 6 years and the factors affecting it.MethodsThis is a population-based cross-sectional study conducted in the Arak metropolitan in the center of Iran from January 2019 to January 2020. We used stratified random sampling to determine recruitment criteria. As 1754 households were invited to the study that 1483 were approved to participate. Children's data were obtained by the interview with their mothers. In order to define self-medication consumption of antibiotics, it was adapted between annually maternal self-reported consumption of antibiotics among their children and history of received antibiotics registered in insurance services during the same time period. Logistic regression models were exploited to obtain odds ratios and 95% confidence intervals.ResultsMean age of mothers was 31.8 years (SD = 5.4), 52.1% of the children were boys. Annually self-medication of antibiotic consumption was estimated 61.6% (n = 914). Based on the logistic regression analysis, in the adjusted analysis, girls were associated with self-medication consumption of antibiotics lower than boys' children (p = 0.016). Older mothers were lower self-medication consumption of antibiotics than youngers (p = 0.001). Moreover, the permanent job of fathers was associated with lower self-medication consumption of antibiotics than temporarily and unemployment (p = .001). The odds of self-medication consumption of antibiotics were increasing with the increase in age of children (OR: 1.21, CI95%: 1.12, 1.31 and p = 0.001). The increase in parity has been a significant association with the self-medication consumption of antibiotics (OR: 1.64, CI95%: 1.38, 1.95and p = 0.001).ConclusionResults of this study show that some factors such as children's age, gender, mother's age, father's occupational status, and parity are the determinants that significantly impact the self-medication prevalence.

Project description:ObjectivesTo investigate leftover antibiotics and their influence on self-medication with antibiotics (SMA) for Chinese children, and further explore the different influences of leftovers from two main sources: previous prescriptions and pharmaceutical purchases.DesignA cross-sectional questionnaire study.SettingThe participants were approached through kindergartens and primary schools as well as in vaccination clinics.ParticipantsA total of 9526 parents from three Chinese provinces whose children were aged 0-13 years completed the survey.Outcome measuresThe prevalence of keeping antibiotics at home for children and the proportion of leftover antibiotics from two main sources were measured by a self-administrated questionnaire. Logistic regression models were established to examine the association between keeping antibiotics at home and SMA for children, specifically the risks of leftovers from two main sources.ResultsOverall, 4580 (48.1%) reported keeping antibiotics at home for children. Among those who had leftovers, 2891 (63.1%) reported that their leftovers came from previous prescriptions and 1619 (35.3%) reported that their leftovers came from pharmaceutical purchases. Mothers, older age of child, higher household income, higher education level and medical background were significantly associated with keeping antibiotics at home. Keeping antibiotics at home was significantly associated with SMA for children (adjusted OR=4.91, 95% CI 3.84 to 6.28). Particularly, compared with parents who did not keep antibiotics at home, parents who kept leftover antibiotics from previous prescriptions and those whose leftovers came from pharmaceutical purchases were 3.80 (95% CI 2.89 to 5.00) and 6.45 (95% CI 4.89 to 8.51) times more likely to engage in SMA for children, respectively.ConclusionsKeeping antibiotics at home for children was pervasive in China. Most leftovers came from previous prescriptions, while those from pharmacies had a higher risk of SMA for children.

Project description:Background and aimDental treatments have been limited to emergency care in many countries worldwide due to the global rapid spread of coronavirus disease-2019 (COVID-19). Fear of contracting the disease in dental clinics has also altered the pattern of dental visits and self-medication. The present study compared self-medication with antibiotics (SMA) and the pattern of dental visits before and after the emergence of COVID-19 pandemic in a referral dental clinic in the north of Iran.Materials and methodsThe data for the present cross-sectional study was collected from 756 patient records retrieved from the archives of the Faculty Clinic of Rasht School of Dentistry during two separate periods: before the COVID-19 pandemic from mid-November 2019 to mid-February 2020, and after the pandemic emergence from mid-April to mid-July 2020. In addition to demographic variables namely age, gender, and place of residence of patients, their smoking status, chief complaint, and SMA were also extracted from patient records. The Chi-square test and binary logistic regression models with 95% confidence interval served for statistical analysis.ResultsIn total, 756 patient records (412 records from the pre-pandemic period and 344 records from the post-pandemic period) were evaluated. SMA was significantly more prevalent after the pandemic compared to that before pandemic (OR = 3.39, 95% CI = 2.43-4.73, P<0.001). The number of patients who smoke significantly decreased after the pandemic by 6.6% compared to that in pre-pandemic period. Dental pain, pus discharge, and abscess as the chief complaints of patients were significantly more prevalent during the post-pandemic period; while, dental checkups, tooth hypersensitivity, and esthetic dental problems were significantly more frequent as the chief complaints of patients during the pre-pandemic period.ConclusionThere is indication that during the COVID-19 pandemic, SMA and prevalence of acute dental problems in patients have increased. With regard to the consequences of SMA, there is a need to raise public awareness on this matter.

Project description:ObjectivesThe study aimed at identifying the commonly used non-prescribed antibiotics (NPAs) and the main health conditions leading to the practices of self-medication with antibiotics (SMAs) in Maputo city, Mozambique.DesignCross-sectional qualitative study based on individual and group interviews.SettingThe study was conducted in nine pharmacies of three socioeconomic areas of Maputo city, from October 2018 to March 2019.ParticipantsThe study included 32 pharmacy clients and 17 pharmacists. The pharmacy clients included men 10 (31%) and women 22 (69%) ranging from 19 to 67 years while the pharmacists included men 6 (35,3%) and women 11 (64,7%) with ages ranging from 24 to 47 years.FindingsThe majority of the pharmacy clients 30 (93.75%) admitted frequent use of NPAs, 15 (88.2%) out of the 17 pharmacists admitted dispensing NPAs. While the majority of the participants (16) mentioned the use of amoxicillin, also known as 'two colours medicine', 14 mentioned the use of cotrimoxazole and seven mentioned amoxicillin with clavulanic acid. Two to five participants also used tetracycline, ciprofloxacin, azithromycin, doxycycline, erythromycin, metronidazole and phenoxymethylpenicillin. The above mentioned NPAs were used to treat self-perceived sore throat, fever, pain, cough, vaginal discharge, eye problems, the common influenza, urinary infections, respiratory tract infections, wounds and toothaches.ConclusionsAntibiotics are perceived as essential medical resources to manage health and illnesses. While taking an active role in their health-disease process, participants commonly used amoxicillin, 'two colours', cotrimoxazole and amoxicillin with clavulanic acid to manage their health and that of their families. In this sense, the practices of SMAs were perceived as part of the self-care process and not necessarily as misuse of antibiotics. A wideunderstanding of health-seeking beliefs and behaviours regarding the utilisation of antibiotics is needed to inform public health experts, health policymakers and other stake-holders in designing and implementing public health education and health promotion programsat all levels in Mozambique.

Project description:BackgroundThere is an increasing trend on the practices of parental self-medication with antibiotics (PSMA) around world, accelerating the antibiotic abuse. This study aims to examine the nationality differences in the practices of PSMA and knowledge, attitudes and practices (KAP) toward antibiotic use, and understand the practices of PSMA among parents of various nationalities in China.MethodsA cross-sectional study based on a structured questionnaire survey was conducted in Xi'an, Shaanxi Province, China, from September 2018 to October 2018. A total of 299 respondents participated in. The practices of PSMA (a dichotomous variable) and KAP toward antibiotic use (a continuous variable) served as dependent variables. Participant's nationality was regarded as the independent variable. Binary logistic regression and ordinary least square regression were employed to examine the association between parent's nationality and the practices of PSMA, and KAP toward antibiotic use, respectively.Results121 (40.88%) Chinese, 100 (33.76%) other Asians and 75 (25.34%) Occidentals were included in final analysis, with a sample size of 296. Chinese were more likely to practice PSMA (OR = 7.070; 95% CI 1.315, 38.01), with worse knowledge (Coef. = - 0.549; 95% CI - 1.021, - 0.078), attitudes (Coef. = - 3.069; 95% CI - 4.182, - 1.956) and practices (Coef. = - 1.976; 95% CI - 3.162, - 0.790) toward antibiotic use, compared to their Occidental counterparts. The main reasons for the practices of PSMA were enough previous medication experience (80.49%) and same ailments with no need to see a doctor (39.02%), with common symptoms such as fever (60.98%) and cough (58.54%). Purchasing antibiotics at pharmacies (92.08%) and using leftover antibiotics (26.83%) were usual approaches.ConclusionsThe study highlights the gaps in the practices of PSMA and KAP toward antibiotic use among parents of different nationalities. The access to obtain antibiotics from pharmacies reflects the pharmacists' unaware of laws on prescription of antibiotics, fierce competition in the pharmacy market, and the government's lax supervision in China. It suggests the need to improve pharmacists' training, enforce current legislations on pharmacy market regarding the sale of antibiotics, and provide practical and effective educational interventions for residents about antibiotic use.

Project description:ObjectivesSelf-medication with antibiotics (SMA) contributes significantly to the emergence of antimicrobial resistance (AMR), especially in low-income countries including Bangladesh. This study aimed to generate evidence on the self-reported prevalence of antibiotic self-medication and its determinants among indigenous people residing in Bangladesh's Chittagong Hill Tracts (CHT) districts.DesignThis study used a cross-sectional design with data collected through a survey using a semi-structured questionnaire.SettingThis study was conducted from late January to early July 2021; among different indigenous group populations aged 18 years or more olders residing in the three districts of CHT.ParticipantsA total of 1336 indigenous people residing in Bangladesh's CHT districts were included.Primary outcome and explanatory variablesThe primary outcome measure was SMA while explanatory variables were socio-demographic characteristics, health status of participants, and knowledge of antibiotics usage and its side effects.ResultsAmong the study participants, more males (60.54%) than females (51.57%) reported using antibiotics. The SMA rate was high among individuals with education levels below secondary (over 50%) and those in the low-income group (55.19%). The most common diseases reported were cough, cold and fever, with azithromycin being the most frequently used antibiotic. Levels of education, family income, having a chronic illness and place of residence were found to be the significant predictors of having good knowledge of antibiotic use as found in the ordered logit model. Findings from a logistic regression model revealed that men had 1.6 times higher odds (adjusted OR (AOR) 1.57; 95% CI 1.12 to 2.19) of SMA than women. Participants with ≥US$893 per month family income had lowest odds (AOR 0.14; 95% CI 0.03 to 0.64) of SMA than those who earned <US$417. Participants living in Rangamati districts had a lower risk of SMA (…) than those in Bandarban district. rate of SMA (AOR 0.52; 95% CI 0.30 to 0.90) than those in Bandarban district.ConclusionMale gender, family income, place of residence and knowledge of antibiotics were the significant predictors of antibiotic self-medication. Hence, it is important to streamline awareness-raising campaigns at the community level to mitigate the practice of SMA in indigenous people and ultimately address the devastating effects of Antimicrobial resistance (AMR) in Bangladesh.

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Self-medication with antibiotics in Georgian population

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