Community consumption of antibacterial drugs within the Jordanian population: sources, patterns and appropriateness

Self-medication with antibiotics in Jordanian population

OBJECTIVES

A survey was conducted to estimate the prevalence of self-medication with antibiotics in Jordan and evaluate the factors associated with antibiotic misuse.

METHODS

Validated questionnaire was used to collect data from a sample of 1943 households (9281 persons) selected from among different cities in Jordan.

RESULTS

842 (39.5%) of 2133 antibiotic users identified via the survey had used antibiotics without a prescription within a one-month study period. Self-medication with antibiotics was found to be significantly associated with age, income, and level of education. The main reason for self-medication as reported by the participants was their previous experience on the efficacy of treatment. The main sources of antibiotics were the previously prescribed pharmaceuticals stored in the household and those purchased in pharmacies.

CONCLUSION

The prevalence of self-medication with antibiotics in Jordan is alarmingly high. Given the growing global resistance to antibiotics and the documented health problems related to their inappropriate use, our findings may have major public health policy implications in Jordan.

Evaluation of immunosuppression induced by metronidazole in Balb/c mice and human peripheral blood lymphocytes

The immunomodulatory effect of metronidazole (MTZ), a nitroimidazole drug used as an antiprotozoal and antibacterial agent, was investigated using Balb/c mice and human peripheral blood lymphocytes. For in vivo studies, mice were divided into six groups, six animals per group, group I received vehicle alone while the other groups (II-VI) received intraperitoneal injections of MTZ (14, 28, 42, 57, and 114 mg/kg) respectively. For in vitro studies different concentrations of MTZ (5, 10, 50, and 200 microg/ml) were used. MTZ showed a significant decrease in the percentage of circulating neutrophils and monocytes and an increase in the percentage of circulating lymphocytes. The relative weights of spleen as well as the relative body weight gain also decreased. Detectable changes were seen in the histology of spleen and thymus. Splenic plaque-forming cells (PFC), hemagglutination (HA) titer to sheep red blood cells (SRBC), spleenocytes and human peripheral blood lymphocytes proliferation (MLR) were markedly suppressed by MTZ treatment as compared to control group. MTZ also induced a significant decrease in delayed-type hypersensitivity (DTH) reaction, phagocytic activity (assessed by phagocytic capacity and phagocytic index) as well as TNF-alpha secretion by peritoneal macrophages. These observations indicate that MTZ significantly induced immunosuppression in mice and in human peripheral blood lymphocytes.

Self-medication patterns in Amman, Jordan

OBJECTIVE

The classification of medicine as Prescription-Only-Medicine (POM) and Over-The-Counter (OTC) drugs in Jordan is present but not yet enforced on community pharmacies, the fact that allows access of the public to a wider range of medications that otherwise are provided only on prescription. This, of course, has its implications on safety and effectiveness of the pharmacotherapy in question. This research aims to establish a baseline data concerning the extent of self-medication among Jordanians, and to assess possible factors associated with self-medication, so that future interventions can be documented and planned.

SETTING

A total of 155 out of Amman's 900 community pharmacies.

METHODS

A cross-sectional observational study using a pre-piloted questionnaire was conducted. Over 800 customers who visited the pharmacies over a period of 4 months were interviewed and their non-prescription drug requests patterns were recorded to assess the prevalence of self-medication and offered justification.

RESULTS

Self-medication was a common practice among Jordanians (42.5%). The variable that was associated with extent of self-medication was respondents' age, where patients younger than 16 years and those older than 60 years were less likely to self-treat. The most common reasons for self-medication were that the ailments were too minor to see a doctor (46.4%), the long waiting time to be seen by doctors (37.7%) and avoiding the cost of doctors' visits (31.4%). People tended to select medication based on advice received from pharmacy staff (14.2%), friends/neighbors (17.6%) or informal advice from other health professionals like dentists and nurses (21.9%). Alternatively, patients selected products based on their previous experiences with similar symptoms (27%) or similar diseases (33.5%).

CONCLUSIONS

Self-medication is a common health care practice in Jordan, where people are becoming increasingly familiar with drugs and their brand names. Self-medication behavior varied significantly with a number of socio-economic factors. Unfortunately, only a small percentage of patients engaged pharmacy personnel in therapeutic consultations beyond briefly mentioning a symptom.