Patient Attitudes and Patterns of Self-Medication with Antibiotics â€“ A Cross-Sectional Study in Bulgaria

Rositsa Dimova; Donka Dimitrova; Maria Semerdjieva; Ilian Doikov

doi:10.3889/oamjms.2014.118

Authors

Rositsa Dimova Medical University, Health Management, Health Economics and Primary Care, 15a V. Aprilov Str., Plovdiv 4002
Donka Dimitrova Medical University, Health Management, Health Economics and Primary Care, 15a V. Aprilov Str., Plovdiv 4002
Maria Semerdjieva Medical University, Health Management, Health Economics and Primary Care, 15a V. Aprilov Str., Plovdiv 4002
Ilian Doikov Medical University, Othorynolaringology, Plovdiv 4002

DOI:

https://doi.org/10.3889/oamjms.2014.118

Keywords:

self-medication, resistance, general practitioner, over-the-counter sales of antibiotics

Abstract

BACKGROUND: Self-medication with antibiotics is a major concern worldwide because of the high risks of antimicrobial resistance which may result in complicated courses of treatment, increased risk of death and excess costs to the healthcare systems.

AIM: The aim was to study the attitudes and self-medication patterns as related to the use of antibiotics among the general Bulgarian population and their determinants.

MATERIALS AND METHODS: A questionnaire-based survey was performed among the patients in two randomly selected municipalities. The questionnaire was mailed to 50 randomly selected adult patients by each of the 33 responding GPs thus addressing a total of 1650 participants.

RESULTS: A total of 1050 patients completed and returned the questionnaire. The observed self-medication rate was 43%. The women and the younger employees and students tended to have a higher self-medication rate. Fever (22%), sore throat and cough (12.7%) and discomfort when urinating (8.2%) were the most frequent patterns related to the practice of self-medication.

CONCLUSION: This analysis reported an extensive use of self-medication with antibiotics in the study population before the changes in the Bulgarian legislation. Younger age and social status (students, employed) were the most important socio-demographic patterns that had probably led towards self-medication with antibiotics.

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References

Smith R, Coast J, Millar RM, et al. Interventions against antimicrobial resistance: a review of the literature and exploration of modelling cost-effectiveness Global Forum for Health Research, WHO, Geneva, 2001.

Harbarth S, Samore MH. Antimicrobial resistance determinants and future control. Emerging Infectious Diseases. 2005;11:794-801. DOI: https://doi.org/10.3201/eid1106.050167

VÃ¤Ã¤nÃ¤nen MH., PietilÃ¤ K., Airaksinen M. Self-medication with antibiotics-does it really happen in Europe? Health Policy. 2006;77:166-71. DOI: https://doi.org/10.1016/j.healthpol.2005.07.001

Goossens H, Ferech M, Vander Stichele R, Elseviers M. Outpatient antibiotic use in Europe and association with resistance: A cross-national database study. Lancet. 2005;365:579-87. DOI: https://doi.org/10.1016/S0140-6736(05)17907-0

Antimicrobial Resistance Fieldwork: November - December 2009. Special Eurobarometer 338.http://ec.europa.eu/health/antimicrobial_resistance/docs/ebs_338_en.pdf, Access 07 July 2013.

Grigoryan L, Burgerhof JG, Degener JE, et al. Determinants of self-medication with antibiotics in Europe: the impact of beliefs, country wealth and the healthcare system. J Antimicrob Chemother. 2008;61:1172-9. DOI: https://doi.org/10.1093/jac/dkn054

Priest P, Yudkin P, McNulty C, Mant D. Antibacterial prescribing and antibacterial resistance in English general practice: Cross sectional study. BMJ. 2001;323:1037-41. DOI: https://doi.org/10.1136/bmj.323.7320.1037

Grigoryan L, Haaijer-Ruskamp FM, Burgerhof JG, et al. Self-medication with antimicrobial drugs in Europe. Emerg Infect Dis. 2006;12:452-9. DOI: https://doi.org/10.3201/eid1203.050992

Levy SB. Antibiotic resistance-the problem intensifies. Adv Drug Deliv Rev. 2005;57:1446-50. DOI: https://doi.org/10.1016/j.addr.2005.04.001

Jaruseviciene L, Radzeviciene-Jurgute R, Lazarus JV, et al. A study of antibiotic prescribing: The experience of Lithuanian and Russian GPs. Cent Eur J Med. 2012;7:790-9. DOI: https://doi.org/10.2478/s11536-012-0062-4

Berzanskyte A, Valinteliene R, Haaijer-Ruskamp FM, Gurevicius R, Grigoryan L. Self-medication with antibiotics in Lithuania. Int J Occup Med Environ Health. 2006;19:246-53. DOI: https://doi.org/10.2478/v10001-006-0030-9

Cockburn J, Pit S. Prescribing behaviour in clinical practice: Patients' expectations and doctors' perceptions of patients' expectations - A questionnaire study. BMJ. 1997;315:520-3. DOI: https://doi.org/10.1136/bmj.315.7107.520

Deschepper R, Grigoryan L, Lundborg CS, Hofstede G, Cohen J, Kelen GV, Deliens L, Haaijer-Ruskamp FM. Are cultural dimensions relevant for explaining cross-national differences in antibiotic use in Europe? BMC Health Serv Res. 2008;8:123. DOI: https://doi.org/10.1186/1472-6963-8-123

Branthwaite A, Pechere JC. Pan-European survey of patientsâ€™ attitudes to antimicrobial drugs and antibiotics. J Int Med Res. 1996; 24:229. DOI: https://doi.org/10.1177/030006059602400301

Surveillance report Surveillance of antimicrobial consumption in Europe ECDC, 2010. Stockholm, 2013. doi 10.2900/76806

Stoyanova R, Dimova R, Raycheva R. Sale of regulated antibiotics without prescriptions â€“ research on the pharmacistsâ€™ attitudes and patterns of economic behavior. Trakia Journal of Sciences. 2012;10:71-5.

Dimitrova D, Dimova R, Levterova B. Self-treatment with antibiotics and its determinants. EGPRN Meeting â€œChildren in General Practiceâ€ 6th -9th .May, 2010, Plovdiv, Bulgaria, European Journal of General Practice, Abstracts, 2010;16:169-170.

Abasaeed AB, Vlcek J, Abuelkhair M, Kubena Al. Self-medication with antibiotics by the community of Abu Dhabi Emirate, United Arab Emirates. J Infect Dev Ctries. 2009;3:491-7. DOI: https://doi.org/10.3855/jidc.466

Andrajati R, Vlcek J, Haaijer-Ruskamp FM. Prevalence a mozne rizikove factory rozvoje samoleceni antibiotiky v Ceske republice. Vnitr Lek, 2005; 51:1096-101.

Borg MA, Scicluna EA. Over-the-counter acquisition of antibiotics in the Maltese general population. Int J Antimicrob Agents. 2002;20:253-7. DOI: https://doi.org/10.1016/S0924-8579(02)00194-2

Al-Azzam SI, Al-Husein BA, Alzoubi F, Masadeh MM, Al-Horani MAS. Self-medication with antibiotics in Jordanian population. Int J Occup Med Environ Health. 2007;20:373-80. DOI: https://doi.org/10.2478/v10001-007-0038-9

Skliros E, Merkouris P, Papazafiropoulou A, Gikas A, Matzouranis G, Papafragos C, Tsakanikas I, Zarbala I, Vasibosis A, Stamataki P, Sotiropoulos A. Self-medication with antibiotics in rural population in Greece: a cross-sectional multicenter study. BMC Fam Pract. 2010;11:58. DOI: https://doi.org/10.1186/1471-2296-11-58

Mitsi G, Jelastopulu E, Basiaris H, Skoutelis A, Gogos C. Patterns of antibiotic use among adults and parents in the community: A questionnaire-based survey in a greek urban population. Int J Antimicrob Agents. 2005;25:439-43. DOI: https://doi.org/10.1016/j.ijantimicag.2005.02.009

Jaruseviciene L, Radzeviciene Jurgute R, Bjerrum L, et al. Enabling factors for antibiotic prescribing for upper respiratory tract infections: Perspectives of Lithuanian and Russian general practitioners. Ups J Med Sci. 2013;118:98-104. DOI: https://doi.org/10.3109/03009734.2013.778925

Al-Bakri AG, Bustanji Y, Yousef AM. Community consumption of antibacterial drugs within the Jordanian population: sources, patterns and appropriateness. Int J Antimicrob Agents. 2005;26:389-95. DOI: https://doi.org/10.1016/j.ijantimicag.2005.07.014