Over-the-counter availability of antimicrobial agents, self-medication and patterns of resistance in Karachi, Pakistan
To determine whether the free availability of antimicrobial agents leads to misuse through self-medication, a house-to-house semi-structured interview was held in three different socio-economic areas of Karachi, Pakistan. Of the 2348 households visited, 1342 (57%) participated; this included 9209 in...
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| Veröffentlicht in: | Journal of antimicrobial chemotherapy 1997-04, Vol.39 (4), p.543-547 |
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| container_title | Journal of antimicrobial chemotherapy |
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| creator | STURM, A. W VAN DER POL, R SMITS, A. J VAN HELLEMONDT, F. M MOUTON, S. W JAMIL, B MINAI, A. M SAMPERS, G. H. M. A |
| description | To determine whether the free availability of antimicrobial agents leads to misuse through self-medication, a house-to-house semi-structured interview was held in three different socio-economic areas of Karachi, Pakistan. Of the 2348 households visited, 1342 (57%) participated; this included 9209 individuals. Three hundred and twenty-two (3.5%) had used one or more antimicrobial in the previous 4 weeks, equivalent to 43 agents per 1000 persons per month. The most frequently used agents were amoxycillin (16.7%), co-trimoxazole (15.7%), erythromycin (10.9%), ampicillin/cloxacillin (Ampiclox, 9.1%) and metronidazole (4.5%). Of these, 91.4% were prescribed by a physician, 2.3% were advised by a chemist and 6.3% were used as self-medication. Self-medication increased with socio-economic status. High levels of resistance were found to ampicillin, co-trimoxazole, chloramphenicol and erythromycin. If these high resistance levels are related to the high frequency of antimicrobial use, over-the-counter availability cannot be held responsible. Education of the medical profession seems to be the single most important tool to control misuse of antimicrobial agents. Innovative approaches for continuous medical education are urgently needed. |
| doi_str_mv | 10.1093/jac/39.4.543 |
| format | Article |
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W ; VAN DER POL, R ; SMITS, A. J ; VAN HELLEMONDT, F. M ; MOUTON, S. W ; JAMIL, B ; MINAI, A. M ; SAMPERS, G. H. M. A</creator><creatorcontrib>STURM, A. W ; VAN DER POL, R ; SMITS, A. J ; VAN HELLEMONDT, F. M ; MOUTON, S. W ; JAMIL, B ; MINAI, A. M ; SAMPERS, G. H. M. A</creatorcontrib><description>To determine whether the free availability of antimicrobial agents leads to misuse through self-medication, a house-to-house semi-structured interview was held in three different socio-economic areas of Karachi, Pakistan. Of the 2348 households visited, 1342 (57%) participated; this included 9209 individuals. Three hundred and twenty-two (3.5%) had used one or more antimicrobial in the previous 4 weeks, equivalent to 43 agents per 1000 persons per month. The most frequently used agents were amoxycillin (16.7%), co-trimoxazole (15.7%), erythromycin (10.9%), ampicillin/cloxacillin (Ampiclox, 9.1%) and metronidazole (4.5%). Of these, 91.4% were prescribed by a physician, 2.3% were advised by a chemist and 6.3% were used as self-medication. Self-medication increased with socio-economic status. High levels of resistance were found to ampicillin, co-trimoxazole, chloramphenicol and erythromycin. If these high resistance levels are related to the high frequency of antimicrobial use, over-the-counter availability cannot be held responsible. Education of the medical profession seems to be the single most important tool to control misuse of antimicrobial agents. Innovative approaches for continuous medical education are urgently needed.</description><identifier>ISSN: 0305-7453</identifier><identifier>ISSN: 1460-2091</identifier><identifier>EISSN: 1460-2091</identifier><identifier>DOI: 10.1093/jac/39.4.543</identifier><identifier>PMID: 9145830</identifier><identifier>CODEN: JACHDX</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adolescent ; Adult ; Aged ; Amoxicillin - therapeutic use ; Ampicillin - therapeutic use ; Anti-Infective Agents - therapeutic use ; Antibacterial agents ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Biological and medical sciences ; Community-Acquired Infections - microbiology ; Data Collection ; Drug Resistance, Microbial ; Erythromycin - therapeutic use ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; Nonprescription Drugs - therapeutic use ; Pakistan ; Pharmacology. Drug treatments ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Respiratory Tract Infections - drug therapy ; Self Medication - statistics & numerical data ; Teaching. Deontology. Ethics. 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J</creatorcontrib><creatorcontrib>VAN HELLEMONDT, F. M</creatorcontrib><creatorcontrib>MOUTON, S. W</creatorcontrib><creatorcontrib>JAMIL, B</creatorcontrib><creatorcontrib>MINAI, A. M</creatorcontrib><creatorcontrib>SAMPERS, G. H. M. A</creatorcontrib><title>Over-the-counter availability of antimicrobial agents, self-medication and patterns of resistance in Karachi, Pakistan</title><title>Journal of antimicrobial chemotherapy</title><addtitle>J Antimicrob Chemother</addtitle><description>To determine whether the free availability of antimicrobial agents leads to misuse through self-medication, a house-to-house semi-structured interview was held in three different socio-economic areas of Karachi, Pakistan. Of the 2348 households visited, 1342 (57%) participated; this included 9209 individuals. Three hundred and twenty-two (3.5%) had used one or more antimicrobial in the previous 4 weeks, equivalent to 43 agents per 1000 persons per month. The most frequently used agents were amoxycillin (16.7%), co-trimoxazole (15.7%), erythromycin (10.9%), ampicillin/cloxacillin (Ampiclox, 9.1%) and metronidazole (4.5%). Of these, 91.4% were prescribed by a physician, 2.3% were advised by a chemist and 6.3% were used as self-medication. Self-medication increased with socio-economic status. High levels of resistance were found to ampicillin, co-trimoxazole, chloramphenicol and erythromycin. If these high resistance levels are related to the high frequency of antimicrobial use, over-the-counter availability cannot be held responsible. Education of the medical profession seems to be the single most important tool to control misuse of antimicrobial agents. Innovative approaches for continuous medical education are urgently needed.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Amoxicillin - therapeutic use</subject><subject>Ampicillin - therapeutic use</subject><subject>Anti-Infective Agents - therapeutic use</subject><subject>Antibacterial agents</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Biological and medical sciences</subject><subject>Community-Acquired Infections - microbiology</subject><subject>Data Collection</subject><subject>Drug Resistance, Microbial</subject><subject>Erythromycin - therapeutic use</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nonprescription Drugs - therapeutic use</subject><subject>Pakistan</subject><subject>Pharmacology. Drug treatments</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Respiratory Tract Infections - drug therapy</subject><subject>Self Medication - statistics & numerical data</subject><subject>Teaching. Deontology. Ethics. 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Antiparasitic agents</topic><topic>Biological and medical sciences</topic><topic>Community-Acquired Infections - microbiology</topic><topic>Data Collection</topic><topic>Drug Resistance, Microbial</topic><topic>Erythromycin - therapeutic use</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nonprescription Drugs - therapeutic use</topic><topic>Pakistan</topic><topic>Pharmacology. Drug treatments</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Respiratory Tract Infections - drug therapy</topic><topic>Self Medication - statistics & numerical data</topic><topic>Teaching. Deontology. Ethics. Legislation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>STURM, A. W</creatorcontrib><creatorcontrib>VAN DER POL, R</creatorcontrib><creatorcontrib>SMITS, A. J</creatorcontrib><creatorcontrib>VAN HELLEMONDT, F. 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Three hundred and twenty-two (3.5%) had used one or more antimicrobial in the previous 4 weeks, equivalent to 43 agents per 1000 persons per month. The most frequently used agents were amoxycillin (16.7%), co-trimoxazole (15.7%), erythromycin (10.9%), ampicillin/cloxacillin (Ampiclox, 9.1%) and metronidazole (4.5%). Of these, 91.4% were prescribed by a physician, 2.3% were advised by a chemist and 6.3% were used as self-medication. Self-medication increased with socio-economic status. High levels of resistance were found to ampicillin, co-trimoxazole, chloramphenicol and erythromycin. If these high resistance levels are related to the high frequency of antimicrobial use, over-the-counter availability cannot be held responsible. Education of the medical profession seems to be the single most important tool to control misuse of antimicrobial agents. 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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Free Full-Text Journals in Chemistry |
| subjects | Adolescent Adult Aged Amoxicillin - therapeutic use Ampicillin - therapeutic use Anti-Infective Agents - therapeutic use Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Biological and medical sciences Community-Acquired Infections - microbiology Data Collection Drug Resistance, Microbial Erythromycin - therapeutic use Female Humans Male Medical sciences Middle Aged Nonprescription Drugs - therapeutic use Pakistan Pharmacology. Drug treatments Public health. Hygiene Public health. Hygiene-occupational medicine Respiratory Tract Infections - drug therapy Self Medication - statistics & numerical data Teaching. Deontology. Ethics. Legislation |
| title | Over-the-counter availability of antimicrobial agents, self-medication and patterns of resistance in Karachi, Pakistan |
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