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Knowledge, awareness, and attitudes toward antibiotic use and antimicrobial resistance among Saudi population

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Abstract

Background Inappropriate use of antibiotics is a public health problem of great concern. Objective To evaluate knowledge of antibiotics, race, gender and age as independent risk factors for self-medication. Setting Residents and population from different regions of Saudi Arabia. Methods We conducted a cross sectional survey study among residents. Data were collected between June 2014 to May, 2015 from 1310 participants and data were recorded anonymously. The questionnaire was randomly distributed by interview of participants and included sociodemographic characteristics, antibiotics knowledge, attitudes and behavior with respect to antibiotics usage. Main outcome measure Population aggregate scores on questions and data were analyzed using univariate logistic regression to evaluate the influence of variables on self-prescription of antibiotics. Results The response rate was 87.7 %. A cumulative 63.6 % of participants reported to have purchased antibiotics without a prescription from pharmacies; 71.1 % reported that they did not finish the antibiotic course as they felt better. The availability of antibiotics without prescription was found to be positively associated with self-medication (OR 0.238, 95 % CI 0.17–0.33). Of those who used prescribed or non-prescribed antibiotics, 44.7 % reported that they kept left-over antibiotics from the incomplete course of treatment for future need. Interestingly, 62 % of respondents who used drugs without prescription agreed with the statement that antibiotics should be access-controlled prescribed by a physician. We also found significant association between storage, knowledge/attitudes and education. Conclusions The overall level of awareness on antibiotics use among residents in Saudi Arabia is low. This mandates public health awareness intervention programs to be implemented on the use of antibiotics.

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Acknowledgments

We are indebted to participants for providing their time and information. Authors would like to thank Deanship for Scientific Research, Jazan University, KSA. The present project was conducted and supervised by Prof. Dr Mohamed Ezzat El Zowalaty as part of the JU Future Scientists program's II projects. This project was supported in parts by the Grant of Charles University in Prague (SVV 260,187) for statistical analysis. The sponsors of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report. The corresponding author had full access to all the data in the study. MEZ conceived and designed the study; SD, MAG, FAM, NIN, RK, RS, KD, MK, SH, BM, AG, RH, JZ, AWA, AAA performed the experiments; MEZ, TB, JDT analyzed the data; JV contributed analysis tools; MEZ and AEZ statistics analysis, MEZ wrote the paper, MEZ and TB revised it at all stages of publication, HAA, SB, AK, TB, AN, AEZ, MEZ revised the manuscript.

Funding

The funding sponsors had no role in the design of the study; collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

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Authors and Affiliations

  1. School of Health Sciences, University of KwaZulu Natal, Westville, Durban, 4000, South Africa

    Mohamed E. El Zowalaty

  2. Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Saudi Arabia

    Mohamed E. El Zowalaty

  3. Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University, 50005, Prague, Hradec Kralove, Czech Republic

    Tatiana Belkina & Jiří Vlček

  4. Department of Pharmacology and Toxicology, Faculty of Pharmacy, Taibah University, Al Madina Al Munawarah, Kingdom of Saudi Arabia

    Saleh A. Bahashwan

  5. Department of Physiology & Pharmacology, College of Veterinary Medicine, University of Georgia, Athens, Georgia, 30602, USA

    Ahmed E. El Zowalaty

  6. Interdisciplinary Toxicology Program, University of Georgia, Athens, Georgia, 30602, USA

    Ahmed E. El Zowalaty

  7. Department of Biophysics and Physical Chemistry, Faculty of Pharmacy, Charles University, 50005, Prague, Hradec Kralove, Czech Republic

    Jurjen Duintjer Tebbens

  8. Department of Microbiology, Faculty of Pharmacy, Taibah University, Al Madina Al Munawarah, Saudi Arabia

    Hassan A. Abdel-Salam

  9. Faculty of Veterinary Medicine, Cairo University, Giza, Egypt

    Adel I. Khalil

  10. Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia

    Safaa I. Daghriry, Nahed I. Nohi, Rafaa H. Khodari, Reem M. Sharahili, Khlood A. Dagreery, Mayisah Khormi, Sarah Abuo Habibah, Bayan A. Medrba, Amal A. Gahtani, Rasha Y. Hifthi, Jameelah M. Zaid, Arwa W. Amshan & Alqasim A. Alneami

  11. Faculty of Medicine, Jazan University, Jazan, Saudi Arabia

    Mona A. Gahtani & Fatimah M. Madkhaly

  12. Faculty of Pharmacy, Chapman University, Irvine, CA, 92618, USA

    Ayman Noreddin

Authors
  1. Mohamed E. El Zowalaty
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  2. Tatiana Belkina
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  3. Saleh A. Bahashwan
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  4. Ahmed E. El Zowalaty
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  5. Jurjen Duintjer Tebbens
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  6. Hassan A. Abdel-Salam
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  8. Safaa I. Daghriry
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  9. Mona A. Gahtani
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  10. Fatimah M. Madkhaly
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  14. Khlood A. Dagreery
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  18. Amal A. Gahtani
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  19. Rasha Y. Hifthi
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  20. Jameelah M. Zaid
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  21. Arwa W. Amshan
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  22. Alqasim A. Alneami
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  24. Jiří Vlček
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Corresponding authors

Correspondence to Mohamed E. El Zowalaty or Tatiana Belkina.

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Conflicts of interest

Prof Dr Mohamed Ezzat El Zowalaty is listed as a member and champion of "Antibiotic Action" an independent UK-led global initiative wholly funded by the British Society for Antimicrobial Chemotherapy (BSAC). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.

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Informed consent was obtained from all individual participants included in the study.

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El Zowalaty, M.E., Belkina, T., Bahashwan, S.A. et al. Knowledge, awareness, and attitudes toward antibiotic use and antimicrobial resistance among Saudi population. Int J Clin Pharm 38, 1261–1268 (2016). https://doi.org/10.1007/s11096-016-0362-x

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  • DOI: https://doi.org/10.1007/s11096-016-0362-x

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