Utilization of Antibiotics in Nablus City

102 Pages·2010·0.56 MB·English

An-Najah National University
Faculty of Graduate Studies

Utilization of Antibiotics in Nablus City-
Palestine Pharmaco-epidemiological Study

By
Maram Zakareya Abdul-Allah Hajjaj

Supervisor
Dr. Suleiman Al Khalil
Co- Supervisor
Dr. Waleed Sweileh

Submitted in Partial Fulfillment of the Requirements for the Degree of
Masterin Public Health, Faculty of Gradated Studies, at An-Najah
National University , Nablus, Palestine.
2005

iii

Dedication

To my family with all my love
iv
Acknowledgement

I wolud to thank my supervisors Dr. Suleiman Al- Khalil and Dr.
Waleed Sweileh for ther sincere encouragment, helpful, and close
supervision which have been invaluable for me throughout all stages of this
study.
Also my sincere thank go to my family for their help and
encouragments espacially my father.
v
Table of Contents
Subject Page
Detication iii
Acknowledgment iv
Table of content v
List of tables viii
List of figures ix
Glossary x
Chapter One : Introduction and Literature Review
History of antibiotics 2
What is antibioticsThe importance of antibiotics- infectious disease 3
Classification of antibiotics 3
Penicillines and cephalosporines 4
Macrolides 4
Sulfas 5
Trimethoprim 5
Nitofurantion 5
Aminoglycosides 6
Quinilones 6
Polumixine 6
Misuse of antibiotics 6
How are antibiotics misused 7
Self medication of antibiotics without prescription 7
The effects of misusing antibiotics 8
Antibiotics resistance 9
The relation between the volume of antibacterial consumption 11
In human community and frequncy of resistant 12
Prevelance of antibiotics utilization influncing 12
vi
Subject Page
This phenomenon 13
In Malta 13
In Manila 14
In Vitnam 15
In Kerala state 15
In USA 17
In China 18
The situation in developing countries 20
Aims of the study 20
Chapter Two: Methodology
2.1 Population of the study 22
2.2 Sample of the study 22
2.3 Instruments 22
2.4 Procedure and data collection 23
2.5 Data analysis 25
Chapter Three: Results
3.1 Profile of study sample 28
3.1.1 Social profile 28
3.1.2 Awareness profile 30
3.1.3 Antibiotics consumption profile 34
3.1.4 Factors affecting consumption of antibiotics without 38
prescription
3.2 Questions answered by pharmacist profile 40
3.2.1 The mostly used antibiotic 41
3.2.2 The price 41
3.2.3 The dose 41
vii
Subject Page
3.2.4 The number of capsules 41
3.2.5 Indication for use 41
3.3 Prevelance of antibiotics utilization with/without prescription 42
3.4 Relationship profile 44
Chapter Four: Discussion
4.1 Prevelance of antibiotics utilization in Nablus city 51
4.2 Social profile 54
4.2.1 Gender 54
4.2.2 Residence 55
4.2.3 Age 55
4.2.4 Type of work 56
4.2.5 Level of education 56
4.3 Awareness Profile 57
4.4 Antibiotics consumption profile 60
4.4.1 Source of antibiotics 60
4.4.2 Indication for use 60
4.5 Factors affecting consuming antibiotics without prescription 63
4.6 Questions answered by pharmacist profile 65
4.7 Implication for Intervention 66
4.8 Limitations 67
4.9 Conclution 68
4.10 Recommendations 69
References 72
Appindexes 81
viii
Lists of Tables
Table page
Table 1 Social profile variables 29
Table 2 Awareness questions 31
Table 3 Doctors prescribing antibiotics 38
Table 4 Mostly used antibiotics 40
Table 5 Indication for antibiotics use 41
Table 6 Prevelance of antibiotics utilizations 43
Table 7 Relation between awareness and education 45
Table 8 Relation between awareness and residence. 47
ix
List of Figures
Figure Page
Fig 1 Source of antibiotics 35
Fig 2 Conditions for taking antibiotics without prescription 36
Fig 3 Mostly used antibiotics. 40
x
Glossary
♦ JAMA: Journal of American Medical Association.
♦ TMP: Trimethoprim.
♦ SMX: Sulfamethoxazole.
♦ IV: Intra venous.
♦ OTC: over the counter.
♦ ED: Emergency Department.
♦ IDSA: Infectious Diseases Society of America.
♦ NIS: new Israeli shekel.
♦ GITI: Gstrointestinal Tract Infection.
♦ NSAID: Non Steroids Anti Inflammatory drugs.
♦ URTI: Upper Respiratory Tract Infections.
♦ UTI: Urinary Tract Infection