Household antimicrobial self-medication: a systematic review and meta-analysis of the burden, risk factors and outcomes in developing countries.
Household antimicrobial self-medication: a systematic review and meta-analysis of the burden, risk factors and outcomes in developing countries.
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DOI：
10.1186/s12889-015-2109-3
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发表时间：
2015-08-01
影响因子：
4.5
通讯作者：
Obua C
中科院分区：
文献类型：
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作者：
Ocan M;Obuku EA;Bwanga F;Akena D;Richard S;Ogwal-Okeng J;Obua C
在大多数低收入和中等收入国家 (LMIC)，抗菌药物自我药疗很常见。然而，尚未对这些环境中非处方抗菌药物的使用进行系统评价。因此，本次审查旨在确定低收入和中等收入国家抗菌药物自我药疗的负担、风险因素和影响。 2012年，我们在PROSPERO中注册了系统评价方案（CRD42012002508）。我们使用以下术语检索了 PubMed、Medline、Scopus 和 Embase 数据库； “自我药疗”、“非处方”、“自我治疗”、“抗菌”、“抗疟药”、“抗生素”、“抗菌”“2002-2012”并使用布尔运算符将它们组合起来。我们对研究管理数据、患病率、决定因素、抗菌药物类型、来源、疾病状况、不当使用、药物不良事件和可能的抗生素自我药疗的临床结果进行了独立和重复的筛选和提取。我们进行了随机效应荟萃分析。该评价共纳入三十四 (34) 项研究，涉及 31,340 名参与者。抗菌药物自我药疗的总体患病率为 38.8%（95% CI：29.5-48.1）。大多数研究评估了抗菌药物（17/34：50%）和抗疟药物（5/34：14.7%）的非处方使用。治疗的常见疾病症状是呼吸道（50%）、发烧（47%）和胃肠道（45%）。抗菌药物的主要来源包括药房（65.5%）、剩余药物（50%）和药店（37.5%）。十二 (12) 项研究报告了不适当的药物使用；未完成剂量 (6/12) 和共用药物 (4/12)。抗菌药物自我药疗的主要决定因素包括教育水平、年龄、性别、过去的成功使用情况、疾病的严重程度和收入。据报告，抗菌药物自我治疗的负面结果包括过敏（2/34：5.9%）、无法治愈（4/34：11.8%）和导致死亡（2/34：5.9%）。最常见的积极结果是疾病康复（4/34：11.8%）。抗菌药物自我药疗的流行率很高，并且在不同的社区以及健康的社会决定因素中存在差异，并且常常与不适当的药物使用有关。本文的在线版本 (doi:10.1186/s12889-015-2109-3) 包含补充材料，可供授权用户使用。
Antimicrobial self-medication is common in most low and middle income countries (LMICs). However there has been no systematic review on non-prescription antimicrobial use in these settings. This review thus intended to establish the burden, risk factors and effects of antimicrobial self-medication in Low and Middle Income Countries. In 2012, we registered a systematic review protocol in PROSPERO (CRD42012002508). We searched PubMed, Medline, Scopus, and Embase databases using the following terms; “self-medication”, “non-prescription”, ‘self-treatment’, “antimicrobial”, “antimalarial”, “antibiotic”, “antibacterial” “2002-2012” and combining them using Boolean operators. We performed independent and duplicate screening and abstraction of study administrative data, prevalence, determinants, type of antimicrobial agent, source, disease conditions, inappropriate use, drug adverse events and clinical outcomes of antibiotic self-medication where possible. We performed a Random Effects Meta-analysis. A total of thirty four (34) studies involving 31,340 participants were included in the review. The overall prevalence of antimicrobial self-medication was 38.8 % (95 % CI: 29.5-48.1). Most studies assessed non-prescription use of antibacterial (17/34: 50 %) and antimalarial (5/34: 14.7 %) agents. The common disease symptoms managed were, respiratory (50 %), fever (47 %) and gastrointestinal (45 %). The major sources of antimicrobials included, pharmacies (65.5 %), leftover drugs (50 %) and drug shops (37.5 %). Twelve (12) studies reported inappropriate drug use; not completing dose (6/12) and sharing of medicines (4/12). The main determinants of antimicrobial self-medication include, level of education, age, gender, past successful use, severity of illness and income. Reported negative outcomes of antimicrobial self-medication included, allergies (2/34: 5.9 %), lack of cure (4/34: 11.8 %) and causing death (2/34: 5.9 %). The commonly reported positive outcome was recovery from illness (4/34: 11.8 %). The prevalence of antimicrobial self-medication is high and varies in different communities as well as by social determinants of health and is frequently associated with inappropriate drug use. The online version of this article (doi:10.1186/s12889-015-2109-3) contains supplementary material, which is available to authorized users.