Dentistry students in the UAE who take unprescribed antibiotics to cure coughs and colds to save time ignore the stark consequences of their actions, a study has found.
Students at the dentistry college of Ajman University were surveyed to gain an understanding of why young people choose to take unprescribed medication, and how much they take.
Bacterial resistance to antibiotics is a natural phenomenon that could make regular medicine ineffective. The consequences of overuse of antibiotics could return medicine to the Dark Ages, with routine surgeries such as Caesarean sections and knee operations putting patients at risk of deadly infections.
Findings by researchers at the University of Sharjah and the University of Gloucestershire, England, have been published in Pharmacy Practice.
Although taken from a small sample size, the results offered an indication of attitudes towards medication among some young people.
“The most common response among all participants was the time commitment of seeing a physician or scheduling limitations of student life that compelled them to self-medicate with antibiotics,” said one of the study authors, Khalid Al Kubaisi.
“Other common reasons for taking antibiotics without a prescription were students experiencing familiar symptoms and relying on prescriptions that had been recommended in the past.
“Some referenced advice from friends and family as a contributing factor in self-medication.”
Students were questioned on four main themes: medication habits and practices, reasons for self-medication, access to antibiotics without a prescription, and gaps in their knowledge of antibiotic resistance.
The sample showed a broad misunderstanding about the use of antibiotics, and a need for wider public education of the dangers of unnecessary use.
With the exception of one Briton, the students were Arabs from Iraq, the UAE, Egypt, Jordan, Palestine, Iran and Sudan, and aged between 18 and 22.
“A few participants reported self-medicating was less expensive or less of a financial burden than seeing a doctor,” said Mr Al Kubaisi.
“For these participants, buying medication was supposedly less costly than first seeing a doctor.
“Some students said their motivation for self-medicating was to avoid worrying or inconveniencing their family members.”
This latest research of UAE students at high risk of misusing antibiotics followed a similar survey of the habits of more than 2,500 university students using antibiotics without prescription.
A further phase is planned by researchers, who aim to interview pharmacists to explore their roles in tackling the sale of antibiotics without prescriptions and to explore the role of physicians in addressing misuse.
Doctors said attitudes towards antibiotics in the UAE are beginning to change slowly.
“People in the UAE should not be able to access antibiotics without a prescription, the rules are there but there is still misuse,” said Dr Nehad Nabil Halawa, an Egyptian specialist in anaesthesia at Burjeel Hospital, Abu Dhabi.
“We are following international guidelines for antibiotic stewardship to bring more control inside hospitals.
“Sometimes, the prescription is given wrongly, for viral infections for example, and this needs to change.
“What’s required is education and the national stewardship programme is now mandatory, so we are seeing improvements.
“The resistance is there and has been as long as antibiotics have existed.”
The World Health Organisation's Global Strategy for Containment of Antimicrobial Resistance provides a framework to slow the emergence and reduce the spread of antimicrobial-resistant microorganisms.
It aims to cut disease and the spread of infection, improve access to appropriate antimicrobials and their use and strengthen monitoring.
The strategy also aims to improve enforcement of regulations and encourage the development of drugs and vaccines.
In his 30 years of practice, Dr Halawa has witnessed a gradual change in approach from patients.
“There is awareness now that common viral infections in children should not be treated with antibiotics, and that is the majority of childhood infections,” he said. “People are accepting this more widely now.
“Ten or 15 years ago, families often demanded antibiotics for their children and physicians were happy to comply, but that is slowly changing.”
Each year, 23000 people die in the US from infections that are caused by resistant bacteria because doctors do not have new antibiotics to eradicate them.
“When using an antibiotic without a proper indication we are endangering ourselves and others,” said Dr Vedrana Vizjak, internal medicine specialist at Zulekha Hospital, Sharjah.
“I cannot emphasise enough that antibiotics are not effective in treatment of common cold and other viral infections and should not be used in those cases.
“Also, when used, antibiotic should be administered in appropriate dose, frequency and a course should always be completed.”
"Many people do not understand that antibiotics are prescribed for illnesses caused by bacteria, not by viruses," said Dr Bobomurod Keldiyorov, a
family medicine specialist at Canadian Specialist Hospital.
"Antibiotics do not work against viruses."