Antibiotic use in Namibia: prescriber practices for common community infections

Background: Despite the threat of resistance, the use of antibiotics globally is high and continues to increase. Much of this use is attributed to overprescribing by physicians. The objective of this study was to assess doctors’ management of common community-acquired infections in Namibia.Methodology: A cross-sectional survey based on a web-based self-administered questionnaire was conducted. Doctors belonging to the local professional associations comprised the study population. Data were collected from March to July 2014.Results: A 10% ( n = 44) response rate was achieved. Respondents were from across the country and practised mainly in the private health sector. Both awareness of local antimicrobial sensitivity rates and ownership of national Standard Treatment Guidelines were poor (20% and 31% respectively). Common practice in managing common infections, with the exception of chronic otitis media, cystitis and pyelonephritis, is to treat empirically. The reported first-line antibiotics of choice were the combination of amoxicillin with clavulanic acid for upper respiratory tract infections and ciprofloxacin for urinary tract infections. Management of infections was the same across all socio-demographic factors and was not influenced by patient workload.Conclusion: This survey revealed that first-line antibiotic choices of doctors are not informed by the Namibia Standard Treatment Guidelines and the local and regional antimicrobial sensitivity data. Interventions to improve antibiotic prescribing in Namibia should include better dissemination of guidelines and information regarding local antimicrobial sensitivity rates as well as strategies for the implementation of guidelines

Public knowledge, attitudes and behaviour towards antibiotic usage in Windhoek, Namibia

Background: The development of antibiotic resistance is a globally recognised human health threat. Overuse of antibiotics is a major contributory factor to the development of resistance. As end users, the public play a role in antibiotic use and the development and spread of resistance. The purpose of the study was to assess the knowledge, attitudes and behaviour of the general population of Namibia accessing care in the private sector regarding antibiotic use. Methodology: A cross-sectional survey based on self-administered questionnaire was distributed to 600 patients through pharmacies in Windhoek, Namibia. The survey was conducted from March to June 2013. Results: A total of 446 completed questionnaires were collected. Eighty percent (80%) of respondents reported to have used antibiotics in the past year mainly for colds and flu symptoms. The majority of respondents obtained antibiotics through a valid doctor’s prescription. A prevalence of fifteen percent (15%) of self-medication with antibiotics mainly obtained from pharmacies without a prescription was reported. Eighty percent (80%) of respondents reported completing the antibiotic course. Gaps in population understanding of antibiotics were observed. Sixty-four percent (64%) of the respondents thought that antibiotics were effective against viruses with just less than half revealing that they should take an antibiotic for a cold. Seventy-two percent (72%) of respondents understood that unnecessary use of antibiotics makes them ineffective. Conclusion: Major findings of this study include the sale of antibiotics without a prescription; over prescribing of antibiotics for self-limiting upper respiratory tract infections; and, the presence of gaps in knowledge, attitudes and behaviour of the general population towards antibiotics and their us