Self-Medication with Antibiotics during COVID-19 in the Eastern Mediterranean Region Countries: A Review

Abstract

Self-treatment with medicines including treatment with antibiotics is a growing global concern, as it can cause public health problems, such as antibiotic resistance and drug toxicity. Therefore, the significance of the self-medication impact of COVID-19 in any region can have an influence on the prevalence of such problems. The review aimed to investigate the self-treatment with antibiotics among the general population in Eastern Mediterranean region countries during COVID-19 pandemic. A comprehensive review of literature in four databases was conducted for the pandemic period from January 2020 to the end of March 2022. Nine studies related to self-treatment with antibiotics were found. The studies were homogeneous in terms of assessing the antibiotic self-treatment usage during the COVID-19 pandemic among the general population and among community pharmacies. The prevalence of self-treatment with antibiotics ranged from 20.8% to 45.8% between the studies. The main reasons for that were cost-saving, fear of COVID-19 infection, quarantine, and ease of accessibility without time limits. Antibiotic self-treatment has been high during the COVID-19 pandemic; however, it was less reported during the study period than before the time of the pandemic. There is a need for more restrictions on dispensing antibiotics from community pharmacies. In addition, there is a need to raise awareness among the population regarding self-treatment with antibiotics.

WHO AWaRe classification for antibiotic stewardship: tackling antimicrobial resistance – a descriptive study from an English NHS Foundation Trust prior to and during the COVID-19 pandemic

“…In Zambia, findings by Mudenda et al (2022 , 2023) further corroborate these findings, suggesting both a regional and a global increase in reliance on azithromycin. Additionally, research conducted in several Eastern Mediterranean countries, including studies by Kalungia et al (2022) and Jirjees et al (2022) , and in other regions such as Ghana, as noted by Amponsah et al (2022) , has also observed this trend, highlighting a consistent global shift towards increased usage of this particular antibiotic. These studies collectively emphasise the growing preference for azithromycin across diverse geographical and clinical settings ( Mugada et al, 2021 ; Sharma et al, 2021 ; Amponsah et al, 2022 ; Jirjees et al, 2022 ; Kalungia et al, 2022 ; Mohamad et al, 2022 ; Mudenda et al, 2022 ; Mudenda et al, 2023 ).…”

Choosing and accessing COVID-19 treatment options: a qualitative study with patients, caregivers, and health care providers in Lebanon

“…There was also misinformation in various media outlets about the benefits of some medications for either preventing or treating COVID-19 [ 23 ]. This resulted in an increase in risky self-medication with several over-the-counter medications [ 2 , 24 ].…”

Polyether Sulfone-Based Organic Nanoparticle Coupled Membrane for Detection and Purification of Amoxicillin Antibiotic from Wastewater

“…Therefore, the efficient removal of antibiotics during wastewater treatment is crucial for public health, in addition to removal of heavy metals, especially in light of current postpandemic scenarios. 4 According to the Codex Alimentarius regulation and European Union (EU), a maximum residue limit for amoxicillin (AMX) is 10 ng mL −1 . 5 Until now, the AMX detection is mainly based on instrumental methods such as liquid chromatography coupled to tandem mass spectrometry (LC−MS), 6 capillary electrophoresis, 7 high performance liquid chromatography, 8 spectrofluorometry, 9,10 electrochemical sensors, 11 fluorescence sensors, 12 ion mobility spectroscopy, 13 and enzymatic quantification.…”

“…Apparently, the removal of health-threatening pollutants from wastewater before its discharge into the environment is of the utmost importance. Therefore, the efficient removal of antibiotics during wastewater treatment is crucial for public health, in addition to removal of heavy metals, especially in light of current postpandemic scenarios . According to the Codex Alimentarius regulation and European Union (EU), a maximum residue limit for amoxicillin (AMX) is 10 ng mL –1 .…”