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      Antibiotics and over the counter medication use and its correlates among Arab pregnant women visiting a tertiary care hospital in Riyadh, Saudi Arabia

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          Abstract

          Background and Objective:

          The use of over the counter medications (OTCMs) is a common practice globally. OTCMs are of special concern among pregnant women as they pose risk to the mother and fetus. The objective was to assess the use of OTCMs by pregnant woman, and factors associated with it.

          Methods:

          A cross-sectional study, using a structured self-administrated questionnaire was conducted at the obstetric and antenatal clinics at King Khalid University hospital, Riyadh. 354 pregnant women were surveyed.

          Result:

          About 32% of the study participants used OTCMs without prescription at least once during their last pregnancy. The most commonly used OTCM was Paracetamol (22%). Pharmacists were the main source of knowledge (53%) for the participants. Correct knowledge regarding the drugs was associated with the usage of OTCM drug.

          Conclusion:

          Use of OTCMs and antibiotics during pregnancy is a common practice among Saudi pregnant women. General awareness regarding OTCMs use during pregnancy without prescription needs to be raised in the community. Pharmacists and media can help in providing accurate knowledge.

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          Medication use during pregnancy, with particular focus on prescription drugs: 1976-2008.

          Allen Mitchell, Suzanne M. Gilboa, Martha M. Werler … (2011)
          The objective of the study was to provide information on overall medication use throughout pregnancy, with particular focus on the first trimester and specific prescription medications. The study design included the Slone Epidemiology Center Birth Defects Study, 1976-2008, and the National Birth Defects Prevention Study, 1997-2003, which together interviewed more than 30,000 women about their antenatal medication use. Over the last 3 decades, first-trimester use of prescription medication increased by more than 60%, and the use of 4 or more medications more than tripled. By 2008, approximately 50% of women reported taking at least 1 medication. Use of some specific medications markedly decreased or increased. Prescription medication use increased with maternal age and education, was highest for non-Hispanic whites, and varied by state. These data reflect the widespread and growing use of medications by pregnant women and reinforce the need to study their respective fetal risks and safety. Copyright © 2011 Mosby, Inc. All rights reserved.
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            Non prescribed sale of antibiotics in Riyadh, Saudi Arabia: A Cross Sectional Study

            Aref A Bin Abdulhak, Mohamad Altannir, Mohammed Almansor … (2011)
            Background Antibiotics sales without medical prescriptions are increasingly recognized as sources of antimicrobial misuse that can exacerbate the global burden of antibiotic resistance. We aimed to determine the percentage of pharmacies who sell antibiotics without medical prescriptions, examining the potential associated risks of such practice in Riyadh, Saudi Arabia, by simulation of different clinical scenarios. Methods A cross sectional study of a quasi-random sample of pharmacies stratified by the five regions of Riyadh. Each pharmacy was visited once by two investigators who simulated having a relative with a specific clinical illness (sore throat, acute bronchitis, otitis media, acute sinusitis, diarrhea, and urinary tract infection (UTI) in childbearing aged women). Results A total of 327 pharmacies were visited. Antibiotics were dispensed without a medical prescription in 244 (77.6%) of 327, of which 231 (95%) were dispensed without a patient request. Simulated cases of sore throat and diarrhea resulted in an antibiotic being dispensed in (90%) of encounters, followed by UTI (75%), acute bronchitis (73%), otitis media (51%) and acute sinusitis (40%). Metronidazole (89%) and ciprofloxacin (86%) were commonly given for diarrhea and UTI, respectively, whereas amoxicillin/clavulanate was dispensed (51%) for the other simulated cases. None of the pharmacists asked about antibiotic allergy history or provided information about drug interactions. Only 23% asked about pregnancy status when dispensing antibiotics for UTI-simulated cases. Conclusions We observed that an antibiotic could be obtained in Riyadh without a medical prescription or an evidence-based indication with associated potential clinical risks. Strict enforcement and adherence to existing regulations are warranted.
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              Use of nonaspirin nonsteroidal anti-inflammatory drugs during pregnancy and the risk of spontaneous abortion.

              Odile Sheehy, Hamid Reza Nakhai-Pour, Anick Bérard … (2011)
              The association between the use of nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) during pregnancy and the risk of spontaneous abortion remains unclear because of inconsistent research results and the lack of evidence for an effect due to specific types or dosages of nonaspirin NSAIDs. We aimed to quantify the association between having a spontaneous abortion and types and dosages of nonaspirin NSAIDs in a cohort of pregnant women. Using a nested case-control design, we obtained data from the Quebec Pregnancy Registry for 4705 women who had a spontaneous abortion. For each instance, we randomly selected 10 controls from the remaining women in the registry who were matched by index date (date of the spontaneous abortion) and gestational age. Use of nonaspirin NSAIDs (identified by filled prescriptions) and nonuse were compared. We also looked for associations between different types and dosages of nonaspirin NSAIDs and having a spontaneous abortion. Analyses of associations and adjustment for confounding were done using conditional logistic regression. We identified 4705 cases of spontaneous abortion (352 exposed [7.5%]); 47 050 controls (1213 exposed [2.6%]). Adjusting for potential confounders, the use of nonaspirin NSAIDs during pregnancy was significantly associated with the risk of spontaneous abortion (odds ratio [OR] 2.43, 95% confidence interval [CI] 2.12-2.79). Specifically, use of diclofenac (OR 3.09, 95% CI 1.96-4.87), naproxen (OR 2.64, 95% CI 2.13-3.28), celecoxib (OR 2.21, 95% CI 1.42-3.45), ibuprofen (OR 2.19, 95% CI 1.61-2.96) and rofecoxib (OR 1.83, 95% CI 1.24-2.70) alone, and combinations thereof (OR 2.64, 95% CI 1.59-4.39), were all associated with increased risk of spontaneous abortion. No dose-response effect was seen. Gestational exposure to any type or dosage of nonaspirin NSAIDs may increase the risk of spontaneous abortion. These drugs should be used with caution during pregnancy.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Pak J Med Sci
                Journal ID (iso-abbrev): Pak J Med Sci
                Title: Pakistan Journal of Medical Sciences
                Publisher: Professional Medical Publications (Pakistan )
                ISSN (Print): 1682-024X
                ISSN (Electronic): 1681-715X
                Publication date (Print): Mar-Apr 2017
                Volume: 33
                Issue: 2
                Pages: 452-456
                Affiliations
                [1 ]Dr. Hafsa Raheel, Associate Professor, Department of Family & Community Medicine, College of Medicine, King Saud University & King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia
                [2 ]Sulaiman Alsakran, King Saud University & King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia
                [3 ]Abdulkhaliq Alghamdi, King Saud University & King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia
                [4 ]Majed Ajarem, King Saud University & King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia
                [5 ]Salman Alsulami, King Saud University & King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia
                [6 ]Dr. Muhammad Afzal Mahmood, School of Public Health, University of Adelaide, South Australia
                Author notes
                Correspondence: Dr. Hafsa Raheel, King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia. E-mail: hafsaraheel@ 123456yahoo.com
                Article
                Publisher ID: PJMS-33-452
                DOI: 10.12669/pjms.332.12376
                PMC ID: 5432722
                PubMed ID: 28523055
                SO-VID: ebc96fb4-5548-4f24-941c-669d1fe55558
                Copyright © Copyright: © Pakistan Journal of Medical Sciences
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 17 January 2017
                Date revision received : 25 February 2017
                Date revision received : 03 March 2017
                Date accepted : 05 March 2017
                Categories
                Subject: Original Article

                Keywords: key word: pregnant women,saudi arabia,riyadh,over the counter medications
                Data availability:
                Keywords: key word: pregnant women, saudi arabia, riyadh, over the counter medications

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