Determinants of Anti-fungal use in the GA-South Municipality; Implications for antimicrobial stewardship

Abstract

Introduction; One of the foremost and important steps towards rational anti-fungal use and conservation is drug utilization research. A lot is known about the determinants and patterns of use of antibiotics. However, only few studies have investigated consumption of antifungals in a given population. Methods; the current study is a cross-sectional drug utilisation study of 304 clients purchasing anti-fungal products from retail community Pharmacies. A structured questionnaire was used to assess patient’s knowledge and attitude towards self- medication with anti-fungals, and to collect data on factors that may be associated with obtaining anti-fungals without prescription. A semi-structured interview guide was employed to explore pharmacists’ perspectives on their patients receiving antifungals without a valid prescription. At 95% confidence interval and with a p –value of 0.05, multiple logistic regression analysis was performed to determine predisposing factors to obtaining antifungals without prescription. Results: The t prevalence of obtaining antifungal medicines without a prescription was 0.74 (SE: 0.025, 95% CI: 0 .69- 0 .79). Average monthly income, health insurance status and educational status were associated with obtaining medicines without prescription even when adjusted for age and sex. Conclusion: Antifungal medicines are frequently obtained from community pharmacies without a valid prescription from a physician. This has the potential to result in irrational dispensing and irrational drug use and increase the risk of adverse events, which may contribute to the development of resistance