Muscat: About six in ten prescriptions issued in Oman’s private medical sector are for antibiotics, raising concerns that doctors in the Sultanate might be giving into the patients’ demands for antimicrobial medicines, health officials say.
“The antibiotics issue is really a dangerous one,” Batool Jaffar, Director, Rational Use of Medicine in the health ministry told the Times of Oman.
“In the private sector, pharmacies usually do not maintain a record of prescriptions, so we cannot get it, but we requested the concerned directorate to ask some of the pharmacies to retain the prescriptions,” she said, describing the survey of antibiotics prescriptions in Oman’s private health sector.
“We collected and screened some 10,000 prescriptions, and took some 3,000 prescriptions as sample, which was considerable. We found that about 60 per cent of the prescriptions from the private sector were for antibiotics...So the situation is very bad,” she said.
Oman has recently launched a campaign to tackle the risk of Antimicrobial Resistance (AMR) and define the rational use of antibiotics in the health, animals and agriculture sectors.
Batool Jaffar said the issue is “dangerous because the patient who is suffering from hypertension or diabetes or any chronic disease and isn’t taking medication properly will only affect himself. But in case of antibiotics, the effect will be on the community as a whole. It will not be limited to Oman but can have ramifications worldwide. One has to be careful while using antibiotics.”
Quoting from another survey, she said the ministry of health has found about 50 per cent Omani households storing antibiotics.
“Two years ago, we visited some 600 Omani households and found that a lot of these houses, about 50 per cent, store antibiotics at home,” she said, adding, “In one house, we found ten different types of antibiotics.”
“The issue is that the antibiotics should never be used as while the symptoms might be the same, the underlying disease could be different,” the health ministry official added. Citing an example, Batool Jaffar explained that the antibiotics used for tonsillitis is not the one used for the urinary tract infection, “although probably in both cases, the patient will suffer from fever.”
She said, “Unfortunately, in case of some of the mothers, when the newborn babies need more than one bottle of antibiotics to complete the course, the mothers find that the antibiotic is available in powder form. One has to add water but with that, the expiry period changes.”
“We should not consider the original expiry date written on the product itself. It can vary for other reasons, too. If you store it at room temperature, it will be just one week. If you store it in the fridge, it will be fourteen days. Some mothers store the remaining part of the dosage in the fridge and when the child has same symptoms the next day, they try to administer the same antibiotics,” she added. The survey, she said, excluded those houses where someone was a doctor, a nurse, a pharmacist or a healthcare provider.
According to Saju George, a Muscat-based infection control expert, the antibiotics should be taken as a finite resource.
“The big challenge nowadays is that people are opting for antibiotics as the first protocol without realising how valuable this resource is. And this is not finite. Things were very different when antibiotics were invented. Now, for the last thirty years, no new family of antibiotics has been discovered,” he told the Times
“The reason is that it makes little sense for the pharmacy companies to actually discover it any longer because you spend billions discovering it but the bacteria become resistant to it within six months or so and wipe out all the investment that had gone into discovering the antibiotics,” George explained.
He said the usage of antibiotics is regulated in Oman “but even here, you can get things over the counter. Doctors prescribe them, dentists prescribe them... So we see the number of prescriptions rising all the time.”