title: Self-medication and self-prescription with antibiotics in the Middle East-do they really happen? A systematic review of the prevalence, possible reasons, and outcomes.
abstract: OBJECTIVE
  There has been no review on the prevalence, possible causes, and clinical outcomes of self-medication with antibiotics (SMA) in the Middle East.
  
  
  METHODS
  Databases were searched (January 2000 through June 2016) for articles on SMA among adults aged ≥18 years living in the Middle East. A hand search for relevant citations and key journals was also performed.
  
  
  RESULTS
  Twenty-two studies were found. The prevalence of SMA ranged from 19% to 82%. Age, sex, and educational and income levels were the main determinants of SMA. Socio-cultural, economic, and regulatory factors were the most commonly cited reasons for SMA. Penicillins were the antibiotics most commonly used; the antibiotics were obtained mainly via stored leftover drugs, pharmacies without prescriptions, and friends/relatives. SMA was mainly for upper respiratory tract problems. The primary sources of drug information included relatives/friends and previous successful experience. Inappropriate drug use such as wrong indication, short and long duration of treatment, sharing of antibiotics, and storing antibiotics at home for use at a later time were reported. Negative and positive outcomes of SMA were identified.
  
  
  CONCLUSIONS
  It is important to understand the links between different factors promoting SMA and to assess the changing trends in order to derive strategies aimed at reducing drug-related health risks.
authors.affiliation: Department of Clinical and Pharmacy Practice, School of Clinical Pharmacy, University of Dammam, Dammam 31952, Saudi Arabia. Electronic address: f.k.alhomoud@gmail.com.
authors.forename: Faten
authors.initials: F
authors.lastname: Alhomoud
authors.affiliation: Department of Clinical and Pharmacy Practice, School of Clinical Pharmacy, University of Dammam, Dammam 31952, Saudi Arabia.
authors.forename: Zainab
authors.initials: Z
authors.lastname: Aljamea
authors.affiliation: Department of Clinical and Pharmacy Practice, School of Clinical Pharmacy, University of Dammam, Dammam 31952, Saudi Arabia.
authors.forename: Reem
authors.initials: R
authors.lastname: Almahasnah
authors.affiliation: Department of Clinical and Pharmacy Practice, School of Clinical Pharmacy, University of Dammam, Dammam 31952, Saudi Arabia.
authors.forename: Khawlah
authors.initials: K
authors.lastname: Alkhalifah
authors.affiliation: Department of Clinical and Pharmacy Practice, School of Clinical Pharmacy, University of Dammam, Dammam 31952, Saudi Arabia.
authors.forename: Lama
authors.initials: L
authors.lastname: Basalelah
authors.affiliation: Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Mecca, Saudi Arabia.
authors.forename: Farah Kais
authors.initials: FK
authors.lastname: Alhomoud
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D006801:Humans; D008877:Middle East; D012651:Self Medication / Q000706:statistics & numerical data
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibacterial; Antibiotic; Middle East; Non-prescription; Self-medication; Self-treatment